Four things you should know about the HIV "cure" before you get too excited

The baby might not even have been infected in the first place.

The story everyone is talking about today is the HIV "cure" - the Mississippi baby who, after being blasted with a cocktail of anti-viral drugs at birth, is now, at two years old, apparently virus-free. But when reading the euphoric news stories about it here, here and here, you should bear the following in mind:

1. The baby may not even have been infected in the first place

Here's a weird section in the NYT version of the story. Have a read of the following two paragraphs - are the doctors certain or uncertain that the baby was infected?

“The one uncertainty is really definitive evidence that the child was indeed infected,” said Dr. Daniel R. Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital in Boston.

Dr. Persaud and some other outside scientists said they were certain the baby — whose name and gender were not disclosed — had been infected. There were five positive tests in the baby’s first month of life — four for viral RNA and one for DNA. And once the treatment started, the virus levels in the baby’s blood declined in the pattern characteristic of infected patients.

The tests are pretty good, but are not usually trusted as a basis for confirmed diagnosis at that early stage. It is normal practice to confirm positive tests at 6 weeks. But as this baby had already been treated by then, lowering its viral load (negative tests came back at 29 days), it would have been difficult to do this. There is a very small chance the baby was not infected.

The virus may not have yet taken a hold on the baby's cells in a permanent way. Here's the WSJ:

Cells in the baby "may have been infected—there was virus around," said Steven Deeks, an AIDS researcher at University of California at San Francisco. "But the cells being infected weren't the type that become long-lived reservoirs."

There is also a small chance the baby was immune to HIV anyway. Around 1 per cent of Caucasians in the US are naturally immune.

Now, these are small chances, but then this baby is an outlier. It was not part of a large study where such anomalies are ruled out. The scientists have said it is unlikely to be replicable. Any way you put it, the baby itself is an anomaly.

2. This "cure" has already been found, and has been used on newly-infected people since 1987. Even if the baby was infected, today's news would simply extend it to newborns.

Today's news applies only to babies. Newborns at that. And it's not really a new method - rather, it's the same idea as PEP: if you have only just been infected, you might avoid HIV if you are immediately given a large amount of anti-HIV drugs. What the scientists confirmed today is that, in terms of emergency treatment, newborns are the same as newly-infected people. 

Here's the NYT again:

“That goes along with the concept that, if you treat before the virus has had an opportunity to establish a large reservoir and before it can destroy the immune system, there’s a chance you can withdraw therapy and have no virus,” said Dr. Anthony S. Fauci, the director of the National Institute for Allergy and Infectious Diseases.

(Oh, and if you were wondering, someone has actually been cured of AIDs before. This was a man called Timothy Brown, a leukemia sufferer who received a bone-marrow transplant from a donor genetically resistant to HIV.)

3. This would not be breaking much ground in preventing HIV in newborns anyway, because we have a solution for that

In countries with access to top-notch medical care (ie western countries), the transference of HIV from mother to child is extremely rare. This is because mothers are treated with antiretroviral therapy during pregnancy - a very effective way of preventing HIV in newborns.

4. Newborns in countries without a solution for that probably wouldn't get this treatment anyway

In countries without access to top-notch medical care, there is no reason that this treatment would be available where antiretroviral pregnancy treatment isn't.

So what does the news mean? Well it means that a few babies in countries with access to this sort of care but whose mothers have somehow slipped through the net of normal practice can be saved. Joyous news. But not quite as joyous as everyone seems to be making out.

UPDATE: This blog originally said that HIV tests at birth couldn't be accurate, but this applies only to antibody tests. The tests on DNA/RNA, which were done in this case, have a greater (although not 100 per cent) degree of accuracy.

HIV cure: not necessarily.. Photograph: Getty Images

Martha Gill writes the weekly Irrational Animals column. You can follow her on Twitter here: @Martha_Gill.

Flickr: B.S.Wise/YouTube
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Extremist ads and LGBT videos: do we want YouTube to be a censor, or not?

Is the video-sharing platform a morally irresponsible slacker for putting ads next to extremist content - or an evil, tyrannical censor for restricting access to LGBT videos?

YouTube is having a bad week. The Google-owned video-sharing platform has hit the headlines twice over complaints that it 1) is not censoring things enough, and 2) is censoring things too much.

