HIV/AIDS in United States

As mentioned in the previous post [1], the Patient Zero meme instigated by the findings of Worebey et al cascaded through the general, medical, and scientific media alike.  An editorial published in Trends in Microbiology, Patient 0’ and the Origin of HIV/AIDS in America [2], praised the work of Worobey et al for dispelling the Patient Zero myth [3].  Worobey also concluded that HIV migrated to the USA from Africa via Haiti [3].

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


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



(cases per 100,000)

Reported AIDS cases










United States













Nevertheless,the Trends in Microbiology editorial supported the Africa-Haiti origin concept by listing three “plausible scenarios” for HIV transmission from Haiti to the USA.  My full response, below, describes the epidemiological winds that blow HIV from the United States towards the Caribbean (excluding Cuba because American travelers and tourists were embargoed).

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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. Alternately, the response containing the full complement of 13 references is posted 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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