On World AIDS Day 2023, with a photomontage depicting some of the many loved ones she has lost to the epidemic as a backdrop, Madonna cried onstage at Amsterdam’s Ziggo Dome during a rendition of the hit midtempo ballad “Live to Tell.” The first photo shown was of the artist Martin Burgoyne, who managed Madonna’s first tour and whose friendship predated her fame. Another was of her first dance teacher, Christopher Flynn, who died of an AIDS-related illness in 1990.

But among those pictured were also individuals Madonna did not know personally—the tour included images offered up by the families and friends of those who had died. The photos were provided with assistance from the Instagram account @theAIDSmemorial.

“I would have cut off my arms if I could’ve found a cure for them to live,” she told the audience at this stop of the European leg of Celebration, her 12th concert tour, which also serves as a career retrospective and living autobiography.

Madonna’s friend Martin Burgoyne

Madonna’s friend Martin Burgoyne@theaidsmemorial

The moment occurred early in the show, reminding the audience that Madonna’s career and AIDS share a similar timeline. “I watched so many people die—male and female, children, straight, gay,” she continued. “It was a devastating time for me.” 

Indeed, when Madonna signed her first record contract, HIV was floating, undetected, in many of the spaces she frequented. The illness we now know as AIDS was discovered in June 1981 when the Centers for Disease Control and Prevention (CDC) first identified a cluster of gay men experiencing pneumocystis pneumonia.

The CDC wouldn’t use the term “AIDS” for another 18 months, on September 24, 1982, just 12 days before Madonna released her first single, “Everybody,” which the singer performs on the Celebration tour. It’s the first time she’s included the song on a tour since The Girlie Show three decades ago.

Featuring a living memorial to people who died of AIDS in the middle of a show titled Celebration underlines the fact that even the bounciest, danciest of Madonna’s pop oeuvre has been shaped and influenced by the epidemic. Although most people might read Madonna as a bubblegum pop queen, loss is an essential part of the Material Girl’s ethos, according to Mark Snyder, cohost of the podcast All I Wanna Do Is Talk About Madonna.

Her entire discography is informed by loss. Those who have seen her landmark film Truth or Dare know that the death of her mother when the singer was just 5 years old affected her deeply, as did the AIDS epidemic and its attendant losses. “That was kind of the first wave of loss after her childhood loss,” he says. “And that’s colored everything she’s ever done since.” Similarly, Snyder’s cohost, Kenny Finkle, says, “The death of her mother and the impact of AIDS on her life are the two defining events of her life. It’s in the thread of who she is. It’s not something she’s doing like, ‘Oh, I have to do my service.’”

Madonna A Rebel LIfe book cover

The cover of the Madonna biography

More than simply nodding to AIDS as a part of her own life, Madonna seems to be pleading that her life and career be seen through the lens of AIDS. Mary Gabriel’s recent biography of the Material Girl, Madonna: A Rebel Life, includes an extensive index entry for AIDS. An AIDS activist who recently formed a book club for the 900-page tome described the book as a de facto cultural history of the epidemic.

In an early chapter set in 1987, Madonna returns to New York City on her Who’s That Girl world tour in support of her third album, True Blue, to find the city transformed by AIDS, Gabriel notes. Andy Warhol is dead, influential queer clubs Danceteria and Funhouse are closed and the dance floor at Paradise Garage is “decimated by AIDS,” Gabriel writes.

Madonna responds by making her Madison Square Garden concert the first large-scale AIDS fundraiser put on by a major American pop star. “Madonna wasn’t afraid” of potential backlash for associating herself with AIDS, Gabriel writes. “She thought it was her duty.”

To finish the chapter, the reader must first thumb through several glossy pages featuring photos of a young Material Girl—including pictures of her as a cheerleader—placing her early history right in the middle of a chapter about AIDS, as if to announce that AIDS is as formative to her as her home state of Michigan or her high school education.

Given the centrality of AIDS to Madonna’s career, it’s fitting that her current retrospective tour commemorates the epidemic. During her performance of “Live to Tell,” the appearance of the faces of people who died of AIDS visibly affects not only the singer but also the fans in the audience.

AIDS information insert in the Like a Prayer CD

AIDS information insert in the Like a Prayer CD

The first images include people Madonna knew personally. These mammoth portraits unfurl from the concert’s ceiling and often directly above the audience. The photos then subdivide and proliferate until hundreds of faces share the space as Madonna is transported through the air in a metallic cage, as if communing in the heavens directly with those lost to the virus. The ethereal number illustrates how AIDS has touched both her and her fans—personally, politically and culturally.

Even Matthew Hodson—who has been working in HIV for 25 years, is living with the virus and is the executive director of aidsmap, a U.K.–based AIDS information charity—was touched when he attended the opening night of the tour in London. Hodson has spoken extensively about both HIV and Madonna; in fact, he contributed interviews to Gabriel’s book and is listed in the index.

image for proposed Madonna jukebox musical

Image for proposed Madonna jukebox musical

Hodson experienced the “Live to Tell” moment without any prior knowledge that it would happen. “It was a very sincere, very heartfelt and very appropriate tribute, not only to the people that she personally lost but the whole communities of people taken from us,” he says.

One of the faces onstage is that of a woman named Debbie, the mother of Crystal Gamet, who was unsure at first whether she should submit her mother’s photograph but ended up feeling “really grateful” that concertgoers saw her mother and celebrated her. “It felt strange to see her in this setting that was so far removed from anything she’d ever done,” Gamet says.

