Exclusive: A Gut Instinct about AIDS

By Russell Schoch

An RTB Exclusive

– Probiotics: A Missing Link?

Image Credit: Dalhousie University

Tony Lance’s experience of the AIDS era has made him feel increasingly lonely and isolated. In the late 1980s and early 1990s, like many gay men, he performed the sad New Year’s Day ritual of crossing out names in his address book of friends who had died of AIDS. “Some were acquaintances, others were guys I knew pretty well; but some were dear friends whom I loved like brothers and whose absence I still feel today,” the 49-year-old Lance said in a recent interview.

Lance witnessed the shocking transformations his friends went through. “These were strong, vibrant men turned in a matter of months into ghoulish caricatures of what they used to be,” he recalls. “Their hair turned grey, their skin turned a purplish color, their gums receded and their teeth fell out; they lost weight; and some couldn’t leave the house because of uncontrollable diarrhea. They were told that all this was a result of infection by HIV and that if they didn’t take this medicine AZT, it would be worse. What an awful choice!”

But to Lance, another possibility seemed apparent: it was the medicine that was making these men sick unto death. “The timing was so obvious—once they started taking the drugs, they started getting sick. I saw this happen from the late 1980s, when AZT was first prescribed. When you see that over and over again, it makes a deep impression.”

The impression convinced Lance that, “if my time came, if I tested HIV positive, I would not take anti-viral drugs.” In 1996, the time came. His doctor said, “I’m afraid I have bad news. You’re HIV-positive.” The doctor insisted that he take the new combination of antiretroviral drugs—“You’ll be dead in two years if you don’t”—but Lance refused, having read of their toxicity and remembering what an earlier generation of drugs had wrought.

Now an HIV-positive gay man, Tony Lance began a more isolating journey: he became a “dissident,” one who questioned HIV as the cause of AIDS and antiretroviral drugs as its treatment. “Being an AIDS dissident was not something I ever wanted to be,” Lance says today. “Being an HIV-positive gay dissident is not the easiest life in the world.”

Lance had discovered Peter Duesberg’s book (Inventing the AIDS Virus, 1996) in a gay and lesbian book store, and read it in one sitting. Duesberg’s thesis was that HIV was a harmless retrovirus and that it was recreational and later antiviral drugs that destroyed the immune system in gay men. Lance contacted HIV-positive dissident Christine Maggiore, who put him in touch with several like-minded gay men in Atlanta, where Lance was living while working for a telecommunications company. He formed a HEAL (Health Education AIDS Liaison) group there with Tim Hand, a professor of behavioral pharmacology at Oglethorpe University.

“Tim Hand was the first person I met who was openly dissident,” says Lance. “He was one of the original signers of the petition for reappraising, or questioning, HIV and AIDS, back in 1991. He was quoted as saying: ‘HlV infection per se seems to entail little danger unless it is addressed with anti-viral therapy.’ He was HIV-positive. And he was super bright.”

Lance asked Hand about his history of drug use and found that Hand had never taken any recreational drugs and had used poppers only a few times in his life. “I thought, great!,” says Lance. “But there was a problem. He didn’t look well. His skin had a really smooth look and a color I’d seen in people on chemotherapy for cancer. Something wasn’t right.”

A year later, in early 1998, Tim Hand, who didn’t believe HIV was the cause of AIDS and had refused the medications prescribed for it, was dead.

Tony Lance’s world was turned upside down. “I thought: We’ve been wrong; we’ve been telling people something that simply isn’t true: that refusing recreational and medical drugs was the answer to AIDS.” Lance had lost not only a dear friend; his belief system had crumbled. “I sold my house, quit my job, and put everything I owned into storage because, honestly, I didn’t think I was going to live much longer. Once Tim died, I had two goals: to outlive my grandmother—I didn’t want her to see me die—and to live to see the year 2000.” He decided to take what he feared would be his final journey: he hiked the Appalachian Trail, a six-month trek from Georgia to Maine.

