Every December 1, we come together for World AIDS Day to reflect on HIV/AIDS and how it continues to impact our lives and communities. The HIV virus and the condition of multiple opportunistic infections, AIDS, are now a 35-year global phenomenon.
According to the Centers for Disease Control and Prevention, there are almost 45,000 new cases of HIV each year in the US. Beyond the statistics, there are numerous families, and communities forever changed by this disease—and in some ways, still haunted. Yet things are much better than they once were. There are at least 25 HIV medications on the market, and combination antiretroviral therapy has made the virus a manageable, chronic condition.
Twenty years ago, things were different. AIDS was a specter people were still beginning to understand, a death sentence for the person diagnosed. Furthermore, public knowledge was still scarce, especially in black communities.
"It was pretty frightening," says Pharoahe Monch, one-half of the duo Organized Konfusion, about the the climate of the HIV/AIDS epidemic in New York City during the mid-90s. "We were becoming aware of what it exactly was, but also there was not a lot of awareness."
That began to change with a few high-profile cases, particularly in 1995, when it became publicly known that Eazy-E, the rambunctious N.W.A. front man, had died due to AIDS-related complications. The public could finally see HIV did not discriminate based on sexual orientation, gender, class, or race. Hip-hop was starting to respond, and the following year, artists across the genre banded together to make America Is Dying Slowly, a compilation album dedicated to the issue.
Creatives, whose circles were especially hard-hit during the 80s and 90s, had written films and plays, including The Normal Heart, Angels in America, And The Band Played On, and Philadelphia. These narratives gave the disease a face in popular culture—but that face was typically a white gay man, often affluent. America Is Dying Slowly, which turns 20 this year, enlisted artists to speak about HIV/AIDS in voices that reflected young, black, urban male youth—something that Philadelphia and Longtime Companion could not achieve in the visual format.
Common, Wu-Tang Clan, Goodie Mob, Spice 1, Mobb Deep, and De La Soul had tracks touching on the HIV/AIDS epidemic. Other artists who contributed tracks included Coolio, Money Boss Players, Lost Boyz featuring Pete Rock, Eightball & MJG, and Organized Konfusion. All these respected MCs lent their talents to the 16 songs on the album, touching on safer sex practices, safer injection drug use, and getting tested.
"It seems the whole subject keeps the world within a daze" MJG of Memphis duo Eightball & MJG raps on "Listen To Me Now," a cautionary tale that personifies the HIV virus over a chorus supplied by a vocal sample from Goodie Mob's "Cell Therapy." He continues, "Well, this is the fact that some of these people be thinking they can't be fazed / Worldwide plague slowly turning into a rage / Up and down, side to side / Heterosex[uals] and gays." It was an important corrective to the vague narratives that had run rampant in the preceding years, many of which persist to this day.
In the early 1980s, a mysterious disease known as GRID (Gay-Related Immune Deficiency) showed up as isolated cases in coastal, gay communities—and then it rapidly expanded to a group known as the 4-H's (Homosexuals, Haitians, Hemophiliacs, and Heroin Users). When the epidemic first emerged, the Reagan administration did little to nothing to acknowledge it. Even those policy makers who recognized the severity of the issue and wanted to address it were stymied—for example, Surgeon General C. Everett Koop coordinated a report on AIDS, but its release was delayed by almost five years by bureaucratic dysfunction. Then, once the disease was properly identified, HIV education was disseminated through cryptic fact sheets and dull public service announcements.
Soon thereafter, activists from ACT UP and Treatment Action Group flooded the streets and the offices of the National Institutes of Health and the CDC to demand research and action. Meanwhile, countless people volunteered with the Gay Men's Health Crisis and at Harlem's Riverside Church, while stories of the disease's impact began to spread through art and popular culture.
During the 1990s, public perception of who was at risk and affected by HIV/AIDS began to change, thanks to the public disclosure by two popular, straight, black men and one black woman of their HIV diagnoses—and the public exposure of another famous straight black man's status as an AIDS victim. First, famed NBA star Magic Johnson announced his HIV-positive diagnosis and retirement from basketball in 1991. One year later, tennis great Arthur Ashe announced he was dying due to his AIDS diagnosis. Then, in 1995, political strategist Rae Lewis-Thornton disclosed her status and became the first HIV-positive black woman to tell her story for a national publication, Essence magazine. That same year, the revelation that Eazy-E's death was due to complications from AIDS rocked the rap world.
"We were becoming aware of what it exactly was, but also there was not a lot of awareness."
Around the same time, messages in black music started changing. These messages started creeping into radio-friendly songs with mass audiences that weren't necessarily part of "the 4 H's." Hip-hop was part of this shift; the early 90s saw a bevy of artists, including Ice Cube, Queen Latifah, Boogie Down Productions, and Coolio, release HIV and STD awareness songs. Even non-hip-hop-heads recall Salt-n-Pepa's "Let's Talk About Sex" and TLC's huge hit "Waterfalls" (and let's not forget Left Eye's condom eye patch). Grand Puba told listeners to take precaution on "Skinz." New Orleans MC Gregory B. (with a very young Mannie Fresh, in his pre-Cash Money days) dropped a public health advisory with "Down w/ HIV." The original B-side of Wu-Tang Clan's first 12-inch single is a story warning about HIV.
