It began, as so many epidemiological investigations do, with a large question mark. In different parts of the country, gay men were falling ill to a disease that, in some manifestations, resembled little-seen varieties of blood cancer, in others, viral pneumonias that were resistant to treatment. Researchers gave the symptoms different names while seeking to isolate and identify the overarching ailment, which had taken on troubling, inflammatory nicknames such as “the gay plague” to accompany the equally alarming medical acronym GRID, or “gay-related immune deficiency.”

By Randy Shilts’ account, it took time, too much time, for health workers to step up their efforts to meet the emerging crisis. In the atavistic age of Reagan, he charged, the moral dimension trumped the medical one. Medical researchers had come to call the malady acquired immune deficiency syndrome, or AIDS, but they still disagreed widely and wildly about what caused the illness and who was a candidate for it. In the meanwhile, hundreds of victims, then thousands—at first, true, mostly men—were dying, while those who had not died were stigmatized and feared.

Shilts’ book And the Band Played On (1987) was the first to bring the central facts about AIDS to a wide audience. A reporter for the San Francisco Chronicle, Shilts tracked the illness to its first (then) known appearance in Africa and its rapid transmission throughout North American cities in the late 1970s and early 1980s. He also documented the political infighting that took place among agencies and institutions, as well as what Shilts charged was a clear pattern of official indifference, which ended only when the popular actor Rock Hudson announced that he was suffering from the disease, from which he died in 1985.

Hudson’s death (and, later, that of a young man named Ryan White, infected by a blood transfusion) brought awareness of AIDS into the mainstream and showed “ordinary” Americans that it was in fact an illness and not some instrument of moral judgment. But Shilts’ reporting had long done as much for readers in the Bay Area, the epicenter of the illness. A pioneering journalist, he was not afraid to court controversy, not just by taking on the federal government—for only when it became apparent that heterosexuals were falling ill, too, did federal funds begin to flow—but also by reporting on political

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divisions within the gay community itself. The title of his book spoke to the business-as-usual attitude that he perceived all around him even as people were dying, which, he argued, in itself cost lives needlessly.

And the Band Played On has been called the first book in the historiography of AIDS, and it inspired and informed many others, including Tony Kushner’s play cycle Angels in America (1993) and Victoria Harden’s medical history AIDS at 30 (2012). Just as he finished writing it, Shilts learned that he had the illness himself.

He died 20 years ago, on Feb. 17, 1994. The year before, he told a reporter for the New York Times that AIDS—which, thanks to medical advances, is no longer an automatic death sentence—had taught him character-improving lessons. He added, with a smile, “Of course, I’d rather have a few more T-cells and a little less character.”

Gregory McNamee is the contributing editor of Kirkus Reviews.