During this time, Lance thought about taking antiretroviral drugs. “But I stayed on the fence and never started them, primarily because I was always feeling well and also because I still thought that not taking drugs was the lesser of two evils. I had read about the toxicity of protease inhibitors, how they also inhibited a particular enzyme, cathepsin D, which is critical to the integrity of the gut. It had been shown in mice that when cathepsin D was inhibited, their intestinal tracts withered up, and they died in 21 days. That was my reason for not taking those drugs. I thought: Maybe they have short-term benefit; but you’re not put on them for the short term. I decided I’d let my health, how I felt, be my guide.”

In 1999, Lance moved to New York City, where he found work as a magazine editor. Still “strongly disillusioned” by Tim Hand’s death, he stayed away from dissident groups, though he looked at their literature and continued to talk to Christine Maggiore, who suggested that he form a support group. He did so, with two requirements: those attending had to be HIV-positive, and they had to be open to alternative views about AIDS. “I needed support at this time, and eventually about 20 of us got together very informally once a month. We had people on meds and people who refused them. One guy worked for the pharmaceutical industry, actually working on anti-retroviral ads. Talk about conflict! He would laugh and say: ‘I’m on the meds, I’m questioning them, and I work for a pharmaceutical company. How crazy is that?’”


Back in 1996, Lance found a book in a health food store that sang the praises of probiotics, and he has been taking probiotics ever since to increase the health of his gut flora and therefore his overall health. It is known that the “microflora” in our gut affect us every moment of our lives, that these microscopic organisms have co-evolved with us for millions of years, and that they aid our digestion, help in the production of vitamins, and modulate our immune systems. Also, bad things happen when these “good bugs” in the gut are destroyed.

This was a topic that nagged at Lance as the years went by. He spotted occasional articles in the mainstream press and in gay magazines on microflora in the gut. “There was one study referred to in a medical journal called—appropriately—Gut. It looked at intestinal permeability—‘leaky gut’—and malabsorption, or the inability to absorb food and nutrients, in about 90 HIV-positive gay men. It turned out that every single one of them had increased intestinal permeability, that malabsorption was prevalent in people with AIDS, and that intestinal permeability and malabsorption increased as people progressed to AIDS.

“So it was clear from that paper that something was going on in the gut that was connected to disease progression in AIDS. The authors were saying all this was caused by HIV. But that didn’t make sense to me. I’d studied the literature and knew that mainstream researchers still cannot explain a cell-killing mechanism for HIV; so how could they say that HIV was affecting gut tissue?”

Lance discussed his developing ideas with the group of HIV-positive men he met with once a month. “I kept telling them that they should treat an ‘HIV positive’ test as a wake-up call—a signal that something serious was going on with their immune systems. But generally they didn’t listen.” Then, in a repetition of what had happened to Tim Hand in Atlanta, nearly half of the group in New York became ill, even though they hadn’t abused recreational drugs and weren’t taking antiretrovirals.

“My god,” wondered Lance, “what is going on?” He knew that something besides viruses, recreational drugs, and anti-viral medications had to be considered in AIDS. His investigations pointed directly to the gut. He concluded that disrupted microflora, or “intestinal dysbiosis,” was a key to acquired immune deficiency and its syndrome of diseases.

In November 2005 he posted a lengthy comment tying intestinal dysbiosis directly to AIDS on Aidsmythexposed.com [now linked at QuestioningAids.com]. He received enough encouraging comments that he upped his research, his Medline searches, his reading—and re-reading—of scientific articles. “I’m not a scientist,” says Lance, “and it was a slow process for me.” In early 2007, he posted a 7,500-word essay on hivskeptic.wordpress.com, run by Henry Bauer, professor emeritus of chemistry and science studies at Virginia Tech and author of The Origin, Persistence and Failings of HIV/AIDS Theory (2007).

Lance’s essay asserted that the destruction of gut microflora is both a simple and a plausible explanation for AIDS. “Most of the diseases and disorders associated with AIDS,” he wrote, “can be connected, in some cases strikingly so, to intestinal dysbiosis”—including T-cell abnormalities, glutathione deficiency, and wasting. One prominent result of destroyed microflora, he knew, is intestinal permeability or “leaky gut.” This state, Lance wrote, allows “microbial translocation—a flood of antigens into the blood stream,” setting off “a systemic immune response and the production of large numbers of antibodies to lots of different things.”

