Sexual minority adolescents who attended school reported higher HIV risk behaviors, and higher prevalence of sexual victimization may partially explain these risks.

Objectives-We compared sexual-minority adolescents living in rural communities with their peers in urban areas in British Columbia, exploring differences in emotional health, victimization experiences, sexual behaviors, and substance use.Methods-We analyzed a population-based sample of self-identified lesbian, gay, or bisexual respondents from the British Columbia Adolescent Health Survey of 2003 (weighted n=6905). We tested rural-urban differences separately by gender with the χ 2 test and logistic regressions.Results-We found many similarities and several differences. Rural sexual-minority adolescent boys were more likely than were their urban peers to report suicidal behaviors and pregnancy involvement. Rural sexual-minority adolescents, especially girls, were more likely to report various types of substance use. Rural status was associated with a lower risk of dating violence and higher risk of early sexual debut for sexual-minority girls and a higher risk of dating violence and lower risk of early sexual debut for sexual-minority boys.Conclusions-Location should be a demographic consideration in monitoring the health of sexualminority adolescents. Lesbian, gay, and bisexual adolescents in rural communities may need additional support and services as they navigate adolescence.Adolescence is marked by many developmental tasks, including the unfolding of sexual identity. Adolescents who are lesbian, gay, or bisexual (LGB) face the additional challenge of being members of a sexual minority in a heterosexually dominant world. This may be an especially complex task in a rural environment, where heterosexism may be more pronounced 1 and supportive resources limited. 2 Scant research has compared the experiences of LGB adolescents in rural and urban areas.In the past decade, a growing number of population-based studies of LGB adolescents addressed the methodological criticisms of earlier studies that relied on urban samples, convenience samples, and samples of adolescents who may have been of legal adult age. 2-5 Population-based research on LGB adolescents has demonstrated that they face health disparities when compared with heterosexual adolescents. For example, LGB adolescents are at increased risk of being stigmatized and victimized. 3,6-11 LGB adolescents also experience Requests for reprints should be sent to Colleen Poon, The McCreary Centre Society, 3552 East Hastings St, Vancouver, BC, V5K 2A7 Canada (e-mail: colleen@mcs.bc.ca).. Contributors C. S. Poon developed the rural component of the study, completed analyses, and led the writing. E. M. Saewyc originated the study and supervised all aspects of its implementation. Both authors helped to conceptualize ideas, interpret findings, and edit drafts of the article. Human Participant ProtectionThe University of British Columbia behavioral research ethics board reviewed and approved the project. NIH Public Access Author ManuscriptAm J Public Health. Author manuscript; available in PMC 2010 January 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript N...

Objective-This study examined whether students' odds of recent substance use were lower in the presence of GSAs or explicit anti-homophobia policy that had been established at their school recently, or at least three years prior.Methods-We analyzed a population-based sample of students in grades 8 through 12 from the British Columbia Adolescent Health Survey of 2008 (weighted N = 21,708). We used multinomial logistic regressions to test the hypothesized effects of GSAs and policies on substance use outcomes for LGB and 100% heterosexual students separately.Results-Results indicated that GSAs and anti-homophobic bullying policies were linked to significantly lower odds of some but not all types of recent risky alcohol use, and past-year harms from alcohol or drug use, for LGB adolescents, but these were predominantly among girls, and almost exclusively in schools where the policies or GSAs had been established for at least three years.Conclusions-Our findings suggest that these school-based strategies (GSAs and antihomophobia policies) to reduce homophobia and foster school inclusion may be beneficial in reducing problem alcohol use among all students, not just sexual minority students.

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