30 years after Magic’s diagnosis, a look at the intersection of hip-hop and the HIV/AIDS pandemic

Were hip-hop lyrics influenced by Johnson, Eazy-E’s death and the arrival of the lifesaving drug cocktail?

When I teach college students about epidemics, I focus on the basic principles underlying how outbreaks happen. Recently, I taught a course where we discussed three large pandemics: COVID-19, the 1918 “Spanish flu” and HIV/AIDS. Surprisingly, HIV/AIDS can be the most difficult of the three to teach. Many of my students came of age in the 2000s and 2010s when HIV no longer generated the same fear that it once did. Because of this, my challenge is to remind them just how real that pandemic was — and in many ways, remains.

One of the most impactful moments in my own understanding of HIV/AIDS came 30 years ago, on Nov. 7, 1991, when Earvin “Magic” Johnson announced his retirement from the NBA after testing positive for HIV.

I was in middle school at the time, and saw myself in the athletes that I watched and the hip-hop artists that I listened to. 1991 was one of the best years in hip-hop history (second only to 1994, in my opinion), with De La Soul’s De La Soul is Dead, A Tribe Called Quest’s The Low End Theory and many others shaping the soundtrack of my year. And so Johnson’s announcement came at a critical time in my development, and forever changed my worldview. I wasn’t alone.

Hip-hop was born in New York City during the 1970s but began its rise to global status around the same time that HIV/AIDS was emerging into public consciousness. Just two years before the first diagnosed cases of AIDS, 40 years ago (1981), the first hit hip-hop song was released by the Sugarhill Gang, “Rapper’s Delight.”

While one may not naturally link hip-hop to the HIV/AIDS pandemic, the two are connected in many ways. While much-needed conversations about discrimination in the LGBTQ community would define the HIV/AIDS conversation in the 1980s, the effect of the pandemic in Black and brown communities (not mutually exclusive to the discussion of LGBTQ discrimination) emerged as a major conversation point during the 1990s.

Given this, one can ask: Is there a signature for the effect of the HIV/AIDS pandemic in hip-hop culture? We might believe that Johnson’s announcement was an influential moment, but how can we be sure? Is there a way to quantify its impact?

Even though HIV is one of the most well-studied diseases in the history of medicine, details of how its public perception changed are difficult to fully grasp, especially in some demographics. For example, postadolescents tend to not participate in surveys as readily, often aren’t plugged into institutions where they can be reached, and participate in cultural practices that change quickly, making it tough to know how they truly feel at any given moment. But going back to the 1991 version of myself, my dual obsessions with sports and music can help.

The age of big data may offer us a pathway. In 2012, the website Genius (formerly Rap Genius) released a word usage tool called “Rap Stats” that allowed users to track word usage patterns in hip-hop songs. That is, one can calculate how frequently a word was used compared with all other words in a given year. One can make similar calculations with books using the Google Books Ngram Viewer tool.

One starting point for interpreting the influence of the HIV/AIDS pandemic is to examine the usage of the words “HIV” and “AIDS.” In books, we observe that the lines cross right around 1999. That is, before 1999, “AIDS” appeared in books more frequently than “HIV.” This is important to note, because it reflects a larger societal understanding of the problem — for many years, “AIDS” was used to describe everything about the disease, even the virus itself (authors would say “AIDS virus” instead of “HIV”). It took many years for this common understanding to manifest in the word usage of books.

But hip-hop lyrics are different. For one, hip-hop lyrics are defined by rhyming constraints. That is, how frequently a word is used is driven by how easy it is to rhyme as much as its cultural relevance. With this in mind, we can analyze usage patterns between “HIV” and “AIDS” in hip-hop and speculate on what that says about the shape of the pandemic and its interaction with the communities that created hip-hop.

For one, from 1988 onward, the usage of “AIDS” is greater than that of “HIV” for the entire period that we analyzed. This likely reflects the fact that “AIDS” is easier to find a rhyming partner with than “HIV.” But it also may partly reflect how public understanding about the differences between “HIV” and “AIDS” were less prevalent in the demographic that writes lyrics (typically teenagers and 20-somethings in hip-hop) relative to those who write books (an analysis of bestsellers suggested an average age of around 48). For instance, Keith Murray rapped, “I spread love like the AIDS virus” on Mary J. Blige’s “Be Happy (Bad Boy Butter Mix)” in 1994.

But even after acknowledging that the usage of “AIDS” has always been higher than “HIV,” some interesting dynamics emerge.

Rapper Eazy-E performs at the Regal Theater in Chicago in November 1992.

Raymond Boyd/Getty Images

One way to analyze how patterns have changed is to highlight notable moments in the HIV/AIDS pandemic history. The ones that I have highlighted are Johnson’s announcement in 1991, the death of artist Eric “Eazy-E” Wright in 1995, the standardization of highly active antiretroviral therapy, or HAART (commonly referred to as the “drug cocktail,” a triumph in the treatment of HIV), and, in 2003, President George W. Bush’s creation of the United States President’s Emergency Plan for AIDS Relief (PEPFAR), which sharply increased funding for treatment and research abroad, especially in sub-Saharan Africa. Each signifies a different moment in our interaction with the HIV/AIDS pandemic, and are markers of attitudes, perspectives and policies.