The technical term for this shock to the immune system has ten syllables: hypergammaglobulinemia. Many researchers agree with Lance that this serious condition alone (without a virus) can cause a reactive result—a “positive” reading—on HIV antibody tests, as can more than 66 other conditions or stresses to the body, including pregnancy and vaccination for the flu. In other words, according to Lance, it is possible that destroyed microflora leading to a leaky gut and a flooding of antigens into the blood stream (“hypergammaglobulinemia”) has been interpreted as an infection by HIV.

He noted, further, that the progression of AIDS itself can be tracked along a continuum of effects from damaged microflora: “Moderate dysbiosis yields a positive ‘HIV test’ but not necessarily illness”; “prolonged insults to the intestinal flora lead to illness and AIDS.”

Since the beginning of AIDS, the syndrome has been associated with two fungal conditions—Pneumocystis carinii pneumonia (PCP) and candidiasis (thrush). The ubiquitous bugs responsible for these conditions are normally kept in check by our healthy microflora. But, Lance pointed out, in the absence of such flora these fungal diseases emerge as opportunistic infections. “Clearly, then, an increase in the incidence of fungal infections would be expected to accompany a decrease of beneficial bacteria, both as a result of vacated space in the gut lining being colonized by fungi and as a consequence of a drop in fungal-fighting agents produced by the microflora.”

According to Lance, intestinal dysbiosis also more adequately explains AIDS in Africa than does a retrovirus. In Africa, intestinal problems are endemic and both sexes are about equally affected by AIDS, unlike in the West. “Conditions of poverty such as malnutrition, poor sanitation, limited access to health care, widespread parasitic infections, and the lack of clean water would likely contribute to and exacerbate intestinal dysbiosis,” he wrote. “And intestinal dysbiosis resulting from living conditions would not skew toward one sex or the other but would instead be evenly divided between the two.”

In support of Lance, Joan Shenton, an independent documentary film maker and author of Positively False: Exposing the Myths around HIV and AIDS (1998), remembers filming at Makerere Hospital in Kampala, Uganda several years ago. “I came across a group of medical students just after a lecture on ‘malabsorption syndrome.’ I asked one of them what that was; he said it was when you couldn’t absorb nutrients and got very thin. I said that sounds like AIDS. He winked and smiled and said: ‘It is AIDS.’”

What about anecdotal reports that AIDS patients, even near death, quickly improved after taking the antiviral drugs that Tim Hand and Tony Lance refused to take? This, too, Lance believes, can be explained by intestinal dysbiois. “The protease inhibitors introduced in the mid-1990s have strong antifungal properties,” and they target both PCP and candidiasis. “It is highly implausible that slow restoration of T-cell numbers and slow suppression of T-cell-killing virus”—which is the reason given for taking antiretroviral drugs—“could bring noticeably quick improvement in health; but antifungal treatment can produce favorable outcomes very rapidly.”

Late in his research, Lance found a 1996 article in Continuum by Russian researcher Vladimir Koliadin. Its title was: “Destruction of normal resident microflora as the main cause of AIDS.” Koliadin placed blame on the heavy and prophylactic use of broad-spectrum antibiotics among gay men, beginning in the late 1970s, to treat and prevent sexually transmitted diseases.

But Lance points to practices related to receptive anal sex—primarily sexual lubricants and rectal douching—as responsible for the destruction of gut flora. “Rectal douching is widely and frequently engaged in by many gay men,” he says. “I know guys who do it daily, even twice a day. This obviously can adversely affect intestinal microflora. And sexual lubricants have been found to cause considerable damage to the intestinal epithelium, altering the gut ecology.” He points out that both practices became standard as the gay sexual revolution took off in the 1970s—and that the use of lubricants and douching preceded his own HIV-positive test in 1996. But bringing sexual practices into the equation has angered some gay men who have accused him of being anti-gay or anti-gay sex.

Lance protests that he is not against gay men or gay sex. His painful journey through the AIDS era, with the deaths of close friends and men he has loved, has taught him to be wary not only of mainstream thinking but also of dissident thinking about the cause and treatment of AIDS.

“I think both sides have missed a very important piece of the puzzle,” he says. “We’ve been so focused on HIV that we’ve almost completely overlooked what I believe is a simple, plausible explanation for much of what’s called AIDS in gay men: frequent assaults to the gut over a long period of time leading to the replacement of commensal flora by pathogenic microbes.”

