Chin, a clinical professor of epidemiology in the School of Public Health at the University of California, Berkeley, formerly served as chief of the Surveillance, Forecasting, and Impact Assessment (SFI) unit of the Global Programme on AIDS (GPA) at the World Health Organization (WHO) in Switzerland.

He spoke with Cybercast News Service from his office in Berkeley.

Cybercast News Service: We've been told for quite some time that AIDS is on the rise - and just about anybody can get it. Is that true for the United States? Worldwide?

Chin: No, that's not true. I think at the very beginning there was the concern that we were dealing with a very infectious agent, because the reported cases of AIDS in the early days almost doubled every couple of weeks, then every couple of months. The doubling time of reported AIDS cases gave the false impression that we were dealing with a very, very infectious disease.

In reality, we were encountering the development of AIDS in people who had been infected many years before - and the more you looked, the more you found, so that the misconception that it was very infectious was compounded by the surveillance.

Cybercast News Service: You argue in the book that the AIDS epidemic in the United States for decades has been dealt with in a politically correct way. What's the basis for that?

Chin: It was extrapolated from the experience of MSM [men having sex with men, or homosexual] populations in the United States that it would spread to the heterosexual population - and ignite epidemics.

That was a major, major concern for almost a decade, and then finally, sometime well into the early 1990s, when heterosexual spread in the United States never materialized to any extent, most of the experts finally backed off that. But they continued to say in the rest of the world, in the developing world, that epidemic heterosexual transmission would overtake the population.

Cybercast News Service: UNAIDS (The United Nations Joint Program on HIV/AIDS) recently formally announced that it was revising its statistics downward - from 39.5 million worldwide in 2006 to 33.2 million in 2007. That would seem to be vindication for you. Haven't you been arguing for years that the U.N.'s numbers were grossly inflated?

Chin: I have. They finally had to admit it because the data never caught up with them. What they kept waiting for was the fact that, if the epidemic was on an upswing - as they kept saying - eventually the data would catch up with their projections. They finally had to admit that, for the past decade, it has been on a downswing. That's why the numbers that they were finally collecting more accurately did not bear out what they were saying.

Cybercast News Service: Let me see if I understand this: AIDS not only didn't explode as predicted in the United States, it really didn't behave like that worldwide?

Chin: Correct. Now the rates found in Sub-Saharan Africa in the late 1980s did start going up and up, and by the mid 1990s, we were in double-digits in terms of infection. Rates of 20 to 30 percent of the adult population of many sub-Saharan African countries were documented or at least estimated to be present.

We now know that some of the estimates were too high, but still we did have populations having at least 10, 20 -- up to 30 percent -- of the adult population affected.

Cybercast News Service: How much of a role did political correctness play in keeping the numbers artificially inflated?

Chin: I don't think that in the United States there has been as much political correctness as in the developing world. I think that clearly in the United States, it has been recognized that MSM and injecting drug users (IVD) comprise more than 90 percent of the problem. So I don't think it has been sugar-coated in the United States.

The political correctness was that instead of attributing the increased rates in Africa to the pattern and intensity of risky sexual behavior, it was sugar-coated to say that this was due to poverty, due to discrimination and due to lack of access to health care. All of these were easier to swallow for the African politicians, and risky sexual behavior really never surfaced to the extent that it should have.

Cybercast News Service: A huge amount of resources have been directed to fighting AIDS. As I understand it, the CDC (Centers for Disease Control and Prevention) has spent almost as much on AIDS alone as on all other diseases and conditions combined.

Chin: I don't know in terms of the budget, but I would suspect that might be true. But you still have to recognize that, even in the United States, where the rates, compared to say Sub-Saharan Africa, are relatively low, we're still talking about maybe a million Americans that have contracted HIV and at least a half-million have already died.

Cybercast News Service: That is certainly a large number of people. But as former N.Y. Lt. Gov. Betsy McCaughey points out, more people die each year in the U.S. from infections they pick up at the hospital.

(Editor's Note : According to the Committee to Reduce Infection Deaths, every year more than 2 million patients contract infections in hospitals, and an estimated 103,000 die each year as a result -- as many deaths as from AIDS, breast cancer, and auto accidents combined.)

Chin:I think that if you focus on mortality in terms of HIV, it's concentrated in the 20- to 40-year-old age range, where mortality is generally very low. So it's been a very dramatic and catastrophic infection in the IDU population and the homosexual population in the United States.

