HIV-related sexual behaviors of men who have sex with men have been conducted primarily in urban areas, despite growing evidence that HIV is becoming much more prevalent in rural parts of the country. Furthermore, few studies have addressed the issues of stigma and risk behaviors of rural men even though the stigma associated with HIV in rural areas may be far more potent and pervasive than the stigma of HIV in urban areas. The goals of the proposed study are to: (1) describe the sexual behavior of rural men; (2) explore and describe any stigma experienced by rural men as it reflects HIV status; (3) describe some of rural men's health care concerns as they relate to attitudes of health care providers and possible barriers to seeking information on HIV and health care; and (4) evaluate a theory-based model which seeks to explain individual and social determinants of the extent of risky sexual behavior practiced by rural men. It is hypothesized that the mental health status of rural men, specifically rural men's self-esteem and any feelings of depression, mediate the impact of their personal beliefs about HIV, perceptions of rural stigma, and concerns about health care on their sexual risk behaviors. The work proposed offers a unique opportunity to document the influence of the stigma found in rural communities on the HIV-related sexual risk behavior of men. Rural male respondents will be sampled through a mailing list and by means of chain-referral sampling through health and social organizations. A self-administered questionnaire will be used to collect the study data. All subjects will be guaranteed anonymity prior to participating. In addition, a sub sample of volunteers will be asked to participate in a confidential, face-to-face individual interview conducted using grounded theory techniques. The proposed research will enhance basic understanding of how rural life affects the sexual risk behavior of men. Through this research effort, patterns of family and community stigma and privacy issues will be assessed. The effects of these factors on mental health and on sexual risk behavior also will be addressed. Critical issues related to accessing health care, health education, and health counseling for rural men will be explored.
| Preston, Deborah Bray; D'Augelli, Anthony R; Kassab, Cathy D et al. (2007) The relationship of stigma to the sexual risk behavior of rural men who have sex with men. AIDS Educ Prev 19:218-30 |
