This past February, Grammy-winning rapper Common announced his “A Minute” contest, which invited young people ages 13 to 25 to create lyrics expressing the importance of getting an HIV test. Common told MTV, “I had an uncle who passed away from AIDS. We need to raise awareness and take control of our lives.”

Such initiatives are not uncommon for major players in the hip-hop game: Ludacris, Lil’ Wayne, Eve, Missy Elliot and even urban model Melyssa Ford have played spokesperson, raised money and joined panel discussions about the exploding epidemic among black youth. If bling can find its way into Webster’s dictionary, then imagine how effective hip-hop stars can be at promoting AIDS awareness. But to some prevention experts, the campaigns pose a troubling question: How can teens take these calls for condoms and self-empowerment seriously when so much of popular hip-hop peddles the opposite message?

Consider Fat Joe and Lil’ Wayne’s video “Make It Rain”: Hundred-dollar bills are thrown on half-naked women gyrating on cars while Lil’ Wayne says, “Got a handful of stacks, you better grab an umbrella…I make it rain on these hos.” With the exceptions of Common, Kanye West, Talib Kweli and Lupe Fiasco, among a few others, hip-hop artists tend to favor imagery flooded with scantily dressed video vixens and hypermasculine thugs or dope boys spitting rhymes about hustling, violence and sex.

Studies show that children who listen to degrading lyrics and see disparaging images are more likely to have riskier sex. But many hip-hop artists defend their art as mere entertainment. And they aren’t the only ones who push—or benefit financially from—the music. “If [networks] or the heads of these record labels really had a problem with the message, the records and the videos would never get made,” says Kwamé Holland, a producer and former rap artist who has worked with Will Smith and Mary J. Blige. Holland adds, “Back in the day, hip-hop wasn’t like this. You could have a record that wasn’t full of curse words. Once people saw that money could be made from the negative, standards changed.”

So if hip-hop, like the rest of the media industry, is truly about the “Benjamins,” is using it for HIV prevention a useless contradiction? Many working in public health and advocacy think it may be the only way to tap into the teen psyche. “Older people just see the negative,” says University of Chicago professor Bakari Kitwana, author of The Hip Hop Generation: Young Blacks and the Crisis in African-American Culture. “Hip-hop is not just what you see on television; it is a generational and global phenomenon that was born out of a climate where young black people were treated like outcasts from certain factors such as welfare and a rise in incarceration. The music is just an expression of that thrust. To not use it would mean we were missing out on the big picture,” Kitwana says.

HipHop4Life, founded by Tamekia Flowers in 2003, uses the culture and its celebrities to address issues teens face. “They are dealing with so much from poverty, sexual abuse, low self-esteem, drugs, you name it,” Flowers says. “We want to use hip-hop to help them and to let them know that what they see on television is not real.”

Carla Stokes, PhD, agrees. In 2001, she created HOTGIRLS, an organization that uses workshop discussions to analyze media images, fight street harassment and promote comprehensive sex ed. Teens in the program rewrite popular songs with more positive lyrics. “Too many programs are designed by adults who are not engaged with young people on a regular basis,” Stokes says.

But hip-hop isn’t the only cultural force influencing black youth. And even without the music, racism, poverty, homophobia and sexism would continue to fuel AIDS in black America. But that doesn’t give the industry a pass. “A lot of artists out there preach positivity, but they’re not well known or are on an independent label,” Holland says. “Young people are getting tired of the ‘shuckin’ and jiving’ artists. Maybe this is why hip-hop sales are down. Hopefully, there will be a shift.” Word.