The influence of self-esteem, self-silencing, and abuse on safer sex behaviors of rural women

Heterosexual transmission is the leading cause of HIV infection among women. At least 38% of AIDS cases diagnosed in women in 1997 were acquired by heterosexual contact (Crosby et al., 2000); of the estimated new AIDS diagnoses among women, 68% have been attributed to heterosexual transmission (The Henry J. Kaiser Family Foundation, 2004). Women living in rural areas have experienced a rapid increase in HIV/AIDS cases, particularly from sex with male partners (Crosby et al., 2000).; To date, 24% of the newly reported cases of HIV in Minnesota are women (up from 15% in 1994). Eleven percent of those newly reported cases live in Greater Minnesota.; The purpose of this study was to identify the relationship of select demographic characteristics (i.e., age, level of education, relationship status), self-esteem, self-silencing, and abuse on the safer sex behaviors of rural women. The overarching framework used for this study was the ecological perspective which provided a multilevel, nested approach to the study of these factors. This approach emphasizes the importance of the reciprocity of the various factors in developing health behaviors. The ecological approach provides a holistic and comprehensive view of the complexity of human behaviors while considering the environmental and relational contexts of individuals.; The sample included women living in rural areas of Minnesota and adjacent northern rural states who were a minimum of 18 years old. The sample was recruited using a community-based sampling strategy; participants were recruited at public sites frequented by women.; This study used a cross-sectional, correlational research design. Participants completed a self administered, self report 90-item questionnaire containing four research instruments and a demographic questionnaire. Data was analyzed using Pearson product moment correlation coefficients and multiple regression analysis.; Research studies are needed to identify HIV risk factors in rural women. Intervention strategies can be developed to assist this at-risk population to eliminate or at least minimize their risk factors and to increase their protective health behaviors.