Thanks for your help. After reading some things online I was becoming afraid that I would never enjoy sex again.
I can't say whether or not you should trust his information. You know him and I don't. But the chance someone like you describe has HIV is extremely low.
Welcome to the HIV forum.
This is an excellent question, but not one I can give a specific answer to, and it is difficult to generalize. Of course rural areas have fewer total cases, simply because the populations are smaller than in cities; the important issue is the rate in comparison for the local population. The rest of my reply comments on those rates -- e.g. no. of cases per 1,000 members of the population -- and not on numbers of HIV/AIDS cases.
For the most part, the rates of HIV are substantially lower in rural than urban areas. However, HIV/AIDS certainly is not absent in less populated areas of the US, and in some geographic areas the rates may be nearly as high as in urban areas. The rate may be higher in certain rural areas of the southeast than in urban areas in many urban areas. For example, I suspect there are more HIV cases (per 1,000 members of the population) in rural North Carolina than, say, in urban areas like Boise or Minneapolis.
The overall rate of HIV is less dependent on rural versus urban (or suburban) area than on the population characteristics. HIV/AIDS rates are many times higher in African Americans, for example, than in whites or persons of Asian ethnicity, partly explaining what I said above -- higher HIV rates in the rural southeast than many urban areas elsewhere. The proportion gay/bi men among all males also has an influence, as you would expect.
In all settings, however, the rate of heterosexual transmission of HIV is low. The high rates in African Americans largely are due to heterosexual transmission, but even there it's very much a reflection of hidden homosexual exposure, injection drug use, and prior incarceration (with jail and prison time largely reflecting sex among men). Of course there are portions of white, Asian, and other population groups with high rates of HIV related to injection drug use, sex between men, etc. Most heterosexual transmission occurs between men with such risk factors who also have sex with women. What might be called "pure" heterosexual transmission -- i.e. sustained passage of HIV from male to female to male and so on, through heterosexual sex -- is uncommon everywhere and virtually nonexistant in most of the country.
As for rural Pennsylvania in particular, I have no data. But most likely the risk of catching HIV heterosexually is extremely low, especially if someone uses a little common sense in partner selection, e.g. avoiding injection drug users, bisexual male partners, etc.
Finally, I am unaware of websites or other resource that specifically address the epidemiology of HIV/AIDS in rural areas. However, CDC has lots of data on the factors cited above. Go to http://www.cdc.gov/hiv/topics/surveillance/index.htm then follow the various links to detailed data from around the country.
I hope this helps. Best wishes-- HHH, MD
I have had unprotected sex with a 63 year old man several times over the past year. I have know this man for 5 years. He has grown children and has been divorced for about 10 years. We live in nw pa in a part of the country that hiv is virtually unheard of. I have asked him about stds and he has said that never in his life has he had any and he would know if he did because he has never had sex with anyone he doesn't know. Should I trust him?