And the Band Played On: Politics, People, and the AIDS Epidemic

by Randy Shilts

The bitter truth was that AIDS did not just happen to America—it was allowed to happen by an array of institutions, all of which failed to perform their appropriate tasks to safeguard the public health. This failure of the system leaves a legacy of unnecessary suffering that will haunt the Western world for decades to come.

The story of these first five years of AIDS in America is a drama of national failure, played out against a backdrop of needless death.

The screening in Ostrow’s clinic had revealed that one in ten patients had walked in the door with hepatitis B. At least one-half of the gay men tested at the clinic showed evidence of a past episode of hepatitis B. In San Francisco, two-thirds of gay men had suffered the debilitating disease. It was now proven statistically that a gay man had one chance in five of being infected with the hepatitis B virus within twelve months of stepping off the bus into a typical urban gay scene. Within five years, infection was a virtual certainty.

The hottest and hunkiest, Gaetan knew, would be among the 4,000 streaming to the chic Galleria design center, where the party was just starting when the steward and his friend arrived. Every corner of the lobby and the five-story atrium was crammed with men pulsing to the synthesized rhythms of disco music.

New studies were showing that 93 percent of gay men were infected with cytomegalovirus, a herpes virus that had been linked to cancer.

The gay sexual revolution had also made the Epstein-Barr virus, a microbe also linked to cancers, pandemic among homosexual men.

Don’t offend the gays and don’t inflame the homophobes. These were the twin horns on which the handling of this epidemic would be torn from the first day of the epidemic. Inspired by the best intentions, such arguments paved the road toward the destination good intentions inevitably lead.

The CDC staffers could tell gay from straight controls by the way they reacted to the questions about every aspect of their intimate sexual lives. Heterosexuals seemed offended at queries about the preferred sexual techniques, while gay interviewees chatted endlessly about them. One gay man nipped out a pocket calculator to estimate his lifetime sexual contacts.

How very American, he thought, to look at a disease as homosexual or heterosexual, as if viruses had the intelligence to choose between different inclinations of human behavior. Those Americans are simply obsessed by sex.

The disease is moving even if the government isn’t.

“What do you do with sheep that get this?” he asked eagerly. “There is no treatment,” the expert said. “We shoot them.”

A typical GRID case had sex with 1,100 men in his lifetime; a few counted as many as 20,000 sexual contacts.

The Spanish flu pandemic of 1918, which struck 20 million people, killing 200,000 Americans, directly followed the massive movements of people during World War I. Mixing Americans from diverse regions during the mobilization for World War II created a big viral mixing bowl that blended the poliomyelitis virus into people from every corner of America. The widespread outbreak of polio in the late 1940s and early 1950s was the direct result. The popularity of air travel had eliminated the need for such dramatic world events to cast the seeds of apocalypse.

rumors began on Castro Street about a strange guy at the Eighth and Howard bathhouse, a blond with a French accent. He would have sex with you, turn up the lights in the cubicle, and point out his Kaposi’s sarcoma lesions. “I’ve got gay cancer,” he’d say. “I’m going to die and so are you.”