"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," wrote San Francisco Chronicle reporter Randy Shilts. "The story of the first five years of AIDS in America is a drama of national failure, played out against a backdrop of needless death."
In these two short sentences in a brief prologue, Shilts summarized a perspective that he would then go on to painstakingly document for more than 600 pages in his landmark book And the Band Played On. Originally released in the fall of 1987, Shilts' landmark book was re-released last year and is well worth a repeat visit in this 20th year of the epidemic. Before And the Band, the early history of the AIDS epidemic was a dizzying welter of contested facts and confused details. But Shilts helped to bring order to this chaos, constructing a narrative framework for understanding the emergence and explosive spread of HIV in the U.S. Because of this contribution, Shilts' book not only provided a record of the early epidemic but also became a major event in its own right.
Full of vivid journalistic portraits of both people and events, And the Band consists of three major, interrelated story lines. The first story line is that of the gay community, mostly in San Francisco and New York, and the ways in which a deeply ingrained hostility toward government authority caused many gay leaders to resist public health efforts and to deny the magnitude of the emerging crisis.
The second story line traces the scientific and medical establishments in their attempts to track down the cause of the new syndrome. On the one side were a cadre of dedicated public servants, on the other ambitious careerists who did not want to taint their professional lives by association with the "4 Hs" of early AIDS: "homosexuals, heroin users, Haitians, and hookers."
Finally, Shilts weaves in a story line about politicians and policy makers, explaining how the best of intentions (such as among concerned public health authorities in San Francisco) could lead to paralysis and how even the worst of intentions (such as among members of the resurgent right-wing of the early 1980s) could sometimes make sound public policy.
Does this version of events sound familiar? If this outline seems to simply reflect the conventional wisdom, it must be remembered that And the Band largely constructed this conventional wisdom.
Of course, there are any number of shortcomings in And the Band. Shilts tried to cover global developments, yet the book's heart is very much in San Francisco. Perhaps more seriously, Shilts often failed to make clear the extent to which he was not only an observer, but also an active participant in many of the debates he covered, particularly about the closure of bathhouses. Likewise, the somewhat sensationalized account of the so-called "Patient Zero" of the North American epidemic, a French Canadian flight attendant, is given emphasis far beyond its actual significance. And his focus on white, gay male communities can be relentless, leaving the stories of other groups to be told by other journalists (such as the excellent The Invisible Epidemic: The Story of Women and AIDS by Gena Corea).
Yet, in all, the book remains a landmark of thorough reporting and hard-headed objectivity (neither of which, it should be noted, were reflected by the watered-down HBO movie version of 1993). Shilts' version of events was, obviously, not the only one possible, and remains contested. But the combination of his incisive historical perspective, his insider-outsider status as a gay man and a journalist, and his dogged reportorial style make his contribution one of historical importance. A century from now, people will probably still be reading And the Band Played On.
Throughout his work on And the Band, Shilts refused to get tested for HIV, fearing that it might compromise his objectivity. After testing HIV-positive, he ignored his doctor's advice and struggled past his illness to finish his last book, Conduct Unbecoming, a weighty account of the then-burning "gays-in-the-military" debate. Shilts died of AIDS in February 1994.
Raymond A. Smith, Ph.D. is the editor of Body Positive.