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More than a number

Gaëtan Dugas — the man dubbed ‘Patient Zero’; a term used to identify Dugas as the source of the Western AIDS epidemic — has, after more than three decades, been scientifically exonerated. By analysing blood samples from the 1970s, researchers have been able to clear the reputation of one of the most stigmatised figures in the history of the epidemic.

The findings — published in the journal Nature — show conclusively that, rather than being the first person in the US to become infected, Dugas was simply one of thousands of gay men who were unknowingly HIV-positive before such a status had been recognised. When Dugas became ill and contracted an AIDS-related cancer (referred to at the time as the “gay cancer” as it seemed to be presenting in primarily homosexual men), there was no hard evidence that it could be sexually transmitted. “No one should be blamed for the spread of a virus that no one even knew about,” said co-author of the research, Dr Michael Worobey from the University of Arizona.

Matching the new findings with previous data, researchers now know that HIV spread to the Caribbean from Africa in the late 1960s before a subtype arrived in New York around 1971 — a full ten years before the first AIDS cases were identified in Los Angeles. “New York City acts as this hub from which the virus moves to the west coast somewhat later and eventually to Western Europe and Australia and Japan and South America,” said Worobey.

Dugas, a French-Canadian flight attendant who died of an AIDS-related illness in 1984, came to prominence three years later when he featured in Randy Shilts’s bestseller And The Band Played On. In the book (that chronicles the early years of the AIDS epidemic), Dugas is outed and blamed for playing “a key role in spreading the new virus from one end of the United States to the other”. Shilts even goes as far as to frame Dugas’s sexual history as a moral failing. The media seized on the story, with the New York Post describing Dugas as “the man who gave us AIDS”. In truth, scholars believe AIDS first affected under-the-radar populations such as the homeless and injecting drug users.

Far from being a malicious spreader of disease, Dugas was something of a hero. It is thanks to his cooperation with researchers from the US Centres for Disease Control (CDC) that scientists were later able to definitively link HIV with sexual activity. Unfortunately, it was through this association that Dugas got saddled with the infamous moniker ‘Patient Zero’; the ‘O’ next to his name was widely misunderstood to be a number when, in reality, it was a letter indicating that Dugas was living “Outside California”.

The hysterical reaction of the media towards the epidemic was encapsulated in the UK Sun, which ran the headline “The Gay Plague”. A lengthy Time feature, “The New Untouchables”, published in September 1985, detailed the extent of AIDS-related discrimination, concluding, “Anxiety over AIDS in some parts of the US is verging on hysteria.” As Steven W Thrasher writes in The Guardian, Dugas’s exoneration is an opportunity “to retire the idea of the HIV/AIDS scapegoat. Let’s stop the shame and blame, so that we may move on the challenge of tackling the real, treatable and preventable ways HIV is transmitted.”

By Christopher Kelly

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