Associated Press - December 18, 2005
Valerie Bauman

But as she approached the exit, Cochran quickly changed her mind as the words spray painted across the bridge came into view: 'Jesus loves you.'

"At this point in my life, I feel like I'm in a revolving door that I can't get out of, because I don't know what to do, I don't know where to turn," said Cochran, whose home is in northwest Mississippi. "I just keep going around and around. I've got to make some major decisions, but I don't know what to do."

Like many HIV/AIDS patients in the Mississippi Delta region, Cochran has struggled to receive medication and medical care. She's had the illness for 13 years and received excellent care until her husband developed throat cancer and was forced to leave his job - and insurance benefits - behind.

Cochran now lives without insurance, Medicare or Medicaid in DeSoto County, one of four northern counties funded through Tennessee's portion of the federal Ryan White Comprehensive AIDS Resources Emergency Act of 1990.

The act provides money for health care systems and support services to medically underserved individuals and families affected by HIV.

But authorities in Memphis told her that she and her husband received too much Social Security to benefit from the White Act in Tennessee.

When she pursued assistance in Mississippi, Cochran had to travel long distances to reach a federally funded clinic. Once there, she was frustrated with the care she received.

She said the clinics didn't remember her appointments and she was treated rudely. Cochran never got into the system to benefit from the White Act and, for the moment, has given up on trying.

She stopped taking her HIV medications almost a year ago.

"If you stop and think about it, with the disease that I have, why would I want to keep on struggling with all the curveballs thrown at me," Cochran said. "Why do I want to keep on taking medicine that's going to prolong my misery?"

The Delta is the region of the state that ranks second for new incidences of HIV and AIDS, said Alonzo Dukes, President and CEO of the Southern AIDS Commission in Greenville.

The commission sends workers into high-risk neighborhoods to educate people about protecting themselves from HIV.

The issues surrounding HIV and AIDS in the poor, rural Delta regions are different from those in the urban areas of Mississippi, he said.

For a long time, finding housing for people with HIV and AIDS was difficult in the Delta, but additional federal funding has minimized that issue, Dukes said.

"Now a lot of people who live in the rural area may have a lot of problems with getting to town and filling their medication," Dukes said.

One problem is that the Department of Health and other agencies that contribute to HIV and AIDS causes are not communicating to ensure that services are not being duplicated in certain areas and neglected in others, Dukes said.

The state Department of Health did not respond to repeated requests by The Associated Press for comment on interagency communication and services.

HIV and AIDS patients in the Delta often have trouble finding a doctor in their area, Dukes said.

"A lot of doctors don't like working with HIV patients," he said. "I don't know if they are afraid, I don't know what it is."

Cochran thinks she knows the answer.

"Down here it's 'Shhh - don't talk about it,' because, man, if you talk about it, you'll never be able to show your face again," she said. "This disease is one of the most humiliating, degrading diseases anyone can have. I am not a prostitute. I have never done drugs. I have no idea how I got it and my husband doesn't have it."

In the Delta, poverty, drugs, prostitution and a lack of education contribute to the spread of HIV/AIDS, Dukes said.

Cochran, and others like her, struggle with the bureaucracy of receiving care and paying for medication.

Michael Kelly, a 39-year-old HIV patient, left Arizona for North Carolina in search of quality care.

Instead, his car broke down in the Mississippi Delta and he ran out of money.

Now, about three years later, he is fed up with what he describes as mediocre medical treatment and a strangled access to medications.

"Having the knowledge and medical care of another state and then experiencing the medical care in this state is something else," Kelly said. "I would compare it to first world medical care and third world medical care."

Kelly was diagnosed in mid-October with eight cavities, but his dentist refused to treat him because funding hasn't come through to pay for the preliminary exam. In the meantime, one of his infected teeth broke off at the gum line.

The state Health Department helped open a dental clinic for Mississippians with HIV at the Jackson Medical Mall.

Unfortunately, Kelly, like many Delta residents, cannot afford to travel to Jackson.

"It seems like a lot of the funding gets stuck down there in Jackson," he said.

While living in Arizona, all of Kelly's medications were paid for through the Ryan White Act, including his pain killers, muscle relaxers and an inhaler. In Mississippi he is forced to pay out of pocket for prescriptions that affect his quality of life.

"I understand some limitations because of overall state funding," he said. "But it doesn't seem like there's been enough money, time and effort put into the budget for people infected and affected by HIV."

051218
AP051229

Copyright © 2005 - Associated Press. Reproduction of this article (other than one copy for personal reference) must be cleared through the AP Permissions Desk.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.

Always watch for outdated information. This article first appeared in 2005. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2005. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .