Single young adults living in rural areas are no more inclined to engage in safe sex behaviors than their non-rural peers, according to a new analysis by Indiana University sexual health experts of a nationally representative survey.

The singles’ behaviors involving number of sexual partners, troubling frequency of unprotected sex and issues involving HIV testing put them equally at risk of acquiring and transmitting sexually transmitted diseases such as HIV.

“Rural living apparently isn’t protective, despite the image that the rural environment is more conservative, with traditional values that result in people being less risky in their personal behavior,” said William L. Yarber, senior director of the Rural Center for AIDS/STD Prevention at Indiana University Bloomington. “The study findings are contrary to beliefs that individuals, just because they live in a rural area, are shielded against many of the factors that contribute to HIV/STD transmission and acquisition.”

The study, “Do rural and non-rural single, young adults differ in their risk and protective HIV/STD behaviors: Results from a national survey,” will appear in the winter Health Education Monograph. Here are some of the findings of the analysis, which involved 1,500 men and 1,888 women between the ages of 18 and 29 who participated in the 2002 National Survey of Family Growth. Non-rural refers to anyone living in a county with more than 50,000 residents:

* Number of sexual partners: Non-rural and rural men reported an average of 8.8 and 7.2 female sex partners, respectively, in their lifetime and 1.7 and 1.4 on average in the previous 12 months. Non-rural and rural women reported an average of 5.9 and 5.6 male sex partners, respectively in their lifetimes, and an average of 1.5 and 1.6 male sex partners in the previous 12 months.

* Condom use and unprotected sex: Non-rural and rural men reported having sex without a condom an average of 4.9 and 6.2 times during the previous four weeks. Non-rural men (46 percent) and rural men (47 percent) were equally likely to report not using condoms the last time they had sex. Non-rural and rural women reported having sex without a condom an average of 6.8 and 6.5 times during the previous four weeks. Non-rural women (51 percent) and rural women (47 percent) were equally likely to report not using condoms the last time they had sex.

* STD and HIV testing and counseling: Non-rural women (59 percent) were more likely than rural women (50 percent) to receive an HIV test. There was no difference between non-rural men (44 percent) and rural men (44 percent). Non-rural men (69 percent) were more likely to discuss STDs after their last HIV test than rural men (37 percent), while no difference existed between the groups of women.

* Recommendation: The study recommends that AIDS prevention specialists continue their work in prevention, taking advantage of this “window of opportunity,” to prevent incidence of HIV from escalating. “Rural residents may be quite hesitant to respond to a health issue that has yet to ‘hit home’ as a reality,” the authors write. “Thus, intensified efforts to promote HIV/STD risk reduction in rural America are warranted. The efforts are warranted because rural outbreaks of HIV may be difficult to contain because of fewer resources in rural areas for controlling HIV compared to urban areas.”
William L. Yarber
This study, funded by RCAP, is the first to compare the sexual risk-taking behaviors of single, young adults living in rural versus non-rural areas. While rates of STDs in rural areas are less than in urban areas, the study shows that the singles engage in similarly risky behaviors.

“In rural communities, if an STD begins spreading within a sexual network, the rate of STD can become pretty high,” Yarber said. “Rural communities are probably less armed to deal with these issues because of lack of resources, more stigma and more denial related to the diseases.”

Co-authors are Robin Milhausen, University of Guelph, Ontario; Bin Huang, University of Kentucky; and Richard Crosby, University of Kentucky.

Source: Indiana University