Abstract
Mississippi is ranked sixth in the nation in the number of HIV/AIDS cases, and the City of Jackson, ranks 4th highest in the rate of new HIV infections in the nation. A review of the literature and personal communications with health providers reveals that public health policy, stigma, cost, and distrust of the healthcare system, are significant barriers to managing the spread of HIV. Education of elected officials and the general public as well as policy advocacy are desperately needed to curb the rising HIV epidemic in Mississippi.
Highlights
Mississippi’s HIV infection rates are among the highest in the country, and the capital City of Jackson has the fourth highest rate of new infections in the country and the highest rate in the country among young black men who have sex with men [1]
While HIV medications are provided to many patients through Ryan White funding, Mississippi receives less than states with lower infection rates, because the formula used for the disbursement of Ryan White funds is based on the total number of HIV infections instead of the number of new infections [9]
The formula does not take into account factors such as rural areas that lack medical providers or the cost of transportation for individuals living in rural areas to travel to medical providers in other areas [10]
Summary
Mississippi’s HIV infection rates are among the highest in the country, and the capital City of Jackson has the fourth highest rate of new infections in the country and the highest rate in the country among young black men who have sex with men [1]. The formula does not take into account factors such as rural areas that lack medical providers or the cost of transportation for individuals living in rural areas to travel to medical providers in other areas [10] These policies are the result of widespread and deeply held conservative religious and cultural beliefs and practices that include the condemnation of HIV and homosexuality. Poverty combined with the challenges of rural life (i.e., distance to services and lack of transportation), stigma, and oppressive practices creates serious barriers in the efforts to curb HIV infection. In this environment with HIV infection rates so high and access to services so scarce, PrEP would seem to be the key to reversing the trend. While care management techniques have proven effective in improving patient compliance in other areas [17], people using PrEP are not ill, and typical care management practices do not apply
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