Patient Zero and the Making of the AIDS Epidemic
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Edmonton, Alberta (Canada), 176, 319– 21
death of, 174, 199– 200, 244, 349, 350 f;
Elliott, Douglas, 69n87, 246– 49, 256n30,
diary of contacts of, 108, 167, 174, 267–
260– 77, 364; AIDS activism of, 260– 63;
68, 281– 83; early life of, 294– 97; Grey-
Krever Commission strategy of, 248–
son portrayal (in Zero Patience) of,
49, 260, 263– 77, 282– 83, 285– 87. See
248– 49, 253– 56, 285– 87; Kaposi’s sar-
also Krever Commission
coma of, 169– 71, 202, 290, 302n43, 304–
Emke, Ivan, 20n61, 264n50
11, 341, 343, 348; meeting with Dritz
“End to the Silence, An” (Campbell),
of, 167– 68, 232, 329– 31, 337; negative
253– 54n22
media coverage of, 197– 206, 232, 318–
epidemic (defi nition), 7n15
20, 326– 37; nickname “The Vector”
Epidemic Intelligence Service (EIS) offi -
of, 174n126, 316; opportunistic infec-
cers, 82– 83, 92– 94, 119– 20, 276
tions of, 342, 344; peer education and
epidemics of the past. See cultural narra-
support work of, 346– 48; persistence
tives of epidemics
of Patient Zero story of, 243– 45, 284–
epidemiology practices, 80– 84, 119– 20;
88; personal experience of Patient Zero
cluster testing methods in, 79– 81, 84–
story of, 4, 30– 41, 176, 183, 197, 289– 94,
87, 90– 92, 120, 123– 38; index cases
331– 53; personal physicians of, 42– 44,
in, 84n16, 111– 12, 287; person- to-
305, 310, 337– 42; photographs of, 183,
person contact approach in, 83– 84, 138;
194, 212– 13, 214 f, 219, 221– 24, 290n6,
population- based approach in, 83; trac-
298 f, 305– 7; physical appearance of, 66,
ing techniques for STDs of, 56– 57, 63,
168, 181, 183, 290, 299– 300, 332, 337,
79– 84, 85n17, 90– 94; visual representa-
343, 370; posthumous reminiscences of,
tion of data in, 124– 38
424
Index
“Epitaph for the Sexual Revolution” (Rus-
AIDS on, 172– 73, 317– 37, 347n187, 375;
sell), v, 68n84
multiple sexual partners in, 69n87, 172–
Epstein, Steven, 103
73, 303, 331, 347n187; physical attrac-
Erasmus of Rotterdam, 62
tiveness in, 68, 149– 50, 181, 301– 3; pro-
Evans, Arthur, 321– 22
miscuity in, 68– 69, 93, 172–73, 212, 333,
Expo ’67, 295– 96
371; regional variations in, 22– 27; re-
search on, 2– 3, 22– 32, 77– 81, 87– 98,
“Face of AIDS, The” ( Newsweek), 186n2,
362– 65; travel in, 25– 27, 42, 104n79, 117,
193n18
124, 126, 129, 154, 187– 89, 250, 297– 99,
Fain, Nathan, 275
304, 321, 338, 370; venereal disease in, v,
false- positive test results, 38– 39
87– 98, 99n65, 375. See also bathhouses;
Falwell, Jerry, 45, 51, 181
Dugas, Gaétan; Kaposi’s Sarcoma and
Farcinatore, Matteo, 52
Opportunistic Infections (KS/OI) Task
Farmer, Paul, 56
Force; Los Angeles cluster study; Shilts,
Fauteux, Norman, 259 f
Randy
Felson, Arthur, 314– 15n83
Gay Men’s Health Crisis, 116, 323
female HIV/AIDS patients, 101
gay physicians, 96– 98
Field, Martha A., 235– 36
gay related immune defi ciency (GRID),
Field Manual of the Venereal Disease
133, 157, 308– 9, 351
Divi sion (CDC), 92– 94
Gay Report, The (Jay and Young), 96– 97,
Fine Print, 319– 21
119– 20
Fleck, Andrew C., 112n99
Geary, Jim, 324– 25
“Forum Fans Fears” (Gilbertson), 332– 33
gender identity disorder, 24
Foto, Rink, 302n44
genetic diversity of HIV, 122n125
Foucault, Michel, 24n71, 25
germ theory of disease, 70, 75
Fracastoro, Girolamo, 52, 67
Gift of Death, The (Picard), 247n3
Francis, Donald, 237n126, 280– 82, 283
Gilbertson, Fred, 332– 33
French Disease. See pox (French Disease)
Ginzburg, Carlo, 294n14
Friedman- Kien, Alvin, 99– 100, 169,
Gladwell, Malcolm, 358n7
318n92, 337; on Dugas, 42– 45, 69, 341;
Goffman, Erving, 24n71
patients of, 305, 309– 10, 342
Goldstein, Richard, 330– 31
“Friend’s Death, A,” 349, 351– 52
gonorrhea, 94– 95
fungal infections, 8, 327, 344
Goodstein, David, 153
Gordon, David, 99
Galen, 52
government policies. See Canada; U.S.
