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The HIV/AIDS epidemic in Britain was an overwhelmingly urban phenomenon. Towns and cities were home to the majority of people living with HIV and boasted most of the hospitals which diagnosed and treated them. The epidemic was not simply understood as urban because of demographic epidemiological factors; it was also seen as antithetical to rural life. This article explores the ways in which HIV/AIDS was positioned as urban through a particular cultural construction of rurality in late twentieth-century England. This cultural imaginary rested on a nostalgic construction of the English countryside in which conventional heteronormativity buttressed social, moral, and sanitary stability. The English countryside was frequently thought to be in need of protection from HIV/AIDS, whether in the form of metropolitan producers shoe-horning the virus into cherished rural soap operas, or more directly from the urban import of HIV and the gay men understood to be its most likely carriers. This article examines the cultural mentality in which rurality was mobilized as distinct from HIV/AIDS, pointing to the wider anxieties about changing rural life for which the epidemic often acted as a proxy.