Health Indicators of Lesbian, Gay, Bisexual, and Other Sexual Minority (LGB+) Youth Living in Rural Communities

Sexual orientation and migration intentions among rural, exurban and urban adolescents in Iceland

Rural areas have often been assumed to be somewhat hostile territory for sexual minorities. As a result, moving to an urban area may be an integral part of "coming out" for those living in a rural area. However, surprisingly few quantitative studies have examined the level of rural-to-urban migration intent among sexual minorities. In this study, we examined the migration expectations of adolescents in Iceland, a country characterised by a heavy urban concentration and a scattered rural population, strong international ties and comparatively high levels of formal rights and public acceptance of sexual minorities. Based on a population sample of 2,858 students aged 15-16 years, we found no evidence of greater overall migration expectations among rural or exurban lesbian, gay, bisexual and questioning (LGBQ) youth than their urban counterparts. However, while urban LGBQ youth were more likely to move abroad, young people in other areas are more likely to move domestically. The results are discussed in the context of prior studies of sexual minorities in rural areas and migration expectations among rural youth.

Adolescent Pride Festival Attendees-Assessing Their Interactions With Primary Care Physicians

PURPOSE

Pride festivals celebrate the lesbian, gay, bisexual, transgender (LGBT) community. This study aimed to describe adolescent Pride festival attendees, determine rates of accessing health care via their primary care physician (PCP), and assess if providers are discussing sex and offering screening for sexually transmitted infections (STIs) to these adolescents.

METHODS

Adolescents, aged 13-17 years, attending the 2017 Minnesota Pride Festival were invited to complete an 18-question survey regarding gender identity, sexual orientation, access to a physician the preceding year, and whether sexual activity was discussed and/or STI screening provided at these encounters.

RESULTS

A total of 490 surveys were evaluated. Sixty-nine percent of respondents identified as having nonheterosexual orientation. Rural participants were significantly more likely to identify as LGBT than urban or suburban participants. The majority (90%) of adolescents had been seen in the past year by a physician. Of these, 68% had been asked a sexual history, and 29% were offered STI testing. Older adolescents were more likely to be asked about sex and offered STI testing by a physician. Identifying as LGBT was not associated with rate of sexual history taken or STI screening offered but was associated with perceived need for STI testing.

CONCLUSIONS

LGBT youth attending Minnesota Pride are accessing a PCP with the same regularity as cisgender, heterosexual peers but are infrequently offered STI testing, despite knowledge of increased STI rates in this population. Taking a sexual history and screening for STIs is something all physicians can do and represents an important first step in any STI reduction initiative.