Health Effects of Intersectional Stigma among Sexual Minority Women

项目摘要 性少数群体女性(SMW)报告的饮酒率始终高于异性恋女性。在……里面 事实上，SMW更有可能是目前的饮酒者、酗酒者和酗酒者，而不是异性恋 女性1和达到酒精使用障碍门槛的可能性是女性的11倍1-6而SMW的研究 近年来，酒精使用有所增长，对2000-2017年间的文献进行的范围审查显示，酒精使用严重 黑人和拉丁裔妇女代表性不足。7概率数据显示，每4名黑人妇女中就有1人，每5人中就有1人 美国的拉丁裔9(不分性别)认为自己是性少数。在抽样中缺乏种族多样性假设 影响SMW饮酒的压力源的类型、严重程度和频率在 种族/民族群体。因此，影响饮酒的关键社会文化和/或社区因素 在黑人和拉丁裔中，SMW被最小化或完全没有被观察到。医学研究所 (2011)10和国家卫生研究院(2019、2020)11、12强调有必要进行研究，以考虑 跨种族和性取向的跨部门污名如何创造独特和协同的体验 压力与健康差距有关。我们之前的工作表明，持续的、持续的交叉 黑人和拉丁裔SMW中的耻辱会导致负面影响和有问题的饮酒。 我们研究的长期目标是减少不同种族SMW与酒精相关的健康差距。我们的 团队拥有执行拟议项目的内容和方法专业知识，包括成功 在黑人和拉丁裔妇女中实施日常日记研究和几项基于社区的研究。 使用基线测量和14天的每日日记，此R21应用程序的目标是测试可行性 一项以理论为导向的初步研究，捕捉与负面情绪和 黑人和拉丁裔SMW的饮酒问题。利用正在进行的研究伙伴关系与几个 在洛杉矶县的社区组织中，拟议的研究将抽样212名SMW(N=106黑人； N=106名拉丁裔)，年龄18-40岁。受访者主导的抽样将确保目标样本的成功招募 以及在性取向、指定身份和社会经济背景方面的适当代表性。 这项研究将追求两个具体目标：(1)检查压力的作用(基于种族的耻辱，性取向- 基于污名、一般生活压力)对黑人和拉丁裔SMW的负面影响和有问题的饮酒， 以及(2)探索个人层面(种族、隐蔽)和社区层面(同伴饮酒规范、社会支持) 在日常压力、负面情绪和有问题的饮酒之间的关系中起到调节作用。这个 拟议的研究具有重要意义，因为它有可能通过深化 关于日常应激对SMW中与酒精相关的健康差距的现有理解，特别是 跨种族和性取向的跨界别污名的作用。

Project Summary Sexual minority women (SMW) consistently report higher rates of alcohol use than heterosexual women. In fact, SMW are more likely to be current alcohol users, binge drinkers, and heavy drinkers than heterosexual women1 and are 11 times more likely to meet the threshold for alcohol use disorder.1-6 While research on SMW's alcohol use has grown in recent years, a scoping review of the literature from 2000-2017 showed severe underrepresentation of Black and Latina women.7 Probability data show that 1 in 4 Black women8 and 1 in 5 Latinos9 (across gender) in the US identify as sexual minority. Lack of racial diversity in sampling presumes that the types, severity and frequency of stressors impacting alcohol use among SMW is uniform across racial/ethnic groups. As a result, key sociocultural and/or community-level factors impacting alcohol use among Black and Latina SMW have been minimized or altogether unobserved. The Institute of Medicine (2011)10 and National Institutes of Health (2019, 2020)11,12 emphasized the need for research that considers how intersectional stigma across race and sexual orientation creates unique and synergistic experiences of stress linked to health disparities. Our previous work demonstrates that persistent, ongoing intersectional stigma among Black and Latina SMW drives negative affect and problematic alcohol use. The long-term goal of our research is to reduce alcohol-related health disparities in racially diverse SMW. Our team has the content and methodological expertise to carry out the proposed project, including successful implementation of daily diary studies and several community-based studies among Black and Latina SMW. Using baseline measures and a 14-day daily diary, the objective of this R21 application is to test the feasibility of a theory-driven pilot study that captures daily risk and protective factors associated with negative affect and problematic drinking among Black and Latina SMW. Levering ongoing research partnerships with several community organizations in Los Angeles County, the proposed study will sample 212 SMW (N=106 Black; N=106 Latina) ages 18-40. Respondent driven sampling will ensure successful recruitment of the target sample as well as appropriate representation across sexual orientation designation and socioeconomic background. This research study will pursue two specific aims: (1) examine the role of stress (race-based stigma, sexuality- based stigma, general life stress) on negative affect and problematic alcohol use among Black and Latina SMW, and (2) explore person-level (race, concealment) and community-level (peer drinking norms, social support) moderators in the association between daily stress and negative affect and problematic alcohol use. The proposed research is significant because of its potential to improve public health for SMW by deepening existing understandings of daily stress effects on alcohol-related health disparities among SMW, particularly the role of intersectional stigma across race and sexual orientation.