Placing HIV beyond the metropolis: risks, mobilities, and health promotion among gay men in the Halifax, Nova Scotia region

Research on HIV/AIDS among gay men in North America has departed from pure disease diffusion models to consider the social and environmental contexts where transmission may take place. Most of this work, however, focuses on large metropolitan areas and operationalizes the concept of place with only some degree of nuance. Large cities—and the bars, bathhouses, and gay villages within them—are often treated as containers of attributes that contribute to and concretize HIV risk. This article therefore seeks to apply a critical, ecological conception of place to understanding HIV risk, education, and prevention among gay men in the small city-region of Halifax, Nova Scotia. Using in-depth interviews with HIV/AIDS-related service providers and self identified gay men, the study highlights four dynamics of HIV risk potentially affecting gay men in smaller cities and rural areas: (1) institutional ambivalence toward HIV education and messaging, (2) narrow conceptions of risk, (3) migrations into unfamiliar social and sexual environments, and (4) social and structural barriers to health service utilization