HIV/AIDS in United States

A co-author and I responded to an editorial in Trends in Microbiology [1]. The editorial was entitled: Patient 0’ and the Origin of HIV/AIDS in America. In the editorial, Gong et al praised the work of Woroeby et al [2].

The story dispelling the Patient Zero myth was a media meme not long ago. The conclusions of a phylogenetic analysis performed by Worobey et al captured that media accalim [2].

Worobey also concluded that HIV migrated to the USA from Africa via Haiti. Gong et al support this concept by listing three “plausible scenarios” for HIV transmission from Haiti to the USA.

See my full response to Gong et al below. It describes the epidemiological winds that blow HIV from the United States towards the Caribbean (excluding Cuba because American travelers and tourists were embargoed).

Haiti got all the press, but 5 years into the AIDS epidemic (1986), it was Bermuda that had the highest AIDS rate in the world, as seen in Table 1.


Table 1:          AIDS Prevalence in United States and Caribbean as of September 1986



(cases per 100,000)

Reported AIDS cases










United States












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Patient Zero did not introduce HIV into the United States!

Not too long ago, this story was a meme cascading through the media. All emanating from a phylogenetic analysis published in Nature, 1970s and ‘Patient 0’ HIV-1 genomes illuminate early HIV/AIDS history in North America [1].

The authors of this phylogenetic analysis (Worobey et al) also concluded that HIV migrated to the USA from Africa via Haiti. However, extensive epidemiological evidence suggests the Africa-Haiti-USA historical narrative is just as incorrect as the narrative regarding Patient Zero.

Stuart Derbyshire and I wrote a Letter to the Editors of Nature in response to conclusions of Worobey et al. At the kind invitation of the Editors, our response is posted on the Nature website. Given the allowance of 300 words and 3 references, the response cites a limited portion of available epidemiological data refuting this concept. The response with the full complement of 13 references is rendered in text, below.

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blog_logoAs principal investigator at the Harvard School of Public Health, Max Essex, was recently awarded $20 million to study HIV prevention in Botswana – a meager reward for the man who played a pivotal role in creating the current conceptual model of the HIV / AIDS epidemic, compared to the billions distributed annually [1].

Essex’s erroneous research spawned the theory that HIV originated in African monkeys. This misconception is critical because the concept is a pillar for the fallacy that HIV / AIDS is endemic in Africa. Continue reading


Recently, a web page of National Public Radio stated “AIDS is the primary killer of African-Americans ages 19 to 44 years of age.”   This misconception is evidently a common one. For example, Peter Piot, the Executive Director of UNAIDS, had broadcast the same belief previously, i.e., “AIDS remains the leading cause of death in African-American women in the USA.” [1]  Neither statement is accurate.

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