PROJECT SUMMARY/ABSTRACT Rates of sexually transmitted infections (STIs) in California have reached epidemic levels that exceed national rates. Half of these infections occur among youth ages 15–24, and rates are disproportionately higher in sexual and gender minority (SGM) adolescents and young adults (AYA). Latine SGM AYA have been shown to have worse mental, physical, and sexual health outcomes than non-SGM AYA and have experiences of discrimination including racism and homophobia. Yet, research is lacking on the experiences of Latine SGM AYA who reside in rural settings who may have increased concerns around confidentiality and stigma in their communities. This critical gap in evidence has impeded the development of interventions to address the needs of rural Latine SGM AYA to increase their access to preventative sexual health services. The overarching goal of this supplement is to understand social, cultural, and structural influences (social determinants) on sexual health among rural Latine SGM AYA, such as those who identify as lesbian, gay, bisexual, transgender, queer, intersex and other genders or sexualities (LGBTQI+) in emerging adulthood (ages 18–21). This study will be a 1- year research supplement to the A Crecer cohort study (R01HD075787). The parent study follows a cohort of adolescents from age 13 into young adulthood at age 21 in Salinas, California, to understand the social factors that affect sexual health among Latine AYA. In the proposed supplemental study, we will analyze existing data and conduct supplementary data collection by recruiting an additional 50 SGM AYA from the study area through community organizations that serve this population. Currently, about 20% (n=73) of the cohort identifies as SGM. This supplementary data collection will allow us to compare sexual health outcomes by SGM identity and to better understand the experiences of SGM AYA in this area. In Aim 1, we will characterize disparities in sexual health outcomes associated with SGM identity in emerging adulthood. Sexual health outcomes include preventing pregnancy and/or STIs, accessing sexual health services, condom use, dating violence, and satisfaction in sexual relationships. We will analyze quantitative data already collected from the A Crecer Phase 2 cohort and include the supplementary sample to characterize disparities in sexual health outcomes. In Aim 2, we will explore AYA identity development and socio-cultural influences on SGM AYA’s experiences with their sexual relationships, health, and well-being. We will conduct in-depth interviews (~20) with purposively selected SGM AYA to understand their needs for and experiences in caring for their sexual well-being as well as perceived socio-cultural influences on their sexual health and how that has shifted over time as their identity has developed. Our established infrastructure, partnerships, and existing cohort position us for efficient initiation and rigorous implementation of the proposed s...