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.


HIV/AIDS, Stigma, Disclosure, Midwest, Low Prevalence

Author Bio(s)

Sarah Donley is an Assistant Professor in the Department of Sociology and Social Work at Jacksonville State University. Her main areas of expertise and research are in gender, work, and culture. Correspondence regarding this article can be addressed directly to: Sarah Donley, 324 Brewer Hall, Department of Sociology and Social Work, Jacksonville State University, Jacksonville, AL 36265. Email: sdonley@jsu.edu.

C. Patrice Lockett is an Assistant Professor in Department of Sociology and Social Work at Jacksonville State University. Her research interests include intimate partner violence, homelessness, and civic engagement.


This research was supported in part by a grant from the Midwest Sociological Society Endowment Committee. The authors would also like to thank Dana Britton and Alisa Garni for reading earlier versions of this work.

Publication Date


Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 International License.





To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.