Community Health Systems, School of Nursing, University of California, San Francisco, CA, United States; Alliance Health Project, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA, United States; The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, United States.
Community Health Systems, School of Nursing, University of California, San Francisco, CA, United States; The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, CA, United States.
Addict Behav. 2024 Oct;157:108079. doi: 10.1016/j.addbeh.2024.108079. Epub 2024 Jun 6.
Substance use disparities among sexual and gender minority (SGM) people are attributed to minority stress, but few studies have examined minority stress and cannabis use over time or investigated differences in cannabis use trajectories by less-studied gender subgroups. We examined if longitudinal cannabis use trajectories are related to baseline minority stressors and if gender differences persisted after accounting for minority stress. Cannabis use risk was measured annually over four years (2017-2021) within a longitudinal cohort study of SGM adults in the United States (N = 11,813). Discrimination and victimization, internalized stigma, disclosure and concealment, and safety and acceptance comprised minority stress (n = 5,673). Latent class growth curve mixture models identified five cannabis use trajectories: 'low or no risk', 'low moderate risk', 'high moderate risk', 'steep risk increase', and 'highest risk'. Participants who reported past-year discrimination and/or victimization at baseline had greater odds of membership in any cannabis risk category compared to the 'low risk' category (odds ratios [OR] 1.17-1.33). Internalized stigma was related to 'high moderate' and 'highest risk' cannabis use (ORs 1.27-1.38). After accounting for minority stress, compared to cisgender men, gender expansive people and transgender men had higher odds of 'low moderate risk' (ORs 1.61, 1.67) or 'high moderate risk' (ORs 2.09, 1.99), and transgender men had higher odds of 'highest risk' (OR 2.36) cannabis use. This study indicates minority stress is related to prospective cannabis use risk trajectories among SGM people, and transgender men and gender expansive people have greater odds of trajectories reflecting cannabis use risk.
性少数群体和性别少数群体（SGM）的物质使用差异归因于少数群体压力，但很少有研究考察随着时间的推移少数群体压力和大麻使用之间的关系，或调查通过研究较少的性别亚组来研究大麻使用轨迹的差异。我们研究了纵向大麻使用轨迹是否与基线少数群体压力源有关，以及在考虑少数群体压力后，性别差异是否仍然存在。在一项针对美国 SGM 成年人的纵向队列研究中，每年（2017-2021 年）对大麻使用风险进行了一次测量（N=11813）。歧视和受害、内化的耻辱感、披露和隐瞒、安全和接受构成了少数群体压力（n=5673）。潜在类别增长曲线混合模型确定了五种大麻使用轨迹：“低或无风险”、“低中度风险”、“高中度风险”、“风险急剧增加”和“最高风险”。与“低风险”类别相比，基线时报告过去一年有歧视和/或受害的参与者更有可能属于任何大麻风险类别（优势比 [OR] 1.17-1.33）。内化的耻辱感与“高中度”和“最高风险”大麻使用有关（ORs 1.27-1.38）。在考虑少数群体压力后，与顺性别男性相比，性别扩张者和跨性别男性更有可能处于“低中度风险”（ORs 1.61、1.67）或“高中度风险”（ORs 2.09、1.99），跨性别男性“最高风险”（OR 2.36）大麻使用的可能性更高。这项研究表明，少数群体压力与 SGM 人群前瞻性大麻使用风险轨迹有关，跨性别男性和性别扩张者更有可能出现反映大麻使用风险的轨迹。