On the one hand, big brands including Marks & Spencer, HSBC, and RBS have suspended their advertisements from the site after a Times investigation found ads from leading companies – and even the UK government – were shown alongside extremist videos. On the other, YouTubers are tweeting #YouTubeIsOverParty after it emerged that YouTube’s “restricted mode” (an opt-in setting that filters out “potentially objectionable content”) removes content with LGBT themes.

This isn’t the first time we’ve seen a social media giant be criticised for being a lax, morally irresponsible slacker and an evil, tyrannical censor and in the same week. Last month, Facebook were criticised for both failing to remove a group called “hot xxxx schoolgirls” and for removing a nude oil painting by an acclaimed artist.

That is not to say these things are equivalent. Quite obviously child abuse imagery is more troubling than a nude oil painting, and videos entitled “Jewish People Admit Organising White Genocide” are endlessly more problematic than those called “GAY flag and me petting my cat” (a highly important piece of content). I am not trying to claim that ~everything is relative~ and ~everyone deserves a voice~. Content that breaks the law must be removed and LGBT content must not. Yet these conflicting stories highlight the same underlying problem: it is a very bad idea to trust a large multibillion pound company to be the arbiter of what is or isn’t acceptable.

This isn’t because YouTube have some strange agenda where it can’t get enough of extremists and hate the LGBT community. In reality, the company’s “restricted mode” also affects Paul Joseph Watson, a controversial YouTuber whose pro-Trump conspiracy theory content includes videos titled “Islam is NOT a Religion of Peace” and “A Vote For Hillary is a Vote For World War 3”, as well as an interview entitled “Chuck Johnson: Muslim Migrants Will Cause Collapse of Europe”. The issue is that if YouTube did have this agenda, it would have complete control over what it wanted the world to see – and not only are we are willingly handing them this power, we are begging them to use it.

Moral panics are the most common justification for extreme censorship and surveillance methods. “Catching terrorists” and “stopping child abusers” are two of the greatest arguments for the dystopian surveillance measures in Theresa May’s Investigatory Powers Act and Digital Economy Bill. Yet in reality, last month the FBI let a child pornographer go free because they didn’t want to tell a court the surveillance methods they used to catch him. This begs the question: what is the surveillance really for? The same is true of censorship. When we insist that YouTube stop this and that, we are asking it to take complete control – why do we trust that this will reflect our own moral sensibilities? Why do we think it won't use this for its own benefit?

Obviously extremist content needs to be removed from YouTube, but why should YouTube be the one to do it? If a book publisher released A Very Racist Book For Racists, we wouldn’t trust them to pull it off the shelves themselves. We have laws (such as the Racial and Religious Hatred Act) that ban hate speech, and we have law enforcement bodies to impose them. On the whole, we don’t trust giant commercial companies to rule over what it is and isn’t acceptable to say, because oh, hello, yes, dystopia.

In the past, public speech was made up of hundreds of book publishers, TV stations, film-makers, and pamphleteers, and no one person or company had the power to censor everything. A book that didn’t fly at one publisher could go to another, and a documentary that the BBC didn’t like could find a home on Channel 4. Why are we happy for essentially two companies – Facebook and Google – to take this power? Why are we demanding that they use it? Why are we giving them justification to use it more, and more, and more?

In response to last week’s criticism about extremist videos on the YouTube, Google UK managing director Ronan Harris said that in 2016 Google removed nearly 2 billion ads, banned over 100,000 publishers, and prevented ads from showing on over 300 million YouTube videos. We are supposed to consider this a good thing. Why? We don't know what these adverts were for. We don't know if they were actually offensive. We don't know why they were banned. 

As it happens, YouTube has responded well to the criticism. In a statement yesterday, Google's EMEA President, Matt Brittin, apologised to advertisers and promised improvements, and in a blog this morning, Google said it is already "ramping up changes". A YouTube spokesperson also tweeted that the platform is "looking into" concerns about LGBT content being restricted. But people want more. The Guardian reported that Brittin declined three times to answer whether Google would go beyond allowing users to flag offensive material. Setting aside Brexit, wouldn't you rather it was up to us as a collective to flag offensive content and come together to make these decisions? Why is it preferable that one company takes a job that was previously trusted to the government? 

Editor’s Note, 22 March: This article has been updated to clarify Paul Joseph Watson’s YouTube content.

Amelia Tait is a technology and digital culture writer at the New Statesman.