While many people may not know his name, Gaëtan Dugas, a gay, Canadian flight attendant, has been seen as one of the most central figures involved in the story of how HIV/AIDS came to the United States, spread throughout the country, and killed millions in the process.
But a newly published study has almost entirely overturned what everyone thought they knew about Dugas and the early history of the disease.
In 1984, the CDC published an in-depth study in the American Journal of Medicine that purported to trace the transmission patterns of the HIV virus by analyzing the sexual habits of gay and bisexual men living in a number of major metropolitan cities on both the east and the west coasts.
Dugas frequently traveled between the coasts due to his job, and the CDC's early analysis found that he was directly connected to a robust network of men who'd had sex with one another and eventually become HIV positive. The study characterized Dugas as sexually irresponsible and promiscuous, playing on sex-negative stereotypes about gay men and feeding into the dangerous, incorrect idea that HIV and AIDS were a "gay disease." It also dubbed him "Patient Zero"—the central person responsible for first contracting and then spreading the virus.
But it was And The Band Played On, the seminal 1987 history of the discovery and impact of HIV/AIDS by journalist Randy Shilts, which fully cemented the idea of Dugas as Patient Zero in the public mind.
"Whether Gaëtan Dugas actually was the person who brought AIDS to North America remains a question of debate and is ultimately unanswerable," Shilts wrote. "There's no doubt that Gaëtan played a key role in spreading the new virus from one end of the United States to the other."
While Dugas willingly participated in early research to determine whether HIV could be transmitted sexually, his designation as Patient Zero led to his being posthumously vilified for allegedly introducing HIV to the American population.
Yet a new historical analysis from the University of Cambridge explodes this by now decades-old conception of the spread of the disease, and Dugas' role in it.
It turns out that a simple clerical error may have led to Dugas being misidentified as the first person in North America to contract the HIV virus. He was not, in fact, identified as "Patient 0." He was identified as "Patient O." The "O" stood for "Outside California."
“The current study provides further evidence that patient 57, the individual identified both by the letter O and the number 0, was not patient zero of the North American epidemic,” the study's co-author Richard McKay, told The Guardian. “Gaëtan Dugas is one of the most demonized patients in history, and one of a long line of individuals and groups vilified in the belief that they somehow fueled epidemics with malicious intent,” said McKay.
This new study, McKay explains, corroborates an increasing amount of data pointing to the fact that HIV was actually circulating in the US for at least 10 years before Dugas became infected. Dugas' willingness to come forward and share information about his sexual habits and partners, study co-author Michael Worobey said, ultimately led to him being turned into a scapegoat.
“Probably what happened here was a case of a guy who was unusually helpful to investigators providing lots and lots of names of sexual contacts,” said Worobey. “He’s just one of many people who is highly sexual active and in this network of people who are popping up as early Aids cases but he ended up looking up as this central character almost certainly just because of how helpful he was.”