On World AIDS Day, some in Mississippi say barriers to care remain

In 2020, Mississippi had the fifth-highest rate of HIV diagnoses in the United States at 16.2 percent, more than 5 percent above the national average. 

Public health efforts to both remove stigma and increase treatment accessibility have reached a national level over the last few decades. With that, developments in medical therapy and prevention have given many who are diagnosed with the disease hope of living a fuller life. 

But the fruits of those programs have yet to gain traction in certain regions of the country, says Dr. Ben Brock, associate professor of medicine at the University of Mississippi Medical Center and a specialist in infectious diseases.

“The problem with rural America and places like Mississippi is that we did not enjoy the benefits of that therapy compared to more urban areas and affluent places,” he said. “We continue to have among the worst rates in the United States for HIV-related deaths or new HIV cases even today. It doesn’t have to happen.” 

The CDC estimates roughly 13 percent of the country's population infected with AIDS aren't aware -- an occurrence many owe to healthcare impediments. 

Brock says when those large-scale public health efforts to combat AIDS began, large disparities emerged where certain communities -- such as residents of the southeast, racial and ethnic minorities or those living in poverty -- did not enjoy the benefits when compared to affluent, white residents of large urban areas.

In Mississippi, with the nation’s highest poverty rate and more than 16% of its residents without health insurance, much of those disparities are owed to income and access to medical transportation, among others. 

“Stigma is still pervasive – people with HIV and sexual and gender minorities like gay men and transgender women may be doubly stigmatized if they’re HIV positive,” said Brock. “Medical transportation is a need, because if you have a 1 hour to 90-minute commute to your nearest HIV clinic, because there aren’t many of them, that may be prohibitively expensive.” 

“And then there’s the hierarchy of needs – if you have somebody who’s experiencing food insecurity, housing instability, childcare needs or other huge financial needs, long-term health is a way lower priority. So if you’re not taking care of those needs, you’re not going to have people effectively taking care of their chronic illnesses.” 

There were more than 30,000 new diagnoses of HIV in the United States in 2021, according to the CDC.