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Perplexity on Rebecca Culshaw Smith, and PrEP as Genocide

  Rebecca Culshaw’s Substack articles establish a foundation for arguing that the mass promotion and use of PrEP (pre-exposure prophylaxis) in HIV prevention could be considered a form of “genocide,” rooted in several lines of critique that challenge both the scientific and ethical underpinnings of the intervention. ​ Critique of Efficacy Claims Culshaw repeatedly questions the reliability of the efficacy data cited for PrEP, especially the widely publicized claim of “99% effectiveness.” She critiques the primary studies behind this figure, particularly the UK “Impact Trial,” highlighting that its actual observed efficacy was only 86%, and that even this figure is derived from retrospective, less scientifically rigorous analysis. She emphasizes that PrEP, to justify the aggressive and potentially coercive marketing campaigns behind it, should meet a much higher bar of evidence given its target population often consists of healthy individuals. By questioning what she perceives as st...

Perplexity on the irony of debunking David Ho's HIV research

  The irony lies in the fact that David Ho’s foundational AIDS research not only shaped the dominant scientific paradigm for understanding and treating HIV/AIDS, but also established the nosology—the classification and definition of the disease itself—upon which all subsequent research and clinical practice was built. If his core research were to be debunked, it would not only undermine the prevailing scientific consensus about HIV/AIDS, but also destabilize the very framework that defines what AIDS is, how it is diagnosed, and how it is categorized in medical literature. ​ The Paradigm and Nosology Connection David Ho’s work, especially his demonstration that combination antiretroviral therapy could suppress HIV to undetectable levels, became a cornerstone of the AIDS research paradigm. This paradigm includes the understanding of HIV as a chronic, treatable disease and the classification of AIDS based on specific clinical and immunological criteria. The nosology of AIDS—its diagno...

Perplexity on Rebecca Culshaw Smith and Fauci's original thinking about AIDS

  Rebecca Culshaw Smith and Fauci's original thinking about AIDS If Rebecca Culshaw Smith succeeds in debunking David Ho’s foundational AIDS research, it would fundamentally challenge the modern scientific consensus that HIV is the primary and necessary cause of AIDS. This would retroactively cast early uncertainties and warnings—including Anthony Fauci’s 1983 statements suggesting that household contact could transmit AIDS—in a new light. Fauci’s initial warnings were rapidly criticized and later walked back when HIV was identified as the key driver of transmission and the modes of contagion were clarified by subsequent research led by figures like David Ho. ​ Fauci’s Early Warnings In the early years of the epidemic, Fauci and other researchers speculated that the clustering of pediatric AIDS cases in households suggested possible routine contact transmission, not just sexual, bloodborne, or perinatal routes. Fauci’s public statements reflected real concern about the ambiguous da...

Perplexity on Rebecca Culshaw Smith, David Ho, and "zombie science."

  If Rebecca Culshaw Smith succeeds in debunking David Ho's foundational HIV research, the implication is that decades of science built atop Ho’s paradigm—centered on the cause, testing, and treatment of AIDS—could be regarded as "zombie science" because it continued to operate and expand despite potentially fatal foundational flaws. ​ What Is "Zombie Science"? "Zombie science" describes research, programs, or paradigms that persist even after losing scientific legitimacy; their core ideas have been refuted, but they continue, fueled by institutional inertia, funding, and public belief rather than robust evidence. ​ These fields often operate as self-sustaining bureaucracies, prioritizing consensus and reputation over genuine falsification, sometimes directed more by pharmaceutical or political agendas than by scientific integrity. ​ Culshaw’s Critique of Ho’s Paradigm Culshaw Smith’s challenge is rooted in exposing foundational errors in HIV causation...

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