Relapse

Media obsession with a new "Patient Zero" reflects a return to the bad old days of AIDS hysteria

by Michael Bronski

If there's one story that sums up where we're headed in attitudes toward AIDS, it would have to be that of Nushawn J. Williams, a 20-year-old African-American man accused of engaging in unsafe sexual activity with a number of women both before and after he knew he was HIV-positive. Headlines in the New York Times referred to Williams as a "one-man epidemic," and one Times story described him as having been "charged with a deadly swath of predatory sex." On the day the Williams story broke, Rudolph Giuliani, New York's law-and-order mayor, declared that "there's no question he should be prosecuted for attempted murder, or worse."

More than any other recent event, the Williams case (and the stories published in its wake) illuminates a frightening shift in public sentiment toward -- well, against -- people with AIDS. And the news media, while ostensibly reporting on it, are actually reinforcing the dangerous trend.

The facts of the case are these: in August of 1997, Williams, a small-time drug dealer and reputed "ladies man" living in Jamestown, New York, tested positive for HIV and reported to Chautauqua County health officials the names of 21 women with whom he had had sex. Three of those women, when contacted, tested HIV-positive. In the following month, three other women (whom Williams had not named) also tested positive for HIV and claimed that they, too, had had sexual relations with him. One male sexual contact of a woman who'd had sex with Williams also tested positive.

On September 22, William was arrested for attempting to sell crack to an undercover cop and sent to Rikers Island, where a psychiatric examination determined him in need of "mental observation." After Chautauqua County health officials released their report, Williams was questioned by New York City Department of Health authorities and claimed to have had sex with a number of women in New York City as well. On September 29, public health officials invoked -- for the first time ever -- a provision in the state's confidentiality law that allows them to publicize the name of a person with HIV if he presents "a clear and imminent danger to public health."

There's really nothing extraordinary about the epidemiology of the Williams case. In fact, it's typical of how AIDS is transmitted every day in towns and cities across the country. What is unique is that because Jamestown is a small city, and because Williams cooperated with health officials, it was possible to trace his sexual partners quickly.

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One Times story described him as having been `charged with a deadly swath of predatory sex.'

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Also unique is the public response to the case. Within days of the first reports, New York City public health officials traveled to Jamestown to help trace his partners. Posters with Williams's photo were placed in and around Jamestown, urging anyone who had had sexual contact with him to contact authorities. Williams remains on Rikers Island, and district attorneys in Brooklyn and Chautauqua County plan to bring criminal charges against him ranging from reckless endangerment to attempted murder.

Rather than taking a critical view of this reaction, the media supported and encouraged it. The New York Times -- which was relatively subdued in its coverage compared to the New York Daily News and the New York Post -- ran nine articles (two of them on the front page) over the course of seven days, devoting an incredible 420 column inches to the story.

And the coverage, though exhaustive, was inaccurate and misleading. Health officials were quoted in the Times as saying that "when we are finished we may find the number of infected people in the hundreds"; later in the same paragraph, the number of confirmed cases was reported as fewer than 10, and there was little concrete evidence that the total would go much higher. The reporting also ignored the most basic precepts of AIDS epidemiology. Because Williams was the presumed epicenter of this "mini-epidemic," it was never acknowledged that his "victims," all of whom admitted to multiple sex partners, might have been infected by someone else. And though reporters repeatedly mentioned drug use by Williams and his partners, they never distinguished between injected and other drugs, nor did they investigate shared needles as a route of transmission. Rumors, hearsay, and conjecture were given the same weight as facts. The result was an invented panic, a hysterical scare that had little to do with the realities of AIDS transmission.

What's going on here? Well, the Williams story played into a series of unarticulated social fears and stereotypes. The most familiar was the image of the deadly African-American man who presents a danger to white people. Williams, with his inner-city background and his record of petty crime convictions, fit the bill perfectly. Not only were all the female sexual partners who got media attention white, but they lived outside urban settings. Would this have been such a big story if Williams's partners had been black and living in Brooklyn or Harlem?

Conflated with this fear is the newer dread of the person with HIV or AIDS who moves secretly through society, purposely infecting "innocent" people. This image -- a deadly phantom whose sexual attractiveness lures and kills -- first surfaced in And the Band Played On, where Randy Shilts manufactured the idea that Gaetan Dugas, one of the first men to be diagnosed with AIDS, was "Patient Zero" -- the evil queen who placed his own sexual appetites above the concerns of public health to help create an epidemic. Since then, the specter of the person who purposely spreads AIDS has taken root in urban myth and has inspired draconian -- and essentially useless -- laws in 18 states that severely penalize people who are deemed to have "intentionally exposed" (a phrase that has been interpreted very broadly) others to HIV.

The coverage of the Nushawn Williams case is an excellent example of the sea change in public attitudes toward people with AIDS, but it is hardly an isolated one. This past summer, for instance, a rash of articles in the mainstream press argued against laws protecting the confidentiality of AIDS patients. Other stories argued that too much money is spent on AIDS research.

What's causing this? Perhaps people who don't feel personally touched by the disease are just getting tired of being sympathetic now that AIDS is in its second decade. Or maybe news coverage of new drugs has given the impression -- as Andrew Sullivan said in the New York Times Magazine last summer -- that "AIDS is over," even though new studies show that protease inhibitors are not working for more than 50 percent of those who began taking them two years ago. Or maybe -- now that it's clear that AIDS is not going away quickly -- it's simply become safe again to stigmatize and vilify people with the disease. Rather than move toward accepting people with AIDS as part of our society, we're redrawing the lines to place them on the outside. Hence the movement to abolish confidentiality laws; hence the shift in AIDS-prevention talk from "everyone should have safe sex" to "watch out -- HIV-positive men are out there, having unsafe sex." Hence the hysteria over a man who may have infected 10 people with HIV -- or who may simply be caught in the same cycle of transmission that has turned a virus into an epidemic.