Talking about, knowing about HIV/AIDS in Canada: a rural-urban comparison.

PURPOSE To explore information exchange about HIV/AIDS among people living in rural and urban communities and to assess the value of social capital theory, as well as demographic factors, in predicting community members' knowledge of HIV/AIDS and their likelihood of having talked about the disease. METHOD A random-digit dial telephone survey was conducted in 3 rural regions and matched urban communities in Canada during 2006 and 2007. A total of 1,919 respondents (response rate: 22.2%) answered questions about their knowledge of and attitudes toward HIV/AIDS, their social networks, whether they were personally acquainted with a person with HIV/AIDS (PHA), and whether they had ever talked to anyone about HIV/AIDS. FINDINGS Rurality was a significant predictor of HIV/AIDS knowledge and discussion. Even after controlling for factors such as age and level of education, respondents living in rural regions were less knowledgeable about HIV/AIDS and were less likely to have spoken with others about the disease. Social capital theory was not as strongly predictive as expected, although people with more bridging ties in their social networks were more likely to have discussed the disease, as were those who knew a PHA personally. CONCLUSION Rural-dwelling Canadians are less likely than their urban counterparts to be knowledgeable about HIV/AIDS or to talk about it, confirming reports by PHAs that rural communities tend to be silent about the disease. The findings support policy recommendations for HIV education programs in rural areas that encourage discussion about the disease and personal contact with PHAs.