Shortly after his own HIV-positive test, Tony Lance turned to probiotics because he thought it was a healthy thing to do. “I’ve been regularly consuming kefir, yogurt, cultured buttermilk, sauerkraut, cultured vegetables, and semi-hard cheeses for more than a decade,” he says. But he has come to believe there are much more important reasons for focusing on the intestinal tract. It is his fervent hope that his gut instinct and hypothesis about intestinal dysbiosis will encourage researchers to explore in new ways both the cause and the treatment of AIDS.

Russell Schoch is an independent journalist in Berkeley, California. Contact him at russellschoch [at] yahoo.com

10 thoughts on “Exclusive: A Gut Instinct about AIDS

  1. I am really glad to see this article about Tony, who I know and have been working with at QA. It helps to fill in some of the gaps in my knowledge of him.

    Tony’s paper on GRID (linked above) should be required reading for every gay man, regardless of their status. It may help explain the single most important component of an overall program to protect our immune systems and to restore our health.

    “HIV”-affected gay men in particular would be well served to learn more about how to respectfully treat their own bodies and how their gut affects their immune system.

  2. I wonder if there is any study adressing the number of death do to AIDS ir relation to sexual preferences. For instance what is the ratio of death between top versus bottom. If bottoms are more likely to die then this might give some support to the gut issue

  3. Tony successfully, and as sterilely as possible, describes behavior that is inconceivable to most people. Most people do not understand the ferocity with which some men pursue anal stimulation. They do not understand the extremes to which they subject their bodies. Nor do most people think of the digestive tract when they think of immunity. Tony shows that it is very likely that extreme anal obsession may be less than totally healthy.

    Tony’s piece hypothesizes that hypergammaglobulinemia is caused by various extreme anal acts in conjunction with modern chemical lubricants. I have to say that I can picture the people he is talking about. I have known men who persistently hunt for extreme anal stimulation. I can picture these men as actors in 70’s porns even some of today’s porn sites, and I can picture them in the very few remaining bathhouses. I also picture them in drug houses and tenement hotels filled with junkies.

    When I read his examples about fisting and high temperature hose douching, I feel as if I am in a circus, or a zoo. I mean, we all know there are Grizzly bears and Tigers and Cobras, yet, we see them so rarely. Yet it makes sense doesn’t it, that fisting and hot water hose douching would seriously affect a person.

    I think, however, that there is a bit of sloppiness when it comes to his use of the labels hiv + and aids, and there are, perhaps, mistaken conclusions based on correlation rather than actual causation. But most importantly, I think, is that drug use is seriously downplayed in Tony’s analysis.

    There is little point in serious detraction at the moment though. I greatly respect Tony Lance for having the care and guts (!) to attempt to explain gay aids. I tend to choose a meeker, less bold approach to intellectualism: I critique instead of building a comprehensive theory. It is far more difficult to build great buildings than it is to blow them up, and Tony has taken the harder road.

  4. Allen,

    I appreciate your thoughtful reply. I’ll address just a couple of points. Although more extreme forms of anal sex (and attendant factors) carry greatest risk, I hope I didn’t come across as saying that ordinary anal sex carries no risk when it comes to the affects on the gut. It’s a matter of degree. You might say fisting is to regular anal sex as smoking a carton of cigarettes a day is to smoking a pack.

    I purposely chose to de-emphasize recreational drug use. First, that angle has been amply examined by others. Second, I’ve known a number of unmedicated “HIV+” gay men who used recreational drugs rarely or not at all yet nonetheless went on to become ill with classic “AIDS defining” conditions. These are the cases I’ve long found most puzzling, so that’s what I focused on. That’s not to say drug use is unimportant.

    Since the GRID article was published on Dr. Bauer’s site two years ago, I’ve continued reading and reviewing, and I’ve found scores of papers which support the idea that an alteration of intestinal microflora underlies much of what is called “AIDS”. One of the most important—the first to look at levels of beneficial and pathogenic bacteria in “HIV+” people in comparison to the general population—is this one: http://jcm.asm.org/cgi/reprint/46/2/757

    In that paper the authors confirmed that the composition of gut flora is, in fact, seriously altered in “HIV+” individuals just as I and Vladimir Koliadin hypothesized it would be. You can read it for yourself, it’s a very short paper, but one finding really jumped out at me. The researchers noted that the levels of candida albicans were about 10,000 times higher in “HIV+” people than in those who are “HIV-“. I was stunned when I read that.