Cybercast News Service: From an epidemiological standpoint, has AIDS been treated in the same way as other epidemics?

Chin: I don't think we've had something like this in the modern era. Just picture, how many mad cow disease cases in the United States would constitute a public health emergency? A thousand? 10,000? 100,000? A million? I think that it would be considered a catastrophic problem at almost any level, and I think that's what we've encountered with HIV, except that it has been concentrated in populations that have been marginalized and stigmatized.

Cybercast News Service: But isn't the image of an epidemic in the popular mind something that virtually anyone is at risk of contracting - like the influenza epidemic of 1918-1919? Smallpox?

Chin: When you have something like influenza, which is a genuine, generalized epidemic, virtually everyone is at high risk. In all of the pandemic influenza situations we've had, at least half or more of the total population was infected.

In the influenza epidemic of 1919, half of the population developed the flu and millions died.

That image - that everyone is at risk - was never a possibility in the United States for AIDS.

Cybercast News Service: So those who have questioned all along whether everyone was at risk to get HIV/AIDS were basically right?

Chin: Correct. I think Michael Fumento wrote his book, "The Myth of Heterosexual AIDS," in the late 1980s, and he was severely blacklisted and set upon by AIDS activists, saying he was preaching complacency, etc. It turns out he was right.

Cybercast News Service: Obviously AIDS activists had an agenda - they wanted funding.

Chin: They wanted treatment, and they wanted a vaccine. And I think without that kind of activism, I doubt very much that we would have progressed as rapidly in the development of treatment as we have. I think they have been successful, but a lot of other disease problems sort of look at the AIDS situation with envy, in the sense of - 'Why don't we get those resources?'

Cybercast News Service: Why has it taken so long for the truth to come out?

Chin: To a certain extent, I think the AIDS activists started to believe their own hype that it would spread. Everybody kept waiting for the other shoe to drop, and when it didn't, I think they finally got embarrassed by it.

Cybercast News Service: But in fact, even today we still hear that there are pockets of high incidence of HIV, even in the heterosexual community. Are there? If so, where do you find them?

Chin: You always look for individuals who participate in high-risk sexual activities. That doesn't just mean premarital and extramarital sex - it means sex involving multiple or concurrent sex partners. That is the major problem. The same thing with IV drug users. If they inject by themselves or with just a friend, epidemic transmission is not going to be possible.

But when they inject and share needles with many other drug users - in "shooting galleries" and situations like that - that's when epidemic spread will occur. So we need to look at situations like gay men in bathhouses, where they will have multiple sexual partners in a given night - that's where we need to focus on.

It's a matter of sharing infected fluids. Worldwide, it would be MSM who engage in those activities, injecting drug users who engage in those activities. In Asia, it would be commercial sex networks. In Africa, it's localized in small groupings where people have sex with five or six regular partners.

Cybercast News Service: What's likely to happen as a result of the newly revised look at the AIDS epidemic? What are the ramifications?

Chin: I keep saying that they didn't have to magnify or exaggerate the numbers, because from a public health perspective, we still are running behind the problem. That is, there are millions and millions of people in Africa who are not getting treatment. There's been a moral commitment to provide treatment for developing countries - and that treatment has so far not been met.

So from my perspective, AIDS programs still require more funding if the commitment to provide more treatment to people in developing countries is to be fulfilled. I don't think global response to AIDS should be penalized for what I consider to be UNAIDS' incompetence or their distortion.

Cybercast News Service: But we already have the Global Fund (to Fight AIDS, Tuberculosis and Malaria - a joint public-private partnership), which has committed over $10 billion to the fight against AIDS. We've got President Bush's PEPFAR plan (the President's Emergency Plan for AIDS Relief) - which has provided more than $30 billion in U.S. tax dollars to AIDS victims worldwide. That's a lot of money. Is more really the answer?

Chin: It's an awful lot of money, and it's a good start, but from my perspective, I would say at the present time less than half of the people in developing countries who need treatment are getting it. So we still have a long way to go. Even though billions of dollars have been poured in, additional billions need to be poured in.

Cybercast News Service: Bottom line, Dr. Chin, what's your message to us about AIDS at this point?

Chin: AIDS is not going to overtake the world. It's going to stay pretty much in those populations where epidemics have occurred. But it's not going to go away, either. And there is a moral commitment to provide treatment for those affected.

END