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Last Reviewed on June 19, 2019, by eNotes Editorial. Word Count: 347

What society judged was not the severity of the disease but the social acceptability of the individuals affected with it.

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Shilts's book is concerned with dissecting the politics of fighting the AIDS epidemic in the 1980s, and especially the way its early characterization as a "gay disease" (Gay-Related Immune Deficiency, or GRID) politicized it negatively and delayed funding and the development of treatments. Shilts contrasts the reaction to AIDS to the quicker and more unified response to the much more socially acceptable Legionnaire’s disease, even though Legionnaire’s disease was less deadly and impacted fewer people.

The primary cause of death was listed as cryptococcal pneumonia, which was a consequence of his Kaposi's Sarcoma and Pneumocystis Carinii pneumonia. Those, however, were only the obvious diseases. The KS lesions, it turned out, covered not only his skin but also his lungs, bronchi, spleen, bladder, lymph nodes, mouth, and adrenal glands.

Shilts's book makes a strong argument about the effects of homophobia on fighting AIDS, but it is also a work of journalism with objective descriptions of the progress and inexplicable spread of a gruesome and frightening disease. Early on, doctors were puzzled and alarmed by the sudden spike in a very rare form of cancer, Kaposi's Sarcoma, that was also appearing with some odd symptoms. At this point, they have not identified it as AIDS. Knowing that it was likely sexually transmitted and transmitted via blood, however, there was ample reason to take action to limit sexual exposure and to prevent unsafe blood transfusions:

Later, everybody agreed the baths should have been closed sooner; they agreed health education should have been more direct and more timely. And everybody also agreed blood banks should have tested blood sooner, and that a search for the AIDS virus should have been started sooner, and that scientists should have laid aside their petty intrigues.

Shilts registers some bitterness over the retrospective and nearly universal handwringing of people that should have done more sooner to help victims of AIDS, noting that the infighting and delays in response cost many thousands of lives.

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