Red Hot, a New York-based nonprofit, had been working for several years on benefit albums for HIV/AIDS awareness. In 1990, the first Red Hot release was a tribute to Cole Porter's music, which boasted the participation of Sinéad O'Connor, Tom Waits, and even a duet of Debbie Harry and Iggy Pop. Six years later, Red Hot, via producers Rene McLean and Grace Harry, brought in De La Soul and Biz Markie for assistance. Up until then, Red Hot was known for enlisting mostly pop artists, not rap stars (although Neneh Cherry and the Jungle Brothers appeared on the first Red Hot HIV/AIDS awareness project, Red Hot + Blue).
"Red Hot has been trying to make to rap album for years," McLean told Vibe in August 1996. She added, "We reached out to rappers, and we'd hear, 'We're not really interested. We're a little fuzzy on the subject.'" Much of that interest changed once Eazy-E died. It served as the catalyst for mobilizing artists nationwide. Wu-Tang Clan, De La Soul, and Mobb Deep were some of the biggest hip-hop artists of the time, and their participation, along with that of well-regarded up-and-comers was significant.
"Everybody on the album is well-respected," says Pharoahe Monch. "It was an honor to be asked, one. Also, it was a privilege to be in the same conversation with these artists, as well as [address] the challenge to write the subject from a perspective that Organized Konfusion would. I remember De La being a part of it. And that's like one of my all-time favorite groups, so we jumped at the opportunity."
America Is Dying Slowly was far from the first time the hip-hop community banded together in the name of social good. Songs like "Self-Destruction," "We're All in the Same Gang," "Close The Crackhouse," "Workin' Together," and "H.E.A.L. Yourself" already proved star power could convey impactful commentary alongside a strong kick and snare drum. But it may have been the first album dedicated to the same message, and it was definitely the first hip-hop album about HIV/AIDS awareness, education, and prevention.
The music that resulted finds ways to be entertaining, musically exciting, and serious all at the same time. On the "The Yearn" by Lost Boyz featuring Pete Rock, the South Jamaica Queens quartet and the esteemed Chocolate Boy Wonder put together an upbeat party banger marrying condom advocacy and a thumping bass line. The group's Mr. Cheeks raps, "Make sure that you protect yourself / That shows that you respect yourself."
Monch remembers the recording process of his contribution, "Decisions," well: "DJ O.Gee, from D.I.T.C. fame, gave me that beat and I felt it was simple but held so much emotion in the way the chords worked. It immediately gave me the feeling of story and the feeling that I could get my point across. It was a great musical bed. It was definitely serious. It wasn't necessarily dark. I just felt like it was perfect to me. I remember coming up with the idea to metaphor the chicken, the eating scenario, the whole layout in terms of what you choose and the choices you make… Actually, it is one of my favorite verses ever. I love that verse. I listen to that song from time to time and I like the song a lot."
"Make sure that you protect yourself / That shows that you respect yourself."
For Goodie Mob's T-Mo, personal loss shaped his verse on the group's song "Blood," an extension of the interlude that appeared on the group's own album Soul Food around the same time. He noted that, for many African-Americans, the HIV/AIDS epidemic seemed to exacerbate the many difficult circumstances already faced by the community. "Part of my verse was inspired by real-life experiences and what touched me," he says. "It related to 'America is Dying Slowly,' even if it didn't relate to AIDS, per se. It just felt like we were losing a lot of good people out here from more than just AIDS. A lot of violence was going on in our community."
By today's standards, some of the album's lyrical content is problematic for its conspiratorial nature, misogyny, slut-shaming, and stigma. And even when the album was first released, these issues were pointed out by writer dream hampton in a POZ Magazine editorial, "AIDS Gets a Bad Rap." The song "(Stay Away From The) Nasty Hoes," for example, has certainly not earned any kudos for male feminist allyship.
Nevertheless, the project marks a stark moment in bridging hip-hop and public health, especially in terms of HIV issues. It serves as a time capsule juxtaposed between the first 15 years of AIDS hysteria and the following two decades of medical, social, and political advances. This period was a watershed moment in the fight against HIV/AIDS. Even while the AIDS Memorial Quilt was sprawled across the National Mall in DC, there was something in the works shifting this death sentence paradigm: combination antiretroviral therapy.
It's been two decades since America Is Dying Slowly was released by Elektra Records and almost a generation since Magic Johnson's HIV disclosure. Then and today, African-Americans are disproportionately affected by HIV. African-Americans comprise approximately 44 percent of all new cases. Racism, unequal access to health resources, homophobia, and stigma all contribute to the ongoing crisis in the black community. Sadly, the misconceptions from the first years of HIV/AIDS hysteria still persist.
For that reason, America Is Dying Slowly is an example culture can look to emulate. It was pivotal, remarkable for its use of peer-to-peer advice from urban artists to urban youth in an effort to save lives. Although it was never certified gold or platinum—indeed, it was outsold by Red Hot + Rio, Red Hot's next installment from the same year utilizing Brazilian bossa nova—its message still resonates, as does its significance as a moment when the hip-hop community served as public health ambassadors in informing their constituencies. And in that realm there's still education to be done, T-Mo urges.
"Practice abstinence if you're not married," he says. "Practice safe sex if you just gotta do it. Definitely wear a condom. AIDS is still out here real heavily, and it's affecting the black community much more than it's affecting any other community due to ignorance and uneducated people… I'm going to put a good message out there—something I want somebody to tell my daughters and my sons… I want my people to educate themselves and be careful out here."
Stephen Hicks is an HIV/sexual health educator. Follow him on Twitter.