Intersectional Approaches to Population-Level Health Research: Role of HIV Risk and Mental Health in Alcohol Use Disparities among Diverse Sexual Minority Youth

人口层面健康研究的交叉方法：艾滋病毒风险和心理健康在不同性少数青少年饮酒差异中的作用

• 批准号: 10325087
• 负责人: Gregory L. Phillips
• 金额: $ 58.83万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10325087
• 关键词: Address; Adolescence; Adolescent Risk Behavior; Adult; Age; Alaska Native; Alcohol abuse; Alcohol consumption; Alcohols; American; American Indians; Anxiety; Area; Attenuated; Behavior; Bisexual; Cities; Climate; Complex; County; Critical Pathways; Data; Data Pooling; Data Set; Dependence; Development; Drug usage; Emergency department visit; Ensure; Epidemiology; Ethnic Origin; Funding; Goals; HIV; HIV risk; Health; Health Status; Health behavior; Heterosexuals; High School Student; Individual; Intervention; Investigation; Journals; Legal; Mental Depression; Mental Health; Methodology; Methods; Minority; NIH Office of AIDS Research; National Institute on Alcohol Abuse and Alcoholism; Neurocognitive; Outcome; Participant; Pathway interactions; Pattern; Pediatrics; Peer Review; Policies; Population; Positioning Attribute; Prevalence; Public Health; Publications; Race; Reporting; Research; Research Personnel; Research Priority; Role; Sample Size; Sampling; School-Age Population; Schools; Sex Behavior; Sex Orientation; Sexual Health; Social Change; Statistical Methods; Stigmatization; Stress; Structure; Suicide; Surveys; Techniques; Time; Time trend; Tobacco use; United States; Unsafe Sex; Vulnerable Populations; Work; Youth; aging population; alcohol consequences; alcohol risk; base; behavioral/social science; binge drinking; college; comparative; drug of abuse; experience; health disparity; high school; individual variation; innovation; interdisciplinary collaboration; large datasets; lens; male; multilevel analysis; non-suicidal self injury; novel; peer; physical conditioning; psychological distress; racial and ethnic; risk minimization; same-sex marriage; sex; sexual identity; sexual minority; social exclusion; social science research; social stigma; substance use; success; theories; time use; trend; young men who have sex with men

PROJECT SUMMARY Alcohol is the most commonly used and abused drug among youth in the US; prevalence of alcohol use is disproportionately higher among sexual minority youth (SMY) than among their heterosexual peers, especially among those at the intersections of multiple marginalized identities. Alcohol use and abuse are associated with a multiplicity of short and long-term negative health outcomes, including HIV vulnerabilities, alcohol and other substance use dependence, neurocognitive deficiencies, and psychological distress. Despite the fact that alcohol use and abuse during adolescence has important consequences for downstream health outcomes and adult patterns of substance use, the majority of research among sexual minorities to date has focused on college-aged populations. This gap in research with SMY is critical to rectify, particularly for SMY who experience multiple, intersecting forms of marginalization based on sex, race/ethnicity, and sexual orientation. Building on our team’s prior work in this area, we propose to use pooled data from the Local Youth Risk Behavior Survey (YRBS), a national biennial survey of high school students that assesses sexual identity and behavior, as well as health behaviors including alcohol use, HIV vulnerability, and mental health. Our uniquely large dataset, which currently contains data from 2005 to 2019 (253 jurisdiction-years) and 950,295 high school youth, will expand to include 2021, 2023, and 2025 data, resulting in an estimated 1,668,078 youth. This will allow us to apply an array of complex epidemiologic approaches to assess the impact of alcohol use on the sexual, mental, and physical health of SMY living in the US, and the disparities that exist between multiply marginalized SMY and their peers. This proposal is a natural extension of our prior work (R01 AA024409) that resulted in numerous publications in high-impact peer-reviewed journals (e.g., Pediatrics, American Journal of Public Health) and a diverse array of interdisciplinary collaborations. The current proposal will continue these successes, incorporating an intersectional lens as well as additional advanced methods of inquiry, including use of multilevel modeling to determine jurisdictional and temporal associations with alcohol use and disparities in HIV risk; latent class analysis to describe alcohol use classes and their association with minority status; and the impact of regional, school, and structural level factors that influence alcohol use and its role in increased HIV vulnerability among diverse SMY. These approaches will allow us to continue identifying critical pathways for intervention to ensure equitable health outcomes and minimize the risks associated with alcohol use and abuse among notably vulnerable populations of youth.

项目概要 酒精是美国青少年最常使用和滥用的药物；饮酒流行率是 性少数青少年 (SMY) 的比例明显高于异性恋同龄人，尤其是 在那些处于多重边缘化身份交叉点的人中。饮酒和滥用酒精与 多种短期和长期的负面健康后果，包括艾滋病毒脆弱性、酗酒和其他 物质使用依赖、神经认知缺陷和心理困扰。尽管事实上 青春期饮酒和滥用酒精对下游健康结果和健康产生重要影响 成人的物质使用模式，迄今为止对性少数群体的大多数研究都集中在 大学适龄人口。与 SMY 的研究差距至关重要，尤其是对于 SMY 来说 经历基于性别、种族/民族和性取向的多种交叉形式的边缘化。 基于我们团队之前在该领域的工作，我们建议使用来自当地青年风险的汇总数据 行为调查 (YRBS)，一项针对高中生的两年一度的全国性调查，旨在评估性别认同和 行为，以及健康行为，包括饮酒、艾滋病毒易感性和心理健康。我们独特的 大数据集，目前包含2005年至2019年（253个辖区年）的数据和950,295个高点 学校青少年，将扩大到包括 2021 年、2023 年和 2025 年的数据，估计有 1,668,078 名青少年。 这将使我们能够应用一系列复杂的流行病学方法来评估饮酒的影响 关于生活在美国的 SMY 的性、心理和身体健康，以及之间存在的差异 倍增边缘化的 SMY 及其同龄人。该提案是我们之前工作的自然延伸（R01 AA024409），在高影响力的同行评审期刊（例如 Pediatrics、 美国公共卫生杂志）和各种跨学科合作。目前的提案 将继续这些成功，结合交叉镜头以及其他先进的方法 调查，包括使用多级模型来确定与酒精的管辖权和时间关联 艾滋病毒风险的使用和差异；潜在类别分析来描述酒精使用类别及其与 少数民族地位；以及影响酒精使用及其影响的地区、学校和结构层面因素的影响 不同 SMY 中艾滋病毒易感性增加的作用。这些方法将使我们能够继续识别 干预的关键途径，以确保公平的健康结果并最大限度地减少与健康相关的风险 特别脆弱的青年群体中的酒精使用和滥用问题。