title: Rural-urban differences in mental health, resilience, stigma, and social support among young Australian gay men.
abstract: OBJECTIVE
  Depression and anxiety are common among young gay men, particularly in comparison with their heterosexual counterparts. Little is known about the mental health and well-being of those living in rural areas, where access to support and opportunities for connecting with other gay men may be relatively limited. We examined differences in the well-being of young rural and urban Australian gay men, including mental health, resilience, stigma-related challenges, and social support.
  
  
  METHODS
  A national online survey was conducted involving 1,034 Australian gay-identified men aged 18-39 years.
  
  
  RESULTS
  All analyses adjusted for sociodemographic differences between the rural and urban samples. On average, rural men had significantly lower self-esteem, lower life satisfaction, lower social support, and were significantly more likely to be psychologically distressed, concerned about acceptance from others, and to conceal their sexual orientation compared to urban gay men. While resilience among the rural group was lower, this was no longer significant following sociodemographic adjustment. An examination of psychosocial predictors of psychological distress in the rural sample revealed that lower education and lower tangible support independently predicted greater distress.
  
  
  CONCLUSIONS
  Young rural Australian gay men appear to be at a considerable disadvantage with regard to mental health and well-being compared with their urban counterparts, and they may need particular attention in mental health prevention and treatment programs.
authors.affiliation: Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.
authors.forename: Anthony
authors.initials: A
authors.lastname: Lyons
authors.forename: Warwick
authors.initials: W
authors.lastname: Hosking
authors.forename: Tomas
authors.initials: T
authors.lastname: Rozbroj
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000628:therapy; D001315:Australia; D003863:Depression / Q000628:therapy; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D012423:Rural Health / Q000706:statistics & numerical data*; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology; D012944:Social Support
keywords: health disparities; men who have sex with men; mental health; rural; social determinants of health