Williams Pamela A, Uhrig Jennifer D, Zulkiewicz Brittany A, Johnson Mihaela, Anderson Stefanie K E, August Euna M
RTI International, 3040 East Cornwallis Road, PO Box 12194, Research Triangle Park, NC, 27709 - 2194, USA.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
AIDS Behav. 2025 May 6. doi: 10.1007/s10461-025-04710-1.
HIV prevention efforts have traditionally focused on urban areas, yet about one-fourth of new HIV diagnoses in the U.S. are in non-urban areas. This study explored rural and urban differences in perceived HIV risk; perceived HIV stigma; and pre-exposure prophylaxis (PrEP) awareness, attitudes, beliefs, communication behaviors, and use to inform the development of communication messages to promote informed decision-making among available HIV prevention options, including PrEP. We conducted interviews, preceded by a brief survey, with 255 adults in 5 rural and 6 urban locations throughout the U.S. with high HIV burden. Participants from rural areas more frequently described their risk of getting HIV as low compared with those from urban areas, although partly due to differences in gender/sexual identity and sexual risk. Participants from rural areas more frequently reported perceived stigma around getting tested for HIV, taking PrEP to prevent HIV, or having HIV and less frequently reported having heard of PrEP and having a healthcare provider talk with them about PrEP compared with those from urban areas. No participants from rural areas reported using PrEP, although 48% of those with HIV-negative or unknown status were at substantial risk based on reported risk factors. Our findings highlight notable differences in perceived HIV risk; perceived HIV stigma; and PrEP awareness, attitudes, beliefs, communication behaviors, and use between individuals residing in rural and urban areas, suggesting that HIV prevention messaging needs to be tailored for rural audiences to support receptivity.
传统上，艾滋病病毒（HIV）预防工作主要集中在城市地区，但在美国，约四分之一的新增HIV诊断病例发生在非城市地区。本研究探讨了农村和城市地区在感知到的HIV风险、感知到的HIV污名化以及暴露前预防（PrEP）知晓率、态度、信念、沟通行为和使用情况方面的差异，以为制定沟通信息提供参考，从而促进在包括PrEP在内的现有HIV预防选项中做出明智决策。我们在美国5个农村和6个城市的高HIV负担地区，对255名成年人进行了访谈，访谈前先进行了简短调查。与城市地区的参与者相比，农村地区的参与者更频繁地将自己感染HIV的风险描述为低，不过部分原因是性别/性身份和性风险方面的差异。与城市地区的参与者相比，农村地区的参与者更频繁地报告在接受HIV检测、服用PrEP预防HIV或感染HIV方面存在感知到的污名化，并且更少报告听说过PrEP以及有医疗服务提供者与他们谈论过PrEP。农村地区没有参与者报告使用过PrEP，尽管根据报告的风险因素，48%的HIV阴性或状况不明者处于高风险状态。我们的研究结果突出了农村和城市地区居民在感知到的HIV风险、感知到的HIV污名化以及PrEP知晓率、态度、信念、沟通行为和使用情况方面的显著差异，这表明HIV预防信息需要针对农村受众进行量身定制，以提高接受度。
