And the Band Played on: Politics, People, And the AIDS Epidemic

A couple contextual notes –

First, this book was written back in 1987, when the AIDS epidemic was still raging.'

Second, the author was gay (he died of AIDS in 1994). Those two facts are important, because they affect how the book is perceived.

So much of the history of AIDS happened after the book was published. The author had no idea what was coming.

And the book is intensely critical of the gay community in places. The author seems to lay some responsibility for the early spread of AIDS at the feet of gay people themselves (more on this below).

But that’s just one conflict among many in the book. In some ways, the book documents a series of arguments between politicians, activists, and the scientific community, all while people kept dying.

The story is told in a series of small vignettes. The book is divided up into chapters, but each chapter is essentially a long series of fragments, telling the stories of a series of men: victims of AIDS, researchers, activists, and politicians.

One of the problems with HIV is that it doesn’t actually kill you. What it does is destroy your immune system so that something else can kill you – an “opportunistic infection,” which is something that’s normally not fatal, but with no immune system, becomes so. The resulting disaster is what we call AIDS.

This made it a great mystery. When clusters of men started dying of strange illnesses, it was hard to figure out what it was. When researchers finally put together that most of the victims were gay, they realized that something was stalking the gay community in large cities. This set off a mad scramble to figure out what it was, and finally, four years later, the French discovered the virus that destroyed immune systems (in fact, the Americans may have lied about this in a very sketchy episode).

And everyone kept pointing fingers, refusing to change, and trying to pretend that the disease was someone else’s problem.

One of the central conflicts throughout the book was the fight over anonymous gay sex in the early 1980s, especially in the bathhouses of San Francisco. The gay community fought fiercely to prevent any regulation or closure of the bathhouses, taking the position that gay sex of this type was a right they had fought for, and any attempt to limit it was an attempt to discriminate against gay men. They were absolutely resolute about this, even when presented with statistical evidence that men who frequent the bathhouses we exponentially more likely to have AIDS (HIV itself hadn’t been discovered yet).

The book also tells the story of Gaetan Dugas, a flight attendant for Air Canada who was notoriously promiscuous, even after he found out he had what was called “the gay cancer” in the early days. The author has been criticized in the years since for claiming Dugas was “Patient Zero” who brought AIDS to the United States, but even setting aside that specific claim, the author is clearly very critical of Dugas for his seemingly reckless disregard of the health of his partners (he was so promiscuous, in fact, that it’s hard to even speak of “his partners” – network analysis of AIDS cases showed that Dugas was at the center of a very large cluster).

All throughout the early years, it was almost impossible to get research funding. The disease affected mostly gay men, who weren’t discussed in polite society, and then IV drug users, who no one really cared about. But then it slipped into heterosexual people, mostly through tainted blood (the blood banks were staunchly opposed to testing), and then Rock Hudson died, and everything changed.

Ronald Reagan, the sitting U.S. president, is strangely absent from the book, because he was mostly absent from the crisis. The book is almost silent on him until the end, because he simply didn’t say anything. Reagan famously never mentioned the word “AIDS” until a press conference in 1985. He wouldn’t give an official policy speech on it until 1987.

This is a masterful book. It’s long, but never tedious. There are a lot of names, but don’t even bother trying to sort them out (sadly, many of them die at some point in the book).

I was started reading the book and after the first 50 or so pages, I told my wife that it was like a horror movie. Clearly, in 2025, I knew how it ended up. But these people in San Francisco in 1980 who couldn’t figure out why weird cases of pneumonia kept popping up, just had no idea.

It was hard to read, knowing what awaited them. It was like watching a horror movie through your fingers.

Book Info