page_title: Joseph Sonnabend
section_title: Views on AIDS treatment and causation
hierarchical_section_title: Joseph Sonnabend / Controversies / Views on AIDS treatment and causation
caption_attribution_description: English: AZT (zidovudine), the first medication shown to be effective against HIV. From the National Institutes of Health website (http://www.history.nih.gov/NIHInOwnWords/docs/page_05c.html).
context_page_description: Joseph Adolph Sonnabend is an Afrikaans physician, scientist and HIV/AIDS researcher, notable for pioneering community-based research, the propagation of safe sex to prevent infection, and an early multifactorial model of AIDS.
  As one of the first physicians to notice among his gay male patients the immune deficiency that would later be named AIDS, during the 1980s and 1990s he treated many hundreds of HIV-positive people. During the height of the AIDS crisis, Sonnabend helped create several AIDS organisations, including the AIDS Medical Foundation, the nonprofit Community Research Initiative, which pioneered community-based research, and the PWA Health Group, the first and largest formally recognised buyers' club.
  Sonnabend became controversial for advocating that gay men change their sexual behaviors to avoid sexually-transmitted infections, rather than to just have fewer sexual partners, as advocated by Gay Men's Health Crisis and other gay community organizations and for hypothesizing a multi-factorial model of causation, including for a period of time after discovery of HIV. He is widely respected as a pioneering and compassionate clinician and researcher.
context_section_description: In the late 1980s, Sonnabend became a prominent critic of the use of AZT monotherapy to treat asymptomatic, HIV-positive people, which he thought was based on insufficient clinical evidence. Nevertheless, he did prescribe the drug in short courses for people with indications of elevated interferon, which he believed might play an important role in pathogenesis and could be controlled by AZT. In 2006 he expressed his view that high doses of AZT had "killed thousands" during the late 1980s and early 1990s.
  Until the late 1990s Sonnabend continued to assert that the issue of AIDS causation "remained open" and that many factors might be involved. This led some researchers and activists to associate him with "AIDS denialists" who deny that HIV has any role in AIDS — a charge that Sonnabend denied:
  I was kind of surprised to find myself on the outside. I had rather thought that I represented a kind of academic caution that I took for granted to be the norm. I always believed my criticisms were reasonable and not radical.
  His unconventional views on the causes and treatment of AIDS led to accusations of malpractice; he says he was shunned by mainstream scientists and refused funding.
  Sonnabend  became an early advocate for combination antiretroviral therapy, which he prescribed to numerous patients. However he strongly disagreed with early US guidelines that recommended treating people during the initial stages of HIV infection (known as "hit early, hit hard").
  The effects of modern medication helped to change Sonnabend's views on AIDS causation, leading him to assert that, "the evidence now strongly supports a role for HIV." Nevertheless, he still disagrees with the scientific consensus, and maintains that people infected with HIV only develop AIDS if exposed to cofactors such as other viruses and bacteria. He suggests that in many people HIV lies dormant without provoking a sufficient immune response to generate a positive antibody test result (seroconversion).
caption: AZT in oral, injectable, and suppository form
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