When silence is criminal

A man in Indiana named Tony Perkins is facing felony charges for having sex with as many as 100 partners without telling them he was HIV positive.  This case instantly made me think of the story of Gaetan Dugas, also known as “Patient Zero.”

Dugas was a French-Canadian flight attendant in the 1970s and 1980s.  He was gay, and a notorious frequenter of bath houses, especially in the San Francisco scene.  He was often described as a beautiful, charming man.  When the AIDS epidemic hit in the 1980s, epidemiologists began looking for its source.  Their research led them back to Dugas.  Due to his position as a flight attendant, he traveled and had sex all over North America.  He may not have been the first North American to contract HIV, but he was most responsible for spreading it far and wide.  Of course, at the time, no one had even heard of AIDS or HIV.

When Gaetan Dugas was told that he was “Patient Zero,” and responsible for the spread of AIDS throughout North America, he refused to believe it. He was angry. He refused to change his behavior–after all, he didn’t even feel sick. As the AIDS epidemic raged on, and Dugas began to show symptoms of the AIDS virus, he lashed out.  He went to bath houses in San Francisco and had anonymous, unprotected sex with the lights off.  Then at the end, he would turn the lights on so his partner could see the lesions on his face (kaposi’s sarcoma – an early AIDS identifier). Then he would say, “I have AIDS and now you do too.”

The San Fransisco gay community ran him out of town. United States public health and law enforcement officials tried to arrest him, but he went back to Canada, where he was safe from prosecution. He lived there until he passed away from AIDS related illnesses, and was never prosecuted.

Learning that you have an STI is not the same as learning you have diabetes.  STIs are difficult to deal with in part because of the physical and health aspects, but more importantly because of emotional aspects.  Contracting an STI means that someone gave it to you–someone infected you–making you a victim.  And feeling victimized or betrayed, often by someone you trust or care for, is often traumatic.  But society does not treat you like a victim.  Society treats you like a leper,  a dirty whore who got what they deserved, or even worse, the butt of a joke.

Even public health officials and educators–the folks who are most invested in STI education and prevention–make you feel like shit. STI prevention campaigns have compared unprotected sex to “getting in bed with tarantulas” or “getting in bed with Hitler.”  Not only are you a victim, a leper, a whore, and a joke, you are Hitler.  Gaetan Dugas was a victim, and not only did he feel the moral stigma of STIs as punishment for being promiscuous (or gay), he was blamed for the deaths of many, many people–even though we didn’t even know HIV or AIDS existed at the time.  Is it really so surprising that Gaetan Dugas reacted the way he did?

The unfortunate reality is that STIs can be used as a weapon, and those who infect others on purpose should face prosecution for their crime. But it is important consider the overwhelming effect of the shame, betrayal, guilt, and stigma that go hand in hand with an STI diagnosis. Most people do not react as Gaetan Dugas did, using HIV as a weapon of revenge, but for many the shame and stigma associated with STIs makes it harder to disclose that information to their partners.

In this interview on ABC news, Tony Perkins said, “The only thing I did was want a relationship and if you tell people you have this they treat you like you got the plague and all I wanted was someone to care about me and if you tell them you got this they wont talk to you.”

To be clear, I do not excuse the actions of Tony Perkins, who confessed to 2 counts of failure to disclose his HIV status, and allegedly put over 100 women at risk. Still, he was no Gaetan Dugas. He may have been criminally reckless and undoubtedly selfish, but I do not think he intended to use his HIV as a weapon of revenge the way Gaetan Dugas did. (One report says he used condoms every time.) Instead, this is an extreme example of the consequences of stigmatizing sexually transmitted infection.  Shaming people with STIs into silence puts everybody at risk.