title: Associations between LGBTQ-affirmative school climate and adolescent drinking behaviors.
abstract: BACKGROUND
  We investigated whether adolescents drank alcohol less frequently if they lived in jurisdictions with school climates that were more affirmative of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) individuals.
  
  
  METHODS
  Data from the 2010 School Health Profile survey, which measured LGBTQ school climate (e.g., percentage of schools with safe spaces and gay-straight alliances), were linked with pooled data from the 2005 and 2007 Youth Risk Behavior Survey, which measured sexual orientation identity, demographics, and alcohol use (number of drinking days, drinking days at school, and heavy episodic drinking days) in 8 jurisdictions. Two-level Poisson models tested the associations between school climate and alcohol use for each sexual-orientation subgroup.
  
  
  RESULTS
  Living in jurisdictions with more (versus less) affirmative LGBTQ school climates was significantly associated with: fewer heavy episodic drinking days for gay/lesbian (incidence-rate ratio [IRR]=0.70; 95% confidence interval [CI]: 0.56, 0.87; p=0.001) and heterosexual (IRR=0.80; 95% CI: 0.76, 0.83; p<0.001) adolescents; and fewer drinking days at school for adolescents unsure of their sexual orientation (IRR=0.57; 95% CI: 0.35, 0.93; p=0.024).
  
  
  CONCLUSIONS
  Fostering LGBTQ-affirmative school climates may reduce certain drinking behaviors for gay/lesbian adolescents, heterosexual adolescents, and adolescents unsure of their sexual orientation.
authors.affiliation: Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, United States; Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, United States. Electronic address: Robert.ws.coulter@pitt.edu.
authors.forename: Robert W S
authors.initials: RW
authors.lastname: Coulter
authors.affiliation: Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, United States.
authors.forename: Michelle
authors.initials: M
authors.lastname: Birkett
authors.affiliation: Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA 92182, United States.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Corliss
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, United States.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Hatzenbuehler
authors.affiliation: Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, United States.
authors.forename: Brian
authors.initials: B
authors.lastname: Mustanski
authors.affiliation: Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, United States; Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, United States.
authors.forename: Ron D
authors.initials: RD
authors.lastname: Stall
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000428:Alcohol Drinking / Q000523:psychology; D005260:Female; D006306:Health Surveys; D020010:Heterosexuality; D006801:Humans; D008297:Male; D012309:Risk-Taking; D012572:School Health Services; D012574:Schools; D019529:Sexuality / Q000523:psychology*; D012944:Social Support; D063106:Transgender Persons / Q000523:psychology*; D000066608:Underage Drinking / Q000523:psychology*
keywords: Adolescents; Alcohol use; Heavy episodic drinking; School climate; Sexual orientation