Abstract
Most investigations describing sexual behavior patterns among persons living with HIV / AIDS have been conducted in large urban centers. However, it is also likely that some individuals in small towns and rural areas who are aware of their HIV infection continue to engage in high-risk sexual behaviors that place their partners at risk for HIV infection. The present study examines rates and predictors of high-risk sexual behavior among 79 persons living with HIV / AIDS in nonmetropolitan areas of a midwestern state. In late 1995, an anonymous self-report survey assessing health-related quality of life, social support, access to health care services, illness-related coping strategies, substance use, and sexual behavior was distributed to persons living with HIV/AIDS in communities with populations under 50,000. One-third of HIV-infected persons reported they had engaged in unprotected sex in the preceding 6 months. Individuals who were more likely to have unprotected sex lived with their partners, reported higher levels of physical well-being, had poor relationships with their physicians, and more frequently used alcohol and illegal drugs. As the prevalence of AIDS in rural areas increases, and as HIV-infected rural residents live longer, interventions are needed to assist HIV-infected rural individuals who have difficulty avoiding high-risk sexual behaviors.