This study examined the relationship between profiles of rural registered nurses' levels of compliance with the use of personal protective equipment and HIV-related attitudes. Survey data were collected from 395 practicing registered nurses in nine rural counties in New York and Pennsylvania. Cluster analysis grouped respondents according to their use of protective equipment by patient HIV status. Seven profiles were identified from the resulting 13 clusters. Profiles were named according to the characteristics of the protective equipment usage that were most evident in each profile. Usage levels included minimal users, appropriate users, anticipatory users, glove users, discriminate users, maximal users, and optimal users. Of these, three were classified as compliant, one as undercompliant, and three as overcompliant. Selective compliance (changing usage in response to patients' HIV status) was characteristic of five profiles. Knowledge that patients were HIV-positive accounted for overcompliance and selective compliance and was related to nurses' HIV attitudes. Undercompliance was related to care of patients who were HIV-negative or unknown. Rural nurses' use of personal protective equipment is not homogenous but discrete and idiosyncratic. This analysis expands current knowledge and redefines nursing practice of standard precautions.