RIGHT AFTER STONEWALL. THAT WAS BAD TIMING. HIV Arrived In The United States In 1971, Long Before The So-Called “Patient Zero.”

Although Mr. Shilts did not accuse Mr. Dugas of starting the American epidemic, he demonized him as a deliberate spreader of the virus who ignored a doctor’s demand that he stop having unprotected sex, and coldbloodedly told some sex partners that he had “gay cancer” and now they might get it.

Back in 1984, the term Patient Zero was not normally used to describe an outbreak’s first case, said Dr. Jaffe, a co-author of the new Nature paper. “I don’t remember who first used it,” he said. “But after Randy Shilts did, we started saying it ourselves.”

Later, he said, when reporters asked if Mr. Dugas had brought AIDS to North America, “We said no, that he wasn’t the first. But I think they went with it anyway. The idea of Patient Zero was very attractive. Letter O would not be a story.”

Richard A. McKay, a Cambridge historian and another co-author of the Nature paper, has long fought for Mr. Dugas’s reputation, saying his friends in Vancouver’s gay community had painted a sympathetic portrait of him for Mr. Shilts, who ignored it.

Journalism.