A study of 10,000 people living in a rural area of Uganda shows that the death rate there is twice as high as it would be without HIV. Scientists found that young adults infected with HIV were 87 times more likely to die prematurely than their uninfected contemporaries.
The research, which has been submitted to the Lancet, provides an unambiguous link between HIV and death. It also clearly demonstrates that HIV is transmitted between sexes.
Both findings contradict a long-running campaign by the Sunday Times newspaper, which has been trying to prove that HIV is not lethal and heterosexual Aids is largely a myth.
Scientists from the Medical Research Council, Overseas Development Administration and the Uganda Virus Research Institute have, since 1989, repeatedly carried out HIV tests on 8,500 people living in 15 villages in a rural region of Masaka District.
Andrew Nunn, the statistician on the study, said about 8.5 per cent of the population is infected with HIV, which is responsible for doubling the death rate in the region. 'So we're getting as many deaths from 8.2 per cent of the population as from the 91.8 per cent who are not infected.'
He said the size of the study means the results 'are not a small effect due to chance alone. We believe it is very relevant to all sub-Saharan countries.'
The study is unique because it takes a large sample of the general population in a rural area where scientists expect to see lower rates of HIV infection than in cities, Mr Nunn said. Studies in cities on prostitutes and hospital patients have proved difficult to extrapolate to the wider African population, who mainly live in villages.
Although the Sunday Times has known of the study since June, it failed to mention the results and their implications in several articles published since. In one it said that the African epidemic is a myth promulgated by an 'Aids establishment' of scientists and aid workers with vested interests.
Last March the newspaper quoted a 'growing body of expert opinion' to support the view that Africa was not in the grip of an Aids epidemic 'and false assertions that the continent is being devastated by HIV are leading to a tragic diversion of resources from genuine medical needs'.
In August, it quoted a Catholic priest working in Kenya, Father Angelo d'Agostino, who 'in common with growing numbers of scientists and doctors around the world, is beginning to question whether HIV really is the killer it has been made out to be. He, like them, suspects that many 'Aids' cases are really old diseases given a new name and that people who test HIV-positive are not, as most have been led to believe, the victims of a new, invariably lethal disease.'
Neville Hodgkinson, science correspondent of the Sunday Times, was told of the Ugandan work at a briefing in June organised by the London School of Hygiene and Tropical Medicine, partly because of the newspaper's coverage.
Richard Feachem, the school's dean, said there was 'complete zero' mention of the study in subsequent articles. 'The failure of the Sunday Times to make any reference to this briefing, or to make any use of the new and extensive information provided, is a flagrant example of the selective nature of its reporting.
'The Sunday Times repeatedly presents at length the opinions of a tiny fringe group, while failing to provide their readers with a full, balanced account,' he said.
Asked why he had not published the research, Mr Hodgkinson said there were only a 'tiny handful' of Aids cases reported in the study which made it problematical. He also questioned the reliability of the blood tests used. 'HIV positivity does not necessarily mean infection with HIV,' he said. But Mr Nunn, in common with the overwhelming majority of Aids scientists, dismisses suggestions that the two blood tests for HIV antibodies used are inaccurate.
Scientists, doctors and health organisations working in Africa are incensed with what they see as distorted reporting on Aids in an influential newspaper. They claim scientific facts and the opinions of field workers in Africa are being deliberately ignored in favour of a 'fringe minority' who are presented as representing a 'growing body' of scientific opinion.
A number of scientists and aid organisations are particularly concerned that letters they have written have either not been published or have been edited in such a way as to minimise their critical impact.
One critical letter was edited in such a way as to make its author, James Deane, Aids programme director at the Panos Institute, appear to hold an ambiguous position. 'I was angry because Panos disagrees fundamentally with the Sunday Times,' he said.
Professor Jim Neil, a leading Aids researcher at Glasgow University, is also angry that his correspondence criticising Mr Hodgkinson's articles has not been published. 'I think the newspaper is having a potentially very damaging impact. People tend to think there's no smoke without fire.'
Andrew Neil, editor of the Sunday Times, wrote to Professor Neil explaining why he had not published his letter: 'Our policy with regard to letters is to publish reasoned argument and rebuttal concerning the ideas, opinions and facts reported in the paper, rather than simply to reflect the weight of opinion hostile to a particular reporter's efforts to shed light on a controversial field.'
Spencer Hagard, chief executive of the Health Education Authority, is exasperated with the Sunday Times's view on Aids and HIV: 'It is quite clear that it's been tremendously difficult to get the Sunday Times to carry and properly assess the overwhelmingly accepted view about HIV transmission and the causation of Aids. It's approach is akin to believing in medieval alchemy.'
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