background: Rural sexual and gender minority populations remain largely absent within academic literature but remain disproportionately impacted by negative health outcomes. To reach this often marginalized and under served population, culturally appropriate methods for participant recruitment is necessary; however, few studies have evaluated these men’s preferences.

methods: Forty rural MSM were recruited and completed a one-time in-depth interview to assess facilitators, barriers, and preferences for health programming. Participants were recruited via flyers placed in venues affirming to the LGBT community. The interviews were recorded, transcribed, and analyzed to identify themes (e.g., open and axial coding).

results: Participants reported they desired public health programming which was culturally relevant and addressed their unique status of being a sexual minority man in rural communities. In particular, men addressed preferred methods for public health outreach which reflected their privacy concerns. This included the use of online marketing via social media platforms and minimization of the use of traditional forms of print media/advertising. Overall, protecting anonymity was described as a key determinant for successful linkage to health programming.

conclusion: There is a continued need to develop best practices for the engagement of rural sexual minority men in public health programs. Addressing both proximal and distal determinants is essential to developing programs which is culturally congruent with the unique experiences of these men. Failure to do so will result in the continued coalescing of social factors which disproportionately place this population at risk for negative health outcomes.