There is the continued need to develop and evaluate models designed to address the health disparities sexual and gender minority groups experience as a result of multiple socio-cultural factors. LGBT populations have been found to have higher prevalence of life-threatening physical and mental health conditions, experience barriers to care, and other unique social and structural inequities. Our team have focused on the development and delivery of more comprehensive and integrated health promotion programs that are responsive to the unique needs of these populations. Within our focus on LGBT population health, we have examined the role of place as a necessary metric to evaluate sexual health. There remains a research gap with rural sexual minority communities, specifically outside of the Deep South. As such, we have focused on social structures, built environments, cultural expectations, and how place of residency may influence sexual health and engagement in care.