    Anyhow, thanks again for taking the time to read the article and comment on it. Thanks to you too Clippi.

  5. Interesting article. The importance of good bacteria and yeasts cannot be understated.

    Long denigrated as vestigial or useless, the appendix now appears to have a reason to be – as a “safe house” for the beneficial bacteria living in the human gut. http://www.sciencedaily.com/releases/2007/10/071008102334.htm

    If memory serves me correctly it can take a period of two years following a course a antibiotics to restore microflora levels which is a long time for damage to occur thus at the very least acting as a co-factor to AIDS.

    People have to realise when they take antibiotics ALL bacteria are killed not only inside the guts but on the skin as well probably leading to fungal infections of the skin.

    I’m glad to see Russell mention Kefir(a powerful immunomodulator by itself) this is the king of probiotics and lots of it survives the acid in the stomach unlike probiotic supplements.

    Let’s put kefir in perspective – a half pint of freshly made kefir contains in the region of 500 BILLION friendly bacterias and yeasts compared to a measly 2 billion in a typical pill. I am talking about the kefir you make yourself not the commercial crap.

    Raw garlic is an excellent prebiotic and always cures my episodes of running to the toilet. Spirulina raises microflora levels 3 fold not to mention is wickedly anti viral.

    I have HIV negative friends that have gut problems they have a typical crap diet and are always run down with thrush in their mouths and other signs of immune suppresion. I have told them that is what they get for drinking coke every day.

    Well done Russell.

  6. All of this makes a lot of sense. As an openly bi and poly woman who enjoys anal pleasure and has always done it naturally and in moderation, I can testify that anal sex CAN enhance the biological function of the rectum and gut in general, but only when there is proportion. There is nothing wrong with anal pleasure per se, the problem arises when the desire for this pleasure overrides the respect for the rectum and gut as an ecosystem with its own biological function and balance. We need to begin to think in terms of holistic sexual health.

    If only we would have known about this back in the 1980s, how many lives, how much grief, fear, and heartbreaks could have been spared?
    And even today, why are the institutions where official science is produced wasting millions in research dollars, while the most simple, plausible explanations come from grassroots heroes like Tony Lance?

    What does that say about professional qualifications and good faith? Why is all of this system so topsy-turvy?
    If you want to know more about the cultural scenario that formed the context for these mistakes, find out in my study
    Gaia and the New Politics of Love


    and at


    for a holistic way to do anal penetration, read my memoir, Eros: A Journey of Multiple Loves

    Deepest thanks to Tony Lance: up with science by the people and for the people!

  7. Dr Fereydoon Batmanghelidj wrote this paper in 1989:
    AIDS – Indicators of a stress induced metabolic disorder.

    He presents a complex series of events following different stressors (emotional, chemical, physiological and infectious) that result in immune suppression and a reversal of the T4: T8 ratio.

    “It may be credulous to think one can repeatedly injure the intestinal tract in pursuit of physical gratification and blame the outcome on a virus that knows it can not survive if that body is not surviving. It is even more bizarre to present the presence of the antibodies to the virus in the serum as a sign of progress of the disease.”


  8. On the Questioning AIDS forum, and unsure of the date, but Tony Lance was taking ARV drugs. I’m not an AIDS Apologist by any means, just find it a bit…confusing to say the least. When checking the forum out, there was a lot of debate about whether or not to take them. At one point it looked like 3 out of 5 moderators were taking them. Makes me wonder–are natural remedies for immune dysfunction that ineffective? I guess it’s a case by case situation, and that one treatment will work for one person and not another. I just wanted to point out to people that although this article portrays Tony one way, he did at one point decide to take ARV drugs. Mostly, people take them for shorter period, or dilute the dose. I myself have been considering phasing them out due their toxicity and long term side effects. I see a doctor who combines regular medicine with holistic medicine this and prescribes LDN. Wish me luck.

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