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

项目摘要 双性恋和其他多性别被吸引的人(例如，泛性恋者，酷儿；“bi+”)不成比例 受不良饮酒后果的影响(例如，大量饮酒、饮酒后果、饮酒 精神障碍症状)与异性恋者和男/女同性恋者相比，歧视 被认为是造成这些差距的关键因素。有色人种(POC)特别可能认为 Bi+和bi+poc在性取向和性取向的交叉点上受到独特形式的歧视 种族/民族。尽管如此，很少有研究考察bi+poc人群饮酒结果的风险， 我们对这一人群中的风险的理解存在严重差距。特别是，对以下问题缺乏关注 影响bi+poc(即bi+、种族/民族和跨界别)的歧视性经历的范围 歧视，如种族/民族社区内的异性恋主义和LGBTQ+内的种族主义 社区)及其与酒精使用结果的关联。有证据表明，双性恋歧视是 与大量间歇性饮酒、饮酒后果和AUD症状有关，但这些研究 没有注意到影响bi+poc的其他形式的歧视及其对酒精使用结果的影响 随着时间的推移。这项拟议的研究将通过审查两国之间的未来联系来解决这些差距。 BI+POC中的歧视(BI+、种族/民族和跨界别)和酒精使用结果，测试理论- 这些关联的受驱动的调解人和主持人，并确定基于最大风险的子组 在类似的歧视资料上。为了做到这一点，拟议的研究将使用来自500个人的纵向研究的数据 Bi+成人，其中包括300 bi+poc。参与者将每隔6个月完成4次调查，包括 测量：间歇性大量饮酒、饮酒后果和AUD症状；BI+、种族/民族和 跨部门歧视；应对动机和身份冲突；以及对双性恋和种族/族裔身份的肯定。 拟议研究的主要目标是：1)审查歧视之间的预期联系， Bi+poc之间的潜在机制和酒精使用结果；2)测试身份相关保护因素 作为歧视和饮酒结果之间关联的调节者；以及3)确定潜在的特征 基于共同的歧视经验，以确定风险最大的bi+poc子组。调查结果来自 这项研究将提供对不良饮酒结果风险的基本见解，潜在的 BI+POC的机制、保护因素和谁的风险最大，并建立基础 为减少这一人群差异的干预措施提供信息的纵向证据。该奖项还将 为申请者提供跨部门双+健康研究、酒精使用研究、高级 纵向统计分析，以及作为一名独立科学家开始职业生涯所必需的拨款写作。

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.