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This new research rewrites the history of HIV in America

If you've ever asked who brought AIDS to the United States, you've likely been told that "Patient Zero" was a man called Gaëtan Dugas.

The Canadian flight attendant was blamed for carrying the virus from Africa and spreading it around the gay community in North America.

Immortalized in books like Randy Shilts's And the Band Played On, Dugas also became central to the narrative at the time that the disease was spread by reckless, promiscuous men who have sex with men.

patient zero hiv

People magazine featured Gaëtan Dugas as Patient Zero. (via NIH)

Now researchers have come out with what is perhaps the most definitive proof that this persistent myth is wrong.

According to Science, a team of researchers from the University of Arizona in Tucson — led by Michael Worobey — recovered near full-length genomic sequences of HIV from blood samples of Dugas, as well as eight other gay and bisexual men taken in 1978 and 1979.

They then did incredible detective work using a technique called "molecular clock." It allowed them to track the mutations of the virus, mapping out how HIV moved through time and place.

What they found was quite amazing: By the late 1970s, the HIV epidemic in the US "already exhibited extensive genetic diversity — particularly in New York City," the study authors write.

So the disease wasn't first brought to America by a 1980s flight attendant. The researchers believe the virus leaped from Africa to the Caribbean in 1967. From there, it probably moved into the US mainland by way of New York City in 1970 and then on to San Francisco by the mid-1970s.

"Moreover," the authors write in their abstract, "there is neither biological nor historical evidence that Patient 0 was the primary case in the US or for subtype B as a whole." In other words, HIV was already well established in the US before Dugas.

The research was presented at CROI, a big HIV/AIDS meeting in Boston, and has yet to be published. But it builds on Worobey's already published work, which has similarly found that the virus was circulating in the US by way of the Caribbean long before researchers previously believed.

Still, the Gaëtan Dugas narrative persists. HIV researcher Richard Elion noted the flight attendant has served as a scapegoat, allowing people to ignore their own risks and vulnerabilities. "It was too scary to think HIV was a general risk due to the vagaries of biology rather than a callous 'bad guy,'" he says.

"Patient Zero became a convenient symbol for a culture ready to panic about gay men and the microbes swirling around in their bodies," says Gregg Gonsalves, an HIV/AIDS activist and co-director of Yale's Global Health Justice Partnership.

"Shilts created a modern-day Typhoid Mary in Dugas and allowed the origin story of this new illness to feature a villain with a foreign-sounding name and an out-of-control sexuality."

This new science should help change that.