Born and grown up in Davenport, Iowa, his parents were Methodist and political conservative. He was educated at the University of Oregon with majors in English and journalism. In 1975 he became the North-West correspondent for the gay publication Advocate. Shortly afterwards he was appointed a staff writer for the Advocate based in San Francisco: he resigned in 1978 following differences with his editor.

Shilts then worked as a professional writer for the San Francisco Chronicle, where he became the first openly gay journalist in the country to work at a major newspaper. The financial freedom generated by this job allowed him to embark on a career as a freelance writer on gay and lesbian issues for a number of major newspapers and magazines.

His first book, The Mayor of Castro Street: The Life and Times of Harvey Milk (1982), received critical acclaim in both mainstream nad gay oress in the US. Shilts also chronicled the early years of the AIDS epidemic, in the book And the Band Played On: Politics, People, and the AIDS Epidemic a completely detailed account of the beginning of the AIDSs Crisis in the 1980s.

Silts' final book, Conduct Unbecoming: Lesbians and Gays in the U.S. Military (1993), was another fine exemple of investigative journalism chronicling the place of homosexuals in the US military and the selective enforcement of its ban on homosexuality.

Shilts found out that he was HIV-positive in 1986. He participated in a commitment ceremony with his lover, Barry Barbieri, in 1993. By 1992 Shilts had developed ull-blown AIDS, from which he died.