Baker Elizabeth, Gilbert Paul A, Wheldon Christopher W, Vanderheyden Brian B
Department of Public Health, College of Health Sciences, Des Moines University, Des Moines, Iowa, USA.
Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA.
LGBT Health. 2023 Jan;10(1):62-71. doi: 10.1089/lgbt.2022.0025. Epub 2022 Aug 10.
The study purpose was to (1) identify latent classes of substance use behaviors among a sample of sexual and gender minority (SGM) adults living in a predominantly rural midwestern state and (2) determine the association between SGM-related discrimination and the empirically derived substance use classes. We conducted a latent class analysis on 494 responses to a state-wide survey, followed by a multinomial logistic regression to test predictors of class membership, including distal experiences of discrimination and sociodemographic variables. A three-class model fit best and included (1) polysubstance use, (2) binge drinking, and (3) no/low use classes. In the adjusted model, polysubstance class membership was positively associated with cisgender male identity and negatively associated with being 60 years of age or older and college educated. Binge drinking class membership was negatively associated with bisexual/pansexual identity and non-White race/ethnicity. In contrast to hypothesized outcomes guided by the Minority Stress Model, experiences of discrimination were not associated with membership in substance-using classes. Likewise, bisexual/pansexual individuals were not more likely to be members of polysubstance use or binge drinking classes, despite published reports of greater risk of substance use. These contradictions warrant intersectional approaches to advance substance use research, which may provide important evidence for targeted prevention/treatment interventions, particularly among polysubstance users.
（1）在居住于中西部一个以农村为主的州的性少数和性别少数（SGM）成年人样本中识别物质使用行为的潜在类别；（2）确定与SGM相关的歧视与根据实证得出的物质使用类别之间的关联。我们对一项全州范围调查的494份回复进行了潜在类别分析，随后进行多项逻辑回归，以检验类别归属的预测因素，包括歧视的远期经历和社会人口学变量。一个三类模型拟合效果最佳，包括（1）多种物质使用、（2）暴饮和（3）不使用/低使用类别。在调整后的模型中，多种物质使用类别归属与顺性别男性身份呈正相关，与60岁及以上且受过大学教育呈负相关。暴饮类别归属与双性恋/泛性恋身份以及非白人种族/族裔呈负相关。与少数群体压力模型所指导的假设结果相反，歧视经历与物质使用类别的归属无关。同样，尽管有已发表的报告称双性恋/泛性恋个体物质使用风险更高，但他们成为多种物质使用或暴饮类别的成员的可能性并不更大。这些矛盾情况需要采用交叉性方法来推进物质使用研究，这可能为有针对性的预防/治疗干预措施提供重要证据，特别是在多种物质使用者中。
