Pilot proof of concept exploring longitudinal links between minority stress, stress physiology dysregulation, and drug use in sexual minority adults

项目摘要/摘要 性少数(SM)成年人不成比例地受到药物使用的影响，并面临更大的风险 物质使用障碍比他们的异性恋同龄人。高吸毒率的一种解释 性少数群体中的使用和物质使用障碍是与成为SM有关的压力增加 使SM个人面临使用毒品的风险。研究表明，慢性压力和随后的 下丘脑-垂体-肾上腺轴的激活导致异位平衡，或持续稳定的状态 在正常功能之外，满足慢性应激源的需求(S)。加班, 变态会导致变态负荷，或由于慢性疾病而对身体造成的累积“磨损” 压力。此外，变态负荷与药物使用的开始和轨迹都有联系。 然而，还没有研究检查在手机短信中的药物使用结果中的异位负荷。这个 拟议研究的目的是进行可行性和概念验证研究，以审查 SM应激(如辨别经验、内在性同负性)、变态反应之间的关系 吸毒和吸毒。具体目标是：(1)评估跟踪调查样本40人的可行性 种族/民族多样化的SM成年人在一年的过程中探索少数族裔压力和 (2)获得效应大小的估计，这将使研究人员能够确定 为后续全面研究所需的样本量，(3)开始探索时间联系 在少数人压力、不稳定负荷和药物使用之间，以及(4)提供有针对性的新的指导 由一名老牌调查员担任调查员。为了实现这些目标，我们将招募一名种族/民族多元化的 德克萨斯州休斯敦的SM成年人样本。符合条件的参与者将完成自我报告措施，包括 少数族裔压力和药物使用，以及通过血液和药物收集的生物措施 人体测量学(例如，细胞因子、体重指数)。这项创新的研究将是第一次探索 在这一人群中的非平衡负荷和药物使用，这已经显示出使用药物的健康差异。 此外，这将是第一次全面测试少数应力对非静力负载的影响的研究 在SM成人中。研究结果将被用来开发后续的NIH拨款申请，以进行 完全动力，为期2年的纵向研究。此外，结果将有助于为 为检测、预防和治疗这一高危人群的成瘾而量身定做的干预措施，这将 有助于减轻吸毒和吸毒成瘾带来的疾病负担。拟议的研究解决了这一通知 特殊利益(非MD-23-001)通过利用休斯顿大学健康中心 上瘾研究和癌症预防进行这项创新的先导研究，研究如何 生物、行为和社会/环境因素有助于SM的健康结果和健康 差异，特别是吸毒和吸毒成瘾。

PROJECT SUMMARY/ABSTRACT Sexual minority (SM) adults are disproportionately affected by drug use and are at greater risk for substance use disorders than their heterosexual counterparts. One explanation for the high rates of drug use and substance use disorders among sexual minorities is that increased stress related to being a SM puts SM individuals at risk for drug use. Research demonstrates that chronic stress and subsequent activation of the hypothalamic-pituitary-adrenal axis lead to allostasis, or a state of sustained stability outside of normal functioning that is necessary to meet the demands of the chronic stressor(s). Overtime, allostasis leads to allostatic load, or the cumulative “wear and tear” on the body as a result of chronic stress. Moreover, allostatic load has been linked to both the initiation and trajectories of drug use. However, no research has examined allostatic load in the context of drug use outcomes among SMs. The purpose of the proposed research is to conduct a feasibility and proof-of-concept study to examine the relationships between SM stress (e.g., discrimination experiences, internalized homonegativity), allostatic load, and drug use. The specific aims are to (1) assess the feasibility of following a sample of 40 racially/ethnically-diverse SM adults over the course of 1 year to explore the links between minority stress, allostatic load, and drug use, (2) obtain estimates of effect size that will allow the investigators to determine the required sample size for a subsequent, fully-powered study, (3) begin to explore the temporal links between minority stress, allostatic load, and drug use, and (4) provide targeted mentoring of a new investigator by an established investigator. To meet these aims, we will recruit a racially/ethnically-diverse sample of SM adults in Houston, TX. Eligible participants will complete self-report measures, including minority stress and drug use, among others, in addition to biological measures collected via blood and anthropometrics (e.g., cytokines, BMI). This innovative study will be the first to explore the links between allostatic load and drug use in this population, which has demonstrated drug-use health disparities. Moreover, it will be the first study to comprehensively test the impact of minority stress on allostatic load among SM adults. Study results will be used to develop a subsequent NIH grant application to conduct a fully-powered, 2-year longitudinal study. In addition, results will help to inform the development of individually-tailored interventions to detect, prevent, and treat addiction in this at-risk population, which will help to lessen the disease burden of drug use and addiction. The proposed research addresses the Notice of Special Interest (NOT-MD-23-001) by leveraging the University of Houston’s HEALTH Center for Addictions Research and Cancer Prevention to conduct this innovative pilot study examining how biological, behavioral, and social/environmental factors contribute to SM health outcomes and health disparities, specifically drug use and addiction.