Jan. 1, 2009 -- Christine Maggiore, an AIDS activist-turned-HIV/AIDS-skeptic, died in her home Saturday of pneumonia, according to the Associated Press.
The Los Angeles coroner's office has yet to determine if her pneumonia was AIDS-related. If it was, it could serve as an ironic end to her work, promoting the idea that there is no definite link between HIV and AIDS, and that HIV tests are inaccurate.
Whatever details her autopsy reveals, Maggiore's life may prove to be more controversial than her death.
Since 1992, Maggiore founded two HIV/AIDS skeptic groups, including the Alive and Well AIDS Alternatives group in Los Angeles. Later, she traveled to Africa and is said to have personally influenced former South African President Thabo Mbeki's decision to block funding for HIV-positive pregnant women in South Africa.
Maggiore also appeared on TV, in Mothering magazine and in documentaries describing her decision to marry, have unprotected sex, and later breast-feed her two children without taking the drug AZT, which is typically prescribed to prevent an HIV transmission from mother to baby.
AIDS researchers and public health advocates have overwhelmingly condemned her work and personal life as deadly.
"They caused the death of thousands of South Africans by delaying treatment and spreading infections," said Dr. Charlie van der Horst, a professor of medicine at the University of North Carolina in Chapel Hill.
Van der Horst referred to a journal study that estimated 330,000 lives were lost to new AIDS infections during the time Mbeki blocked government funding of AZT treatment to mothers.
"There is a space in hell reserved for them," said van der Horst.
Other scientists have a more visceral reaction to Maggiore's cause.
"The image, on the cover of a magazine aimed at mothers, of her heavily pregnant, naked belly, daubed with a slogan 'No AZT' in red paint was one of the single sickest images the AIDS pandemic has ever seen," said John P. Moore, a professor of microbiology and immunology at the Weill Medical College of Cornell University in New York City.
At the time of the picture, Maggiore was pregnant with daughter Eliza Jane Scovill. In 2005, Eliza Jane died at age 3 of pneumonia. The Los Angeles County Coroner's office determined her death to be AIDS-related, but the Scovill family claimed Eliza Jane died from a reaction to antibiotics.
Maggiore and her husband, Robin Scovill were investigated, but never faced any charges related to the death.
A Friend Lost
Michael Ellner, a long-time friend and associate of Maggiore's, believes the stress from her loss and the public backlash to her views caused her untimely death.
"I lost somebody that I admired and loved, and I expect in the next couple of weeks that she'll be raked over the coals, even though she's dead," said Ellner, who teaches hypnosis techniques to medical professionals and is the founder of HEAL, a volunteer group that disseminates AIDS skepticism information.
Ellner met Maggiore in 1992, shortly after she received an HIV diagnosis and shortly after she met Dr. Peter Duesberg, a professor of molecular and cell biology at the University of California, Berkeley. Duesberg became known as a lone wolf in the AIDS research world for his theories that the strong, toxic nature of AZT drugs actually induces AIDS.
"She didn't match everyone else who had AIDS," said Ellner, explaining that Maggiore came to doubt mainstream AIDS research during her early years as an AIDS activist. Ellner said Maggiore never appeared to be as sick as others around her.
"There are always positions and counter-positions in science and legitimate differences of opinion," said Thomas J. Coates, the Michael and Sue Steinberg professor of global AIDS research at the University of California, Los Angeles School of Medicine. "There have been those who have questioned many links -- tobacco and cancer, emissions and global warming, circumcision and reduction of HIV risk, etc."
Coates said many big debates, such as evolution versus creationism, are not life threatening.
"People still have the right to disagree," said Coates. "But, in the case of questioning the link between HIV and AIDS, one has to ask a bigger question: What are the consequences? In the case of HIV/AIDS denialism, the consequences are death and disability and suffering and misery."
Life in the Spotlight
Ellner pins the blame for Maggiore's misery elsewhere.
This November, Ellner said Maggiore was bombarded with calls and e-mails about an episode of "Law & Order" that seemed to mimic some elements of Eliza Jane's story. The episode featured a baby who died of AIDS-related pneumonia and a mother who believed it was a reaction to an antibiotic.
"She lost a child, she was accused of murdering her child and then everything was brought up again in November," said Ellner. "This time of year, suddenly you develop the cold and flu, and with stress, that can lead to pneumonia. ... You can blame it on the HIV, but that's my opinion -- she was killed by chronic stress."
Ellner never denies that AIDS itself exists. However, he does question the accuracy of the HIV tests, he questions that HIV leads to AIDS and agrees with Duesberg that AZT causes AIDS.
"I see Christine with different eyes. The average person doesn't appreciate that she studied this issue," said Ellner.
But that does not impress van der Horst.
"There's no question that HIV causes AIDS," said van der Horst. "There's absolutely not a single credible scientist who would disagree."
Ellner said that the HIV antibody test can only detect a "footprint" of a virus that was once in the body. However, van der Horst said the antibody test can detect both -- evidence of an eradicated virus, and evidence of a "chronic" virus, like herpes or HIV that continually lives in the system.
Van der Horst also points out that doctors have a second test for HIV that can detect the virus in the blood directly -- called the HIV viral load test. With drugs, doctors see less HIV in a patient's system.
Van der Horst joined 5,000 other scientists by signing the so-called "Durban Declaration" in 2000. Developed in Durban, South Africa, the document asserted that HIV causes AIDS and that an effort to treat HIV is the best hope of fighting AIDS.
Gail Wyatt, a couple's sex therapist associated with UCLA, personally encountered Maggiore, and thinks a different approach would settle the debate.
"I was on the Ricki Lake show about four years ago speaking against Christine's insistence that she and her husband did not need to use condoms and that she did not need to be on medication," said Wyatt. "I think that pointing the finger at those who doubt they need to re-examine their resistance to obtaining care may just entrench them in their positions.
"We always need to leave the door open to those who may want to get tested, treated and protect themselves and others from HIV and AIDS," she said.