A longitudinal investigation of intersectional discrimination, alcohol use outcomes, and underlying mechanisms among bisexual people of color

点击翻译按钮获取中文摘要

Project Summary Bisexual and other multi-gender attracted people (e.g., pansexual, queer; “bi+”) are disproportionately affected by adverse alcohol use outcomes (e.g., heavy episodic drinking, drinking consequences, alcohol use disorder [AUD] symptoms) compared to both heterosexual and gay/lesbian people, and discrimination has been implicated as a key driver of these disparities. People of color (POC) are especially likely to identify as bi+, and bi+ POC are subjected to unique forms of discrimination at the intersection of sexual orientation and race/ethnicity. Still, very few studies have examined risk for alcohol use outcomes among bi+ POC, leaving critical gaps in our understanding of risk in this population. In particular, there has been a lack of attention to the range of discriminatory experiences affecting bi+ POC (i.e., bi+, racial/ethnic, and intersectional discrimination, such as heterosexism within one’s racial/ethnic community and racism within the LGBTQ+ community) and their associations with alcohol use outcomes. Evidence indicates that bi+ discrimination is associated with heavy episodic drinking, drinking consequences, and AUD symptoms, but these studies have not attended to other forms of discrimination that affect bi+ POC and their effects on alcohol use outcomes over time. The proposed study will address these gaps by examining prospective associations between discrimination (bi+, racial/ethnic, and intersectional) and alcohol use outcomes among bi+ POC, testing theory- driven mediators and moderators of these associations, and identifying subgroups with the greatest risk based on similar discrimination profiles. To do so, the proposed study will use data from a longitudinal study of 500 bi+ adults, which includes 300 bi+ POC. Participants will complete 4 surveys at 6-month intervals, including measures of: heavy episodic drinking, drinking consequences, and AUD symptoms; bi+, racial/ethnic, and intersectional discrimination; coping motives and identity conflict; and bi+ and racial/ethnic identity affirmation. The primary goals of the proposed study are to: 1) examine prospective associations between discrimination, underlying mechanisms, and alcohol use outcomes among bi+ POC; 2) test identity-related protective factors as moderators of associations between discrimination and alcohol use outcomes; and 3) identify latent profiles based on shared discrimination experiences to identify subgroups of bi+ POC at greatest risk. Findings from this research will provide essential insights into risk for adverse alcohol use outcomes, underlying mechanisms, protective factors, and who is at greatest risk among bi+ POC and establish foundational longitudinal evidence to inform interventions to reduce disparities in this population. This award will also provide the applicant with training in intersectional bi+ health research, alcohol use research, advanced longitudinal statistical analysis, and grant writing necessary to launch his career as an independent scientist.