Gallo, Robert, 4n9, 7n14, 17
government policies
Garchik, Leah, 160
Gregory- Lewis, Sasha, 143, 151
gay community. See lesbian and gay
Greyson, John, 40, 213– 16, 248– 58, 284– 88,
communities
363; critical response to work of, 255– 57,
gay liberation movement, 23– 25, 95– 98,
292; transnational experience of, 252–
145, 189, 299– 300; commercial sex es-
53. See also Zero Patience (Greyson)
tablishments and, 303; government
Grmek, Mirko, 19, 358n8
policies on disease transmission and,
Guinan, Mary, 98, 105n82
229– 37; pink triangle of, 211– 12n74; on
same- sex marriage and family rights,
H1N1 epidemic, 361
288; Stonewall riots and, 95, 145; World
Haiti/Haitian immigrants, 2– 3, 10, 102n72,
Pride and, 354– 55
165; early HIV/AIDS among, 14, 21,
gay male sexual culture: commercial estab-
103; origin stories of, 55– 56, 135– 37
lishments of, 68, 152, 300– 301, 303, 320,
Halifax, Nova Scotia (Canada), 176, 210,
336, 343, 351, 364, 369, 374; impact of
219, 278, 297, 304
Index
425
Hall, Barbara, 354– 55
and, 27– 30; PWA movement in, 169–
Hall, I. Walker, 73– 74
70n106, 314– 15n83; social construc-
Harden, Victoria, 17n49
tion of knowledge and, 5– 7, 22– 26, 99–
Hardy, Anne, 74n117
100n66, 356– 57; stories of deliberate
Haverkos, Harry, 103– 4, 343– 44n178
spreading of disease in, 57, 75– 76, 229–
Hawaii (Michener), 155
35, 317– 42, 351– 52; transnational ap-
Health Insurance Portability and Account-
proach to, 20– 27, 286– 88; treatment ac-
ability Act (HIPAA), 36n102
tivism in, 187– 89; written accounts of,
healthy carriers, 30n88, 42– 45, 69– 76,
18– 20, 25– 27. See also And the Band
292– 93
Played On (Shilts); Shilts’s portrayal of
Helen of Troy, 66
Patient Zero
Helmont, Jan Baptist van, 54
HIV- 2, 10n25
&
nbsp; Helms, Jesse, 222
HIV denialism, 17n51, 237n126
hemophiliac patients, 3, 195– 96, 236n124,
Holleran, Andrew, 64, 318n92
248. See also transfusion- acquired
homophobia, 22– 26; regional variations
HIV/AIDS
in, 22– 25; transmission of disease and,
hepatitis B, 95, 150– 51, 335
29– 31; in written accounts of HIV/
hepatitis C, 247– 48, 268n61
AIDS, 26
Herbert, Alan, 334
homosexuality. See same- sex sexual
Hernández, Édgar, 361
activity
herpes virus, 9n20, 99, 100n68
“Homosexuality as a Source of Venereal
Herrup, Cynthia, 50n27
Disease” (Kanee and Hunt), 89– 90
Herzberg, Tom, 218 f
Hooper, Edward, 12, 13n34
heterosexual HIV/AIDS infection, 101–
How to Have Sex in an Epidemic (Callen
3, 165
and Berkowitz), 173
highly active antiretroviral therapy
Hubbard, Jim, 15– 16n45
(HAART), 16, 249, 287– 88
Hudson, Rock, 186
high risk group (as term), 2n5
human T- cell lymphotropic virus type III
historical epidemics. See cultural narra-
(HTLV- III), 7n14
tives of epidemics
humor, 183, 205– 6, 209– 10, 319, 321– 22,
History of AIDS (Grmek), 19
346– 47
history of HIV/AIDS in North America,
15– 22, 354– 76; combination therapy
Iliffe, John, 358n8
(HAART) in, 16, 249, 287– 88; deaths
Illich, Ivan, 24n71
from HIV in, 7, 15; discovery of the vi-
images of cluster study data, 79, 80 f, 123–
rus in, 17, 315; diversity of literature
38; “Cluster— Connection of LA and
