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And the band played on. - book reviews
National Review, Dec 4, 1987 by Henry Klingeman
And the Band Played On
by Randy Shilts (St. Martin's, 630 pp., $24.95)
WHEN RANDY SHILTS finished And the Band Played On, he must have known the damage his account might inflict on gay politics. While Shilts blames the Reagan Administration for ignoring the deaths of thousands of homosexuals and attacks the Christian Right for seeing AIDS as God's plague on homosexuals, his focus is the homosexual community. A gay reporter who has covered AIDS for the San Francisco Chronicle since 1982, Shilts is specially qualified to report this story, and his tale is not flattering.
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If the U.S. Government had spent more money on AIDS research and care of AIDS patients, the virus might have been identified sooner, a test developed earlier, and some suffering marginally reduced; but no amount of money could have prevented the spread of the disease. That would have required behavioral changes and philosophical concessions that homosexuals were unwilling to make.
When the gravity of AIDS was first made clear to leaders of the gay community in 1982, Shilts reports, many of them seemed reluctant to give their followers the simple--but unpopular --advice to cease dangerous sexual practices and habits. The New York Gay Men's Health Crisis, the first non-scientific group devoted to fighting the disease, "had a hard time putting down the activities they had spent most of the past decade pursuing.'
To many of the activists in And the Band Played On, promiscuity is a sign of political maturity, for homosexuality is nothing if not the rejection of traditional sexual behavior. Gay doctors who counseled against promiscuity for purely hygienic reasons were acidly labeled "monogamists.' The issue of sexual liberty versus public health may seem absurd to heterosexual "monogamists.' The failure of gay leaders and, more significantly, public-health officials in San Francisco and New York to press for closing the gay baths, however, allowed thousands of men to infect themselves with AIDS.
Shilts has tracked down dozens of stories of individual homosexuals, activists, and bathhouse proprietors who put their own sexual, political, and financial gratification over the lives of their gay brethren. One of the most intriguing characters in the book is "Patient Zero,' the Canadian airline steward Gaetan Dugas, who scientists believe bears more responsibility for spreading AIDS than any other individual. Forty of the first 248 cases of AIDS could be traced to him; the first cases in New York and Los Angeles were linked to him; and as early as 1982, 11 AIDS cases could be traced from a single partner of Dugas.
AIDS researchers and gay activists identified Dugas while he was still alive. (He died in 1984.) Selma Dritz, a San Francisco public-health official, recalled a conversation she had with him in 1982. She asked him to stop deliberately infecting other people. "It's my right to do what I want to do with my own body,' Dugas told her.
Dr. Dritz was one of the few public-health officials in either San Francisco or New York who urged radical action. As early as 1982 she wanted to close the baths, whose patrons averaged 2.7 partners a visit and had a 33 per cent chance of contracting syphilis or gonorrhea during a single visit before the onset of AIDS. By taking action at that time, when millions of gay men were infecting each other, it might have been possible to prevent many deaths. "After all, lives were at stake,' Shilts writes. "A city health department that would yank a restaurant license for cockroach infestation certainly [should] pull a bathhouse license for fostering a far more lethal activity.' Shilts believes that Mervyn Silverman, Director of the San Francisco Department of Public Health, resisted such suggestions because the gay political leadership, not to mention the general gay population, wouldn't even consider the subject. It remained for gay leaders who understood the seriousness of AIDS to forge a consensus against the bathhouses and for "safe sex.' This took precious time.
Shilts reports that gay sexual behavior has changed, and the latest statistics, after the book's publication. seem to bear him out. We are told that the spread of AIDS has slowed considerably among gays, and that, for example, in New York City more drug addicts than homosexual men are now afflicted with AIDS.
In an effort to attract government interest and popular support for AIDS research and patient care, homosexuals have long argued that AIDS is not a "gay disease.' Now, this is in fact true. Unfortunately, from a public-relations standpoint, the other major risk group is intravenous-drug users. Because public approval for the activities that are the most common means of transmitting AIDS is low, much of the concern about AIDS has been paranoid and selfish.
The conservative response to AIDS, coverage of which Shilts limits to Reagan Administration policy and an unsympathetic portrayal of Jerry Falwell, has been schizophrenic. Some conservatives fear that AIDS researchers and gay activists have obscured the dangers that AIDS poses to the general population, while others eagerly point out that very few heterosexuals have contracted the disease, implying that the danger to them is exaggerated.