For instance, while usage of “AIDS” in rap lyrics has always been higher than “HIV,” there are moments when the gap between them shrank. In 1993, the gap between the two narrowed to the closest it ever would be, with the “HIV” usage about 55% of the “AIDS” usage. One can speculate that Johnson’s announcement made a difference. This narrow gap would reverse course shortly thereafter, however, and would grow to a large gap (“HIV” only 17% of “AIDS”) in 1998. That is, hip-hop lyricists were more aware of HIV/AIDS than ever before, even if they were using the term “AIDS” far more than “HIV.” For example, The Lost Boyz endorsed the use of condoms on “The Yearn” in 1996:

No man know he play he the f—in’ game

But AIDS ain’t got no f—in’ name

All you chancy n—as that’s playin’ cute

Don’t jump, without a parachute

Eazy-E was unquestionably the most visible hip-hop artist to die due to complications associated with AIDS. That Wright was the former leader of N.W.A. and famously vocal about sex and violence in his music, led to a complicated response from the hip-hop community. His death came as “AIDS” was already near an all-time high in hip-hop lyrics, suggesting that Wright’s experience was reflective of the experience of a great number of Black people. And the public health data would bear that out. Just two years before Wright’s death, data from the federal Centers for Disease Control and Prevention reported that in November 1993, HIV infections became the leading cause of death for African American men ages 25 to 44, and the second-leading cause of death for African American women in the same age range. The disproportionate burden on the Black community remains a signature of the HIV/AIDS pandemic in the United States, even today.

While Wright’s death didn’t seem to leave a lasting statistical signature of an example of how “HIV” or “AIDS” were used, his death did influence the culture in other ways, best summarized in the 1996 compilation America is Dying Slowly, which featured artists ranging from Common to Wu-Tang Clan, 8Ball & MJG and many others. Biz Markie, on “No Rubber, No Backstage Pass,” dropped this bar:

And me, I don’t want to catch no HIV

So we’ll protect you, and me but mainly me

If you don’t want no rubber then P-E-A-C-E

Notably, this compilation came out just as HAART therapy would transform the treatment of HIV. This late 1990s era would typify a point when society started to see the disease as potentially defeatable. 

The elephants in the room of discussions about how hip-hop interacted with the HIV/AIDS pandemic are anti-gay bias and misogyny. While hardly specific to hip-hop, they have long been two of the genre’s most lamentable features. Most recently, this came up in DaBaby’s references to AIDS and homosexuality during a 2021 concert, demonstrating the long reach of anti-gay bias in hip-hop. In general, usages of “HIV” and “AIDS” in lyrics range in tone and context, from storytelling contexts, political, bigoted and other instances that are more challenging to characterize. And some of the patterns that we observe might also be reflected in how bigoted terms are used to describe individuals in the LGBTQ community. This is a topic that warrants its own study, but is almost certainly a factor in how “HIV” and “AIDS” manifested in hip-hop lyrics.

What about the more modern picture? Since about 1999, the usage of “AIDS” has declined significantly, with the 2014 value only one-third of the 1999 value. This time frame contained two different trends:

  1. A shift in the American perspective on HIV/AIDS, as improved drug treatments, activism and policy began to have a meaningful effect on the American face of the pandemic. During this time, HIV/AIDS slowly began to decrease in usage in both hip-hop lyrics and in books.
  2. In the 1990s, the serious consequences of the HIV/AIDS pandemic around the world, and especially in Africa, came into focus. This coincided with the emergence of a new health and human rights movement that involved bodies such as the World Health Organization and UNAIDS. It was this movement that led to the creation of PEPFAR in 2003. (Aspects of PEPFAR were contested because of an early element that promoted abstinence as a public health intervention, a strategy for which there was little supportive data.)

The change in perspective is reflected in Kanye West’s “Roses” from 2005:

You know the best medicine go to people that’s paid

If Magic Johnson got a cure for AIDS

And all the broke motherf—ers passed away

You telling me if my grandma’s in the NBA

Right now, she’d be OK?

As the 2010s rolled around, however, HIV/AIDS fell down lists of global priorities. Drug cocktails and the emergence of preexposure prophylaxis (PrEP, a drug cocktail that prevents HIV infection, largely in men who have sex with men) have led to meaningful decreases in HIV infection overall in the United States (down 18% from 2008 to 2014; an additional 8% from 2015 to 2019). Much of this decline had to do with notable decreases in infection rates among men who have sex with men. But not all demographics saw the same proportional decrease. Black people were still infected at a rate eight times that of white people, and Latino individuals’ rates were four times as high as that of white people. Much of the discrepancy can be attributed to a lack of access to preventive care, including PrEP.

The signature of this new status of HIV/AIDS in hip-hop can be observed by low usage numbers in songs. In 2014, uses of “HIV” and “AIDS” were at some of the lowest numbers ever. 

As we mark the 40th anniversary of the first reported cases of AIDS, and the 30th anniversary of Johnson’s announcement, we are chest-deep in another pandemic. While the viral causes of these pandemics — HIV and SARS-CoV-2 — are completely different, we find ourselves at a similar point where culture is responding to a worldwide scourge. And not unlike HIV, health care disparities, conspiracy and misinformation have defined the American experience of the coronavirus pandemic. How hip-hop will respond remains to be seen. But we can hope that the music, and the community it represents, might become part of the solution.

Liner Notes

The data comes from’s Rap Stats. The website’s data appears to no longer be online, and the last dataset that was scrubbed was from 2014. This was more than enough data to comment on the earlier phases of the pandemic, which was the focus of this article. For questions about the data, contact the author via Twitter or Instagram: @big_data_kane

The author would like to thank Nelson K. Bennett, Nkemelue Candice and Michael King for feedback and support.

C. Brandon Ogbunu, a New York City native, is a computational biologist at Yale University. His popular writing takes place at the intersection between sports, data science, and culture.