on, 4– 5, 8n16; divine punishment nar-
NYC Cases,” 123– 38, 125 f; “Clus-
ratives in, 45– 46, 51; early period of,
ter— LA Cases,” 125 f; “Cluster—
15– 17, 307– 17; federal spending and,
Relationship of Symptom Onset to Sex
160; geographic focus in, 2– 3, 7, 9– 10,
Contact,” 125 f; “Extension of the LA
22, 104– 5, 308, 311; on healthy car-
Cluster to NYC and Elsewhere,” 128 f;
riers, 73n113; on living with HIV, 7,
Klovdahl’s network dynamics analy-
207, 252, 288; mainstream media cov-
sis of, 134– 35, 136 f; “Patient #O and
erage in, 23, 139– 41, 186– 90, 191– 92,
his Contacts,” 126 f; pertinent informa-
198; medical practitioner accounts of,
tion excluded from, 129– 30, 133– 34;
31, 292– 93, 308; normalized medical
representational conventions in, 130–
response in, 17– 18; origin debates in,
32; Shilts’s mistaken reading of, 133–
9– 14, 17, 54– 56; patient viewpoint ac-
37, 239– 40
counts of, 290– 94; public awareness of,
Imagining Patient Zero project, 30n87,
161n77, 187, 198; public health system
377– 78
426
Index
immunosuppressive drugs, 121
Katz, Jonathan Ned, 89n30
incubation period for AIDS- causing agent,
Keegan, Michael, 113n100
120– 22, 132, 135– 38, 167, 226 f
Kepner, Jim, 226– 27, 229
index cases, 84, 111– 12, 287
Kingston, Tim, 226 f
Inside Out collective, 258
Kinsman, Gary, 266
International AIDS Conferences, 8n16, 16,
Klenk, John, 230– 31
21, 156, 287, 359
Klovdahl, Alden, 134– 35, 136 f
International Health Regulation (WHO),
Knabe, Susan, 250
279– 80n82
Koch, Robert, 70– 71, 83
intravenous (IV) drug users, 2– 3, 14, 101,
Koplan, Jeffrey, 315
103, 165
KQED, 151– 52, 155
isolation measures, 28– 30, 72, 228
Kramer, Larry, 64, 91, 192, 194n22, 196–
97, 375
Jackson, Ed, 207– 9, 249, 253n20, 265– 66
Kraus, Bill, 165
Jacobsen, Frank, 329
Kraut, Alan M., 69n89
Jaffe, Harold, 82, 99, 108n92, 278– 79;
Krever, Horace, 246, 267, 282, 284
Shilts’s interview of, 157; silence on
Krever Commission, 20– 21n61, 32, 40,
Patient Zero’s identity of, 210
69n87, 246– 52, 258– 88; as arena of his-
Jan Hus, 58– 59, 60– 61 f
torical production, 264– 67; costs of,
Jay, Karla, 96– 97
249; on Dugas and Patient Zero, 269–
Jerome of Prague, 58– 59, 60– 61 f
72 t, 280– 88; Elliott’s strategy at, 248–
Jessamine, Gordon, 274– 77, 284
49, 260, 263– 77, 282– 83, 285– 87; Final
Joint United Nations Programme on HIV/
Report of, 284– 87; goal of, 246– 47, 252,
AIDS, 7
259; hearing schedule of, 268, 273; in-
Jones, Cleve, 165
tervener participants in, 247, 251, 259–
Jones, David, 50
60; media coverage of, 247n3, 263– 64,
Journal of the Plague Year, A (Defoe), 62,
282n89; Picard’s book on, 247n3; public
319
hearings of, 247– 48, 251, 258– 59, 282;
Juranek, Dennis, 100
theatricality of, 251– 52; transnational
approach of, 251– 52
Kaposi’s sarcoma (KS), 2, 9, 304– 7; demo-
KS/OI Task Force. See Kaposi’s Sarcoma
graphics of, 101; Dugas’s experiences
and Opportunistic Infections (KS/OI)
of, 169– 71, 202, 290, 302n43, 304– 11,
Task Force
341, 343, 348; early study of, 308– 17; as
KTVU, 155
gay cancer, 57, 208, 244, 305, 323; her-
Kushner, Rose, 28– 30
pes virus and, 9n20, 100n68; increases
