Skip Navigation Bar


Higher Education Modules

Patient Zero and the Early North American HIV/AIDS Epidemic

Class 5: Responses to “Patient Zero”

There was a significant media response to the New York Post ’s front-page article and the 60 Minutes exposé. Randy Shilts’s depiction of Gaétan Dugas as “Patient Zero” travelled around the world and a variety of groups deployed the story for widely diverging purposes. AIDS activists protested the caricatured portrayal of a dead gay man, deeply concerned about how it would reinforce existing stereotypes and jeopardize the health and lives of people with AIDS and those at risk of infection. To these concerns they could add the newly enacted travel bans restricting the entrance of HIV-positive foreigners into the United States. Conservative policymakers were swift to insert Shilts’s description of Dugas’s activities in 1982 into an emerging debate on the value of enacting laws to criminalize the transmission of HIV. Doctors and staff members in a hospital in Central Africa, an area which was increasingly viewed by Western scientists as a likely point of origin for the virus, resisted these claims and instead pointed defensively to Dugas. Similarly, a promotional advertisement for California magazine in the New York Times identified the flight attendant as the American epidemic’s cause, as did the anonymous author of a crank letter to the San Francisco AIDS Foundation.

Others lamented a focus on Dugas’s actions during an earlier time when knowledge about AIDS was vastly different. Canadian AIDS activist and filmmaker John Greyson used the controversy around “Patient Zero” to critique the explanatory frameworks used to interpret the epidemic: he and other activists saw these as being overconfidently posited by the scientific establishment, cynically exploited by the pharmaceutical drug industry, and reported uncritically by the news media. In their chapters, Knabe and Pearson unpack Greyson’s complex film Zero Patience and situate it in its historical and political contexts. Also paying homage to the film, Crimp continues his critique of Shilts’s history-writing and the journalist’s aims to achieve an “objective” reporting of the facts about AIDS.

While viewing Zero Patience is more important for the class discussion, students who have sufficient time may also wish to view the HBO movie of And the Band Played On for a strikingly different filmic interpretation.


Besharov, Douglas J. “AIDS and the Criminal Law: Needed Reform.” The State Factor 13, no. 8 (1987): 1-8,

Boorstin, Robert O. “Criminal and Civil Litigation on Spread of AIDS Appears.” New York Times, June 19, 1987, pp. A1, A16.

Crimp, Douglas. “Randy Shilts’s Miserable Failure.” In Melancholia and Moralism: Essays on AIDS and Queer Politics. Cambridge, MA and London: MIT, 2002, pp. 117-28.

Johnston, David. “Africans Asking: Did Canada Give AIDS to World?” Gazette [Montreal], June 3, 1989, p. A9. Proquest (431799647).

Knabe, Susan, and Wendy Gay Pearson. “Synopsis,” “Credits,” “Abbreviations,” “One: Song and Dance,” and “Two: History Lessons.” In Zero Patience: A Queer Film Classic. Vancouver: Arsenal Pulp Press, 2011, pp. 9-11, 13-14, 15-16, 17-35, 36-70.

Additional Resources

Greyson, John. Zero Patience, DVD. Zero Patience Productions, 1993; Toronto: Alliance Atlantis Home Video, 2007.

“Patient Zero.” [Annotated clipping sent to San Francisco AIDS Foundation] c. 1988, Carton 2, folder: “Assorted Bizarrities” [mail received] (2 of 2 folders) 1985-91, San Francisco AIDS Foundation, MSS 94-60, Archives and Special Collections, UCSF Library and Center for Knowledge Management.

Spottiswoode, Roger. And the Band Played On, DVD. HBO Pictures, 1993; Warner Home Video, 2004.

“While Everyone Was Searching for a Cure for AIDS, We Discovered the Cause.” New York Times, August 23, 1988, p. D17.

Discussion Questions
  1. How did different groups deploy the “Patient Zero” story, Gaétan Dugas’s name, and his photograph following the release of the book?
  2. Very few prosecutions for the knowing or intentional transmission of HIV had taken place by the time And the Band Played On was published in the autumn of 1987. What obstacles did prosecutors who sought convictions for the transmission of HIV face? Why, in 1987, might Shilts’s description of Dugas’s alleged exploits have been useful to policy makers eager to enact legislation that would criminalize the transmission of HIV?
  3. In what ways does the film Zero Patience build upon filmmaker John Greyson’s earlier activism? What are some of the key messages of protest he captures in his film? To what extent were these concerns particular to the historical moment, of the late 1980s and early 1990s, during which the film was developed and produced?
  4. Why, in Zero Patience, does Zero remain unhappy with Richard Burton’s eventual decision to exonerate him in the curator’s revised history of the epidemic? What might this imply for any attempt to tell a story about “Patient Zero” or Gaétan Dugas?
Additional Questions
  1. How do Zero Patience and the TV movie of And the Band Played On differ from each other in their treatment of their source material? To what extent are they similar? How central is “Patient Zero” to each?
  2. What are the key messages for Zero Patience and the TV movie of And the Band Played On? How important is the choice or combination of cinematic genre (i.e., drama, thriller, musical, documentary, fantasy, etc.) to each film’s message?