Alcohol and Cannabis Use Trajectories and Outcomes in a Sample of Hispanic, White, and Asian Sexual and Gender Minority Emerging Adults

Abstract

Substance use disproportionately affects health and psychosocial outcomes for some racial/ethnic groups, but few longitudinal studies examine the extent to which sexual and gender minority (SGM) emerging adults of different racial/ethnic groups may experience disparities in outcomes at similar levels of alcohol or cannabis use. This study used five waves of annual survey data (spanning 2015 (average age 18) to 2020 (average age 23)) from an ongoing longitudinal cohort study of emerging adults. In the subset of 359 SGM emerging adults, separate sequelae of change models assessed differences in trajectories of alcohol or cannabis use (past 30-day frequency) and multiple health and psychosocial outcomes across Hispanic, Asian, and White individuals. White SGM emerging adults showed higher baseline levels of alcohol and cannabis frequency compared to Hispanic and Asian peers, but all groups showed similar rates of change (slope) over time. We observed few racial/ethnic differences in SGM emerging adult outcomes at the same levels of alcohol or cannabis use; that is, racial/ethnic groups showed similar patterns on most health and psychosocial outcomes; however, some differences emerged. For example, Asian respondents reported less engagement in sex with casual partners after using alcohol, marijuana, or other drugs compared to their White peers, at the same levels of alcohol use (β = −0.579, p = 0.03) or cannabis use (β = −0.737, p = 0.007). Findings underscore a need to consider multiple outcome domains and factors beyond additive stress in examining the effects of substance use across different groups of SGM individuals. More longitudinal studies with large, contemporary, and diverse samples of SGM emerging adults are needed to better characterize similarities and differences in patterns of substance use and use-related consequences in relation to intersecting SGM, racial/ethnic, and other identities.

Unpacking disparities in substance-related outcomes among racial, ethnic, sexual, and gender minoritized groups during adolescence and emerging adulthood.

“…There is much less work assessing disparities in outcomes due to AOD use among SGM individuals. To date, our team has addressed this by examining how trajectories of alcohol and cannabis use from adolescence through emerging adulthood are prospectively associated with differences in a range of health and psychosocial outcomes for SGM compared to non-SGM emerging adults (Dunbar et al, 2022a(Dunbar et al, , 2022b. This work indicates that SGM individuals show steeper increases in cannabis use, but not alcohol use, throughout adolescence and into emerging adulthood.…”

Life course differences in heavy episodic drinking behaviors across age, gender, and sexual identity in the United States

“…Several studies have found that sexual minority youth are more likely to start drinking at younger ages ( Phillips et al, 2019 , Schuler and Collins, 2019 , Talley et al, 2019 ) and this may help explain elevated rates of negative alcohol outcomes (e.g., AUDs) given that early age of drinking onset is associated with the development of AUDs ( Cheng et al, 2016 , Lopez-Quintero et al, 2011 ). Supporting this contention, several ( Coulter et al, 2018 , Marshal et al, 2009 , Marshal et al, 2012 ), but not all ( Dunbar et al, 2022a , Dunbar et al, 2022b , Talley et al, 2012 ), cohort studies have identified sharper increases in alcohol use trajectories among sexual minorities in early adulthood.…”

Risk and protective factors of social networks on alcohol, cannabis, and opioid use among urban American Indian/Alaska Native emerging adults.

“…Finally, our sample included a large percentage of sexual gender minority (SGM) individuals. Previous studies have shown that SGM individuals report greater consequences at the same levels of alcohol and cannabis use compared to their non-SGM peers (Dunbar et al, 2022a;Dunbar et al, 2022b). Furthermore, research with lesbian, gay, bisexual, and two-spirit Native American people has shown that these individuals tend to report higher rates of AOD use (Balsam et al, 2004) and also experience more health disparities compared to their non-SGM peers (Wilson et al, 2021).…”