Perplexity on the implications of Rebecca Culshaw Smith's critique of HIV

 If Rebecca Culshaw’s HIV critique on Substack were factually correct, it would imply that the overwhelming majority of modern AIDS research—potentially tens of thousands of studies and policy frameworks—would require retraction or radical re‑evaluation. Her position is that the connection between HIV and AIDS is unproven or misinterpreted, meaning that almost all virological, pharmacological, and epidemiological work based on that premise would collapse.​

Scope of Research Impact

Since the 1980s, more than 300,000 peer‑reviewed papers have been published citing HIV as either the cause or major cofactor of AIDS. These encompass molecular biology, immunology, pharmacology, antiretroviral drug development, epidemiology, vaccine research, and global health policy. If HIV were not the etiologic cause, the chain of inference underlying nearly this entire corpus would be invalidated, necessitating retraction or reinterpretation of most AIDS‑related literature.​

Culshaw’s Core Critique

In her 2024–2025 Substack essays, including “AI on Me” and [Correction] The Quality of ‘HIV’ Studies May Be Even Worse Than Ever, Culshaw argues that what is called HIV science relies on circular reasoning, unreliable diagnostic tests, and manipulated statistical pools. She highlights tiny infection counts, inconsistent adherence measures, and “meaningless” viral metrics in contemporary PrEP trials as emblematic of pseudoscientific practices. She further claims that drug trials show self‑reinforcing bias, where modeled efficacy replaces observed data, and that the entire biomedical apparatus profits from what she portrays as a non‑existent virus.​

Scientific Consensus Response

Mainstream virology rejects her view. Multiple reviews in PLOS Medicine and PubMed Central characterize AIDS‑denialist arguments as factually false and methodologically flawed, emphasizing that hundreds of independent lines of molecular, clinical, and epidemiological evidence confirm HIV as the cause of AIDS. Critics note that Culshaw’s earlier book Science Sold Out misrepresented data ranges, used discredited sources (such as Peter Duesberg), and misapplied statistical methods.​

Estimated Proportion of Retractions

If her premise were validated, virtually every paper assuming HIV causality—from the first identification of the virus in 1983 through present‑day treatment and prevention research—would need to be withdrawn. In practical terms, that would encompass roughly 95–99 percent of existing AIDS literature, affecting public‑health policies, clinical guidelines, and pharmaceutical research worldwide—an unprecedented upheaval in modern biomedical history