HIV in the heartland: Experiences of living with HIV in urban and rural areas of the midwest

Abstract

Scholarly research on HIV/AIDS and stigma has largely demonstrated a different experience for people living with HIV and AIDS (PLWHA) who inhabit urban and rural areas. Largely missing from this scholarship are experiences in low prevalence areas. Low prevalence areas typically have fewer resources, social networks, and HIV infection and prevalence is less common. In this paper, we examine the challenges PLWHAs in rural and urban areas of the Midwest face and how these individuals manage, respond, and combat HIV/AIDS related stigmas in their communities. This paper utilizes interview data to understand the lived experiences of 18 persons living with HIV and AIDS. This paper reveals that respondents in rural areas are likely to be geographically dispersed, struggle with accessing healthcare services, believe their communities are less tolerant, and are less likely to disclose their positive status or seek out social support. Respondents who lived in urban areas were more likely to disclose their positive status, have access to AIDS service organizations and social support, and to participate in advocacy in the “HIV Community.” Our study demonstrates how social and community context are agentic players in shaping life chances, decisions, and behavior of the PLWHAs we interviewed.