Gamet doesn’t know whether her mom was a Madonna fan. And although she hesitated when the director of the AIDS Memorial asked her to participate, she is glad she did. “My mom kept the biggest secret for 17 years from the moment she was diagnosed until right before she died,” she says. “She’d be very into it. I’m sure of it. She would love it. She would be bragging.”

Gamet has received messages from people an ocean away who have seen her mom’s portrait. “Part of my healing is always the sharing,” she says. “I’ve kept this a secret for all these years. At first for both of us but eventually just for [her]. For me, I don’t want to keep it a secret anymore.”

Forcing uncomfortable conversations about AIDS and sexuality is par for the course for the superstar, whose embrace of her sexuality has always been political. In 1991, while speaking at an amfAR gala, Madonna responded to the rumor that she was HIV positive herself, a speculation fueled by her forthright attitude toward sex and outspokenness about the virus.

“What if I were? I would be more afraid of how society would treat me for having the disease than the disease itself,” she told guests that evening. She would go on to embrace sexual taboos with her charged 1992 album, Erotica, which included songs dedicated to those lost to AIDS during some of the bleakest days of the epidemic.

“So many people used AIDS as an excuse to be moralistic or judgmental about people’s sex lives,” Hodson says, praising Madonna’s unceasing sex positivity, even as other stars endorsed an abstinence message. “She was like, ‘I’m not going to put it away. Sex is good.’”

Madonna’s own knowledge of AIDS and the incorporation of the disease into her work, particularly her tour stagecraft, has evolved alongside the epidemic. During her 2006 Confessions tour in support of her album Confessions on a Dancefloor, Madonna sang “Live to Tell” while a clock tolling the deaths of people with AIDS in Africa ticked above her.

It was during rehearsals for that tour that Madonna first visited Malawi, after admitting that she knew nothing about the country or its specific epidemic. Rather than shy away from learning about AIDS in Africa, she became an adroit student of the topic.

The small country, which at the time had some of the world’s highest infant and maternal mortality rates as well as poverty rates, was the ninth most affected by AIDS globally, with one out of every 12 people testing HIV positive.

When Madonna visited Malawi, according to Gabriel’s book, she saw children orphaned by AIDS, and she held sick babies who, at 1 year old, weighed as little as three pounds. “It was like history repeating itself,” she said of her visit, alluding to New York in the early 1980s. Gabriel points out that for Madonna, the orphans spoke to her as a daughter who lost a parent and the children spoke to her as a young person who had lost friends as well as a mother.

What separates Madonna’s activism from that of many other performers is that it is intertwined with her artistry. As is clear from her Confessions tour, her 1980s tours and her most recent one, she wants her audience to think of her music and AIDS as coexisting in the same sphere of conversation.

The AIDS Memorial art work


Celebration kicked off later than expected because the singer was battling a bacterial infection, but had the tour started when planned, it would’ve been one of two summer stadium tours from some of the biggest names in popular music to have featured a nod to the role that AIDS has played in culture over the past 20 years.

During her Renaissance tour, Beyoncé discussed her uncle Johnny, whom she has previously acknowledged died of AIDS in the early days of her career. In fact, the final image shown on the jumbo screens as fans left her shows is a several-stories-tall rendering of Johnny with his sister Tina, Beyoncé’s mother.

As their own type of retrospectives, Renaissance the album and Madonna’s Celebration tour fulfill similar cultural and critical roles. But Renaissance is also an album built around the idea of archiving queer history, specifically the house music created and popularized by Black and brown queer people, populations hard hit by HIV. Thus, Beyoncé asks us to understand her discography through the lens of AIDS. So, too, does Madonna, albeit more directly.

Of course, Madonna has not been the only one to make that connection. Brian Mullin, a U.K.-based playwright, turned his experience living with HIV into a theatrical production—titled Live to Tell, naturally—that is both a jukebox musical and a manifesto about living with AIDS in modern times.

While most AIDS narratives are marked by Greek-style drama and conflict befitting the early days of the AIDS epidemic, Mullin asks us to consider life with HIV today, including everything from taking daily pills to living with an illness still mired in stigma. Mullin uses Madonna as a metaphor throughout. He admits that the metaphor is “not the most charitable,” but it is a useful one. Madonna, like HIV, posits Mullin, adapts, mutates and, most of all, survives.

“I use Madonna as a symbol of constant adaptability,” he says. Brian, the character in the show based on the real-life Mullin, aches to adapt and evolve and, to paraphrase Madonna in the song “Music,” not think of yesterday, look at the clock and boogie-woogie. “It’s the idea that there’s a past experience that you had that you can put aside. You can reinvent yourself with each new iteration, each new album,” says Mullin.

Live to Tell the musical ends with Madonna speaking to Brian as the voice of God, telling him that his obsession with Madonna is misplaced. Instead, God/Madonna says he should be obsessed with himself, including taking care of himself, acknowledging what’s happened in the past and moving into the future.

In a way, that sums up the moment when Madonna cried onstage on World AIDS Day in Amsterdam. Even at 65, she is still looking toward the future while acknowledging the past and the virus that continues to shape not only her own life but also the world we all inhabit.

Read "Living for Love," Mathew Rodriguez’s essay on seeing Madonna live in concert at Madison Square Garden in New York City in January 2024.