Book Review

And The Band Played On by Randy Shilts

an essential non-fiction read and a new documentary on its legacy

I’ve been thinking and reading about AIDS a lot recently. I think there are a few reasons why, but I won’t get to them here.

Alongside reading Randy Shilts’ 600+ page journalistic book on the politics and damaging bureaucracy of the AIDS Crisis, And The Band Played On (1987), I’ve also been watching the 2003 HBO serialisation of Harold Kushner’s 1991-2 play, Angels In America and I watched a documentary on Gaetan Dugas at Toronto’s Hot Docs festival. That film, Killing Patient Zero (2019, dir Laurie Lynd), focused a lot on the legacy of And The Band Played On, and its part in the cruel mythologising that caused Dugas, a handsome French-Canadian air steward, to become demonised as “the man who brought AIDS to America”.

Gaetan Dugas

Killing Patient Zero also gave a personal biographical history of Shilts, which was something this massive book was conspicuously lacking (in my opinion): there are often allusions to an anonymous “San Francisco Chronicle reporter” who happens to be speaking to key people at key times, and though this is obviously Shilts, his refusal to allow the intrusion of the non-journalistic “I” is one of the few factors that stops this serious, important and sadly still-relevant book from being a perfect (though hard-going) readerly experience.


And The Band Played On is a significant text because it was the first book to explore in detail the behind-the-scenes missteps, mistakes and negligence that allowed the AIDS crisis to become as serious as it did.

Scientists were far ahead of governments from the off: HIV (though it had different – rival – names for years) was discovered almost two years before it was announced; the fact that AIDS could be spread by blood transfusion was known years before standardised tests on blood were introduced, likewise the need for sex education, the need for clean needles for intravenous drug users, the fact that babies can be born with AIDS etc etc etc.

In great detail and with huge amounts of direct research (the impressive iteration of Shilts’ interview records at the end of the book is daunting!) Shilts charts who, how and why these discoveries and this knowledge failed to be disseminated and responded to by public health officials.

AIDS was “gay cancer”, it was heralded by the dickhead Christian right (who rose to prominence alongside Reagan) as the wages of sexual liberation. Shilts discusses the backlash against gay community leaders who tried to talk about safe sex early in the crisis, and then about the “well, it’s already too late I’ve probably got it anyway” attitudes that rose to prominence once the scientific theories about the viral modes of infection became scientific facts.

The same problems reoccured: public health organisations felt uncomfortable talking about gay sex and politicians dithered as they feared appearing too pro-gay, too anti-gay or – commonly – both. There was a lot of sex positivity involved in the gay liberation movement, and unfortunately there wasn’t enough blunt enunciation of “fuck who you want but wear a condom”, instead there was only garbled, muddled, talk of “reducing numbers of partners”. “Have less sex”, “have no sex” was the preached idea, rather than the – much more useful – advice to slip into latex before getting it on with a stranger.


The AIDS epidemic wasn’t avoidable, Shilts argues, but the depth of its tragedy and its global damage was. Shilts regularly refers to the rapidity with which the potential spreads of Ebola (1976) and Legionairre’s Disease (also 1976) were managed.

The fact that AIDS wrought the damage it did was a tragedy of politics and societal-wide sexual repression, of right wing buffoonery and pig-headed negligence. What happened wasn’t inevitable given the virus itself (though the long time it took scientists to develop effective treatment once they were properly funded shows that AIDS would have still had a not-inconsiderable impact), but it was a bleakly predictable result of the imperfect, prejudiced conservative society in which we live.


In Killing Patient Zero, I learned that Randy Shilts himself died of AIDS in the early nineties, and he had held off having himself tested until he finished writing this book, so as to remain “unbiased”. This in itself shows a clear personal connection to the crisis, as too do the regular references to the San Francisco Chronicle reporter.

Gaetan Dugas’ infamy resulted from his depiction in And The Band Played On, the documentary argued, particularly from the scandalising excerpt that was serialised in homophobic newspapers as a marketing push for Shilts’ book. In And The Band Played On, Dugas is depicted as fucking men in bathhouses and then cruelly flipping on the lights to show his Kaposi’s Sarcoma and informing his lover that they too now have “gay cancer”. To me, this felt like a clear fabrication, as too did a lot of the contents of the generally-overwrought scenes that dramatised the “real lives” of those infected with HIV.

And The Band Played On feels heightened when it explores human suffering and tragedy, but this is appropriate: Shilts’ book is about the emotionless official response to a health crisis, and lathering emotion is an effective way to draw attention to the failings of the bureaucrats, and also to stop the book from becoming too dry.

Image result for randy shilts
Randy Shilts

Shilts was not a bystander in the AIDS crisis: his knowledge on the national and international situation was a direct result of him living as a gay man in San Francisco as the epidemic began. Shilts knew people who died, Shilts stayed in communication with scientists and politicians as he sought explanations and understanding, and he was infected before he’d finished writing the book. Shilts’ attempts at detachment and distancing fall flat: this was an epidemic that he was involved with, in as personal a way as possible. The prose isn’t always beautiful, and the faux-unbiased reporting is particularly conspicuous to a contemporary reader, but neither of these factors invalidate And The Band Plays On. Not at all.

I’ve got another book on AIDS in my pocket and three episodes of Angels in America left to watch, so this is a topic that will permeate into at least the next post on here before I’m done with it. I’ll explore what – if any – connection I have with the crisis in the next post, too.

And The Band Played On is an important, emotionally tough, book. It’s engagingly written despite often describing complex ideas, and I’d highly recommend it to anyone who feels like an informed (though draining!) look at the AIDS crisis. It’s long, it’s important, it’s impeccably researched. Very very very much worth your time.

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