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Many African-American women who live in rural areas do not perceive themselves as being at great risk for contracting HIV,new study results suggest. Consequently, these women may engage in more sexually risky behaviors than their urban and suburban counterparts, researchers report.
"Much more work with low-income rural women of color needs to be conducted regarding HIV prevention needs and how best to respond to those needs," lead study author Dr. Richard A. Crosby of the Rollins School of Public Health at Emory University in Atlanta, Georgia, told Reuters Health. "This is an important population of women who can clearly benefit from increased HIV prevention efforts."
Crosby and his team surveyed 571 low-income African-American Missouri residents. About one quarter of the respondents lived in rural counties, while the majority lived in urban or suburban areas.
Rural women were twice as likely as urban or suburban women to say that they did not have a preferred way to prevent HIV or sexually transmitted diseases (STDs), because they "don't worry about HIV or STD," the investigators report in the April issue of the American Journal of Public Health, journal of the American Public Health.
The women who lived in rural areas were also two times more likely to report never using condoms or not using condoms because they believed that their partner did not have HIV--regardless of whether or not their partner had actually been tested for the virus. And these women were twice as likely to report that their past or current partner had not been tested for HIV.
"Because this belief (that their partner did not have HIV) was based on something other than the partner's HIV test, the finding suggests that rural women may be more likely than non-rural women to 'take their partners' word' that they are HIV negative," the authors write.
Rural study participants were about half as likely as their non-rural counterparts to report that they had ever been diagnosed with syphilis or gonorrhea. They were also about twice as likely to report not having received counseling about HIV during their last pregnancy, the report indicates.
Overall, however, the reason for the discrepancy in HIV beliefs and prevention practices between urban and rural women may be because "HIV is less salient, as a threat, among rural women," Crosby speculated.
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"In urban areas, women may be more likely to have friends or know of people who are HIV positive--this may punctuate the idea that 'AIDS could happen to me,"' he said. "(But) in rural areas, where first-hand knowledge of someone who is HIV positive may be far less likely, an 'it can't happen to me' type of perception may be more salient."