in occurrence of, 98– 101; public educa-
Laboratory Centre for Disease Control
tion on, 328– 29; treatments for, 314– 15;
(LCDC), 274– 77, 282– 83, 284
visibility of patients with, 327– 28
Langmuir, Alexander, 82
Kaposi’s Sarcoma and Opportunistic In-
Lanzaratta, Philip, 309– 10, 316
fections (KS/OI) Task Force, 81, 82,
LaRouche, Lyndon, 180, 221
98– 107, 279; case control study of, 101–
LaRouche Initiative, 180, 186– 87
5; case numbering by, 104n79; Case/
Latour, Bruno, 116n105
Patient 57 of, 104– 9, 110 f, 126 f, 127 f,
Laubenstein, Linda, 42– 43, 170– 71, 174,
298, 310– 12; geographic hypothesis of,
315– 16; on Dugas as “The Vector,”
104– 5; infectious disease hypothesis of,
174n126, 316; patients of, 305, 309, 342
102– 3; Jay- Young data set and, 96– 97,
Lawrence v. Texas decision, 23
101, 118– 19. See also Los Angeles clus-
leather, 332
ter study
Leavitt, Judith Walzer, 43, 293
Kaposi’s Sarcoma Research and Education
legal considerations. Se
e patient rights
Foundation, 318, 328– 29
Leishman, Katie, 144
Index
427
leprosy, 46
Los Angeles Herald Examiner article and
lesbian and gay communities, 10, 15n44; in
image, 113n100, 114 f
Canada, 299– 301; decriminalization of
Lovato, Pietro Antonio, 52
homosexuality and, 94– 95, 299; early
Luther, Martin, 59– 62, 64– 65
signs of HIV/AIDS in, 14, 21; gay lit-
Luyombya, Henry, 354– 55
erature of, 64; homophobia and, 22–
lymphadenopathy- associated virus (LAV),
25, 29– 31; leather as signal in, 332; nar-
7n14
ratives of beauty and vice in, 67– 69;
Lynch, Michael, 20– 21n61, 23, 189n14,
regional variations in, 22– 27; as risk
241, 366
group for HIV/AIDS, 2– 3, 9n20, 22,
68– 69, 80; as risk group for STDs, 64,
Macdonell, Spencer, 330, 365
86– 98; written accounts of, 25– 26. See
MacNeil, Robert, 196– 97
also activism; history of HIV/AIDS in
Mains, Geoff, 336
North America
Maley, Ken, 152– 53
Levaque, Pedro, 300– 301
Mallon, Mary (“Typhoid Mary”), 30n88,
Levin, Martin, 131 f
45, 69– 75, 292– 93, 335
Levy, Jay, 7n14
“Man Who Gave Us AIDS, The” ( New
“Liberace’s Music Helped Cure Me”
York Post), 195– 98
(Greyson), 215n77
March on Washington, October 1987, 202,
Linder, Johan, 54
207, 238, 241
living with AIDS. See people with AIDS
Marmor, Michael, 117
(PWAs)
Marshall, Stuart, 254
living with HIV. See people living with
Martin, Brian, 12n31
HIV
Mass, Lawrence, 191, 303n48
Loeffl er, Friedrich, 70
Mathias, Richard, 30n87, 273– 74
long- term nonprogressors, 8n17
Maupassant, Guy de, 63– 64
Lorch, Paul, 325, 328
Maupin, Armistead, 153– 55
Los Angeles cluster study, 19, 27– 28, 32,
Maynard, Michael, 176, 333– 35, 337– 40,
40, 77– 138; actual exposures of cases
345
in, 122; background and context of, 77–
Mayor of Castro Street, The (Shilts), 153,
105; coding of cases in, 108– 12; commu-
155– 56, 191, 193n18, 203
nication and interpretation of, 81; Dar-
Mbeki, Thabo, 17n51
row’s reported repudiation of, 137, 238;
McCaskell, Tim, 249
Dugas and, 310– 13; effort to identify a
McGough, Laura, 67
source in, 107– 16; incubation period es-
McQueen, Robert, 146– 50
timates and, 120– 22, 132, 135– 38; infl u-
media reporting, 17n49, 23, 39, 86, 139– 41,