March 9, 2011

VII. Conclusion

HIV and Human Rights in Mississippi: An Environment of Risk

Factors that contribute to HIV risk in Mississippi. © 2011 Human Rights Watch

In Mississippi, harsh socio-economic conditions place people at high risk of acquiring HIV and make it difficult to access adequate treatment and support. Yet instead of promoting policies that might ameliorate these conditions, Mississippi‘s response ranges from inadequate support to actively opposing interventions that could make a difference to the health and lives of its residents. Mississippi relies almost exclusively on limited federal programs to provide HIV prevention, medical care, housing, and transportation, but even with this approach the state fails to maximize federal dollars that are available for these services. Federal health care reform would expand access to health care for many Mississippians living with HIV, but the state has joined a lawsuit to block its implementation.

At the same time, Mississippi continues to ignore evidence-based recommendations for comprehensive sex education, requiring abstinence before marriage to be the primary message delivered to a student population that is reporting the highest rates of sexually transmitted disease and teen pregnancy in the country. The state criminalizes failure to disclose HIV status despite recommendations to the contrary from national and international health and HIV experts. HIV Infection among young black men who have sex with men is increasing at an alarming rate, yet efforts to reach out to this population are undermined by anti-gay laws and policies that keep them underground and away from public health services.

The severe and disproportionate impact of these failed laws and policies on African-Americans in Mississippi is highly problematic from a human rights perspective. The US is obligated to address health disparities based on race, an obligation that includes the duty to end ostensibly neutral policies that nevertheless have a discriminatory impact on racial groups and to ensure compliance at the state and local levels. Mississippi’s current approach to HIV is inconsistent with both public health and human rights imperatives.

The federal government bears the ultimate responsibility to protect the right to health, ensure access to health services free from discrimination, and to address racially-based health inequities. The goals of the National AIDS Strategy will not be realized without improved federal oversight of state approaches. Strong leadership, both federal and state, will be needed to eliminate ineffective, stigmatizing, and discriminatory policies that are placing health and life at risk in Mississippi.