For many years it was believed Gaetan Dugas was the man whom HIV originated with in the U.S. Being a flight attendant for Air Canada and one of the earliest high-profile gay men to die of the virus he seemed like a likely candidate…as suggested by some back in the early 1980s.

The media ran with this idea calling him “patient zero” and Robert Shilt’s 1987 book on the AIDS crisis titled “And the Band Played On” further implicated Dugas. 

In the late 1980s Doctors and scientists were still struggling to understand the disease and how it operated and most of all where it came from. By complete coincidence around the same time as Shilts’ book’s release some doctors studying the AIDS virus were recalling an incident that happened nearly 20 years before in 1969.

In 1968 a 15-year-old African-American boy named Robert (Bobby) Rayford admitted himself into a St. Louis, MI area clinic with some rather unusual symptoms. His genitals, pelvic region, and lymph nodes were swollen. He had warts, sores, and lesions all over his body. After spending a short amount of time in the clinic he grew weaker, began to look pale and had trouble breathing. Doctors initially believed he had lymphedema but became more alarmed when he claimed these symptoms have come and gone since 1966. 

Further testing revealed he had chlamydia, herpes, and genital warts that had spread all over his body. Rayford refused to allow the doctors to perform a rectal examination. When asked about his sexual history Rayford became very shy and withdrawn. He would only admit to having had sex once with a neighborhood girl.

Still...doctors believed him to be highly promiscuous and the idea of homosexuality was never something that occurred to doctors at the time to even ask about. They tried everything they could think of to slow his declining health, but nothing seemed to stop it. A beacon of hope came in early 1969 when after giving him strong antibiotics his condition briefly improved.

By spring of 1969 his condition declined again. His white blood cell count was almost nonexistent and doctors found his immune system to be simply nonfunctioning. He was so weak one of his doctors said he could barely say the words “boo” and shortly thereafter he developed a fever that turned into pneumonia which killed him at 11:20 p.m. on May 15, 1969, just one month before the Stonewall Riots.

His autopsy did nothing to help solve the mystery. In fact, it further puzzled doctors when they learned that the lesions on his body were Kaposi Sarcoma, then only known as a rare form of skin cancer that often only affected older Mediterranean men. With no idea what was wrong with Rayford doctors froze his blood, brain, and organ tissue for preservation at a University of Arizona lab for further study in the future. His case was only professionally published once in the university's Journal of Lymphology in 1973.

By 1987 Rayford’s case was long forgotten about but a few doctors who once worked on Rayford's case were now investigating the AIDS crisis and one recalled his symptoms back then and pressed to locate Rayford's preserved tissue samples and blood for further testing against the information they now knew about HIV. A most sophisticated and sensitive test was performed on his tissue samples and it came back solid with nine HIV proteins in Rayford's blood. There was now no doubt that Rayford was suffering from the effects of AIDS in his final days.

While it was a relief to have finally solved that mystery, all it did was open up another one. It was now proven with Rayford's case that HIV was certainly in the U.S. well before the late 1970s as previously hypothesized. There were so many unanswered questions...how did Rayford get it? Where did that person get it? Where did they come from?

Little is known about Rayford's life prior to this incident. He was described in the 1973 "Lymphology" journal article as being “mildly retarded.” Rayford was likely living on the streets and doctors at the time had suspected he had been sexually abused, but with more known about the gay community in the late 1980s it was now recognized he most definitely could have been a male prostitute. In the late 1960s homosexually was heavily condemned which would explain Rayford's unwillingness to talk much about his sexual activity with doctors or the fact that he did not allow them to examine his rectum. 

So why didn't this disease spread quickly at the time in St. Louis? Doctors believed that because St. Louis was a hub for Trans World Airlines it was likely someone who entered the city through that connection that brought it to the area in the first place. But, because there was a very small gay population, if really at all, at the time there was no major vehicle for the disease to continue to spread quickly. It's very possible that there were other AIDS cases in the area at the time, but because the disease hides so well doctors simply saw these individuals as dying of other causes, such as pneumonia, which was not uncommon. Rayford's case was only different because he was a minor and had so many things wrong with him that were unusual for someone his age. 

Still, there is no solid proof any of the above was how Rayford got the disease. There are other theories. There are accounts that Rayford had claimed to doctors that his grandfather, Percy Rayford, had suffered similar symptoms and died in his early 50s in 1966. Researchers had tossed around the idea that perhaps Rayford was born with the disease, but Rayford did have two siblings who lived full lives and his mother lived to be 80. 

Edward Hooper's book "The River" even theorizes he might have gotten it from open-air chemical tests done by the Army Chemical Corps in the 1950s in the area of St. Louis that Rayford lived. This book, however, has been heavily criticized since its publication in 1999 and that scenario seems unlikely.

In all likeliness the most widely accepted theory is that Rayford likely contracted the disease through prostitution. The mystery is just where and from whom. Today further tests could be done to his tissue and blood to study the strain of HIV he had which might reveal more information, but his samples have since disappeared after the initial 1987 discovery. Other than pictures in the 1973 journal article of his swollen body parts, no photographs of him have ever surfaced.

Despite the importance of his story, it is relatively completely forgotten today. Rayford's memory should be remembered though as one of first certain victims to suffer from this horrid disease...not only in the context of the disease but because he suffered from it when nobody could understand what it was or what to do about it and, as only a teenage boy, that must have been terrifying.

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