Abstract
Purpose: The unique experiences of men who have sex with men (MSM) residing in culturally conservative rural areas are not well represented in the scientific literature. The human immunodeficiency virus (HIV) epidemic in the United States has shifted toward rural areas where populations are dispersed and health care resources are limited.Methods: We recruited 40 sexual minority men, ages 22–66, residing in rural Oklahoma for in-depth, qualitative sexual health interviews that sought to understand how cultural and social environments impacted health behaviors.Findings: Participants described a stigmatizing social environment and less access to quality, sexual minority medical care within rural communities and perceived these as substantial barriers to enhancing health. Structural issues, including lack of sexual minority-affirming policies, institutional practices, and hostile cultural norms, were noted.Conclusions: Results indicate the need to develop greater awareness of stigma as an etiologic factor that contributes to the health of rural sexual minority populations, specifically when it relates to provision of culturally appropriate care.
Highlights
The unique experiences of men who have sex with men (MSM) residing in rural areas of the United States are not well represented in the scientific literature
The nature of the human immunodeficiency virus (HIV) epidemic in the United States has changed with a shift toward rural areas where populations are dispersed and health care resources are limited.[4]
Qualitative data Two main levels emerged in our evaluation of structural stigma among MSM in rural Oklahoma: (1) societallevel conditions and (2) cultural norms
Summary
The unique experiences of men who have sex with men (MSM) residing in rural areas of the United States are not well represented in the scientific literature. Rural communities are typically more culturally conservative and may be less welcoming to openly lesbian, gay, bisexual, and transgender (LGBT) individuals.[1,2,3] the socioeconomic conditions of rural communities mean that most individuals born into these rural communities are unable to move to areas where they would be accepted. The nature of the human immunodeficiency virus (HIV) epidemic in the United States has changed with a shift toward rural areas where populations are dispersed and health care resources are limited.[4] concurrent socioeconomic factors, geography, and cultural context are coalescing for sexual minorities living in rural communities in a way that places individuals at risk for HIV infection.[4] Greater attention is needed to build a more comprehensive understanding of the health of marginalized populations living in rural areas of the United States, among MSM
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