Intersectional stigma subgroup differences in unhealthy drinking and disordered marijuana use among Black and Latino cisgender sexual minority young men

• Published in: Drug and alcohol dependence Vol. 241; p. 109652
• Main Authors: Layland, Eric K., Bray, Bethany C., Kipke, Michele D., Maggs, Jennifer L.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.12.2022; Elsevier Science Ltd
• Subjects: Adolescent; Adult; Age; Age differences; Alcohol; Alcohol use; Black people; Cannabis; Cisgender; Discrimination; Drinking; Drinking behavior; Drug use; Friendship; Heterosexism; Hispanic Americans; Humans; Internalization; Intersectionality; Latent class analysis; Latin American cultural groups; Male; Marijuana; Marijuana Smoking; Marijuana Use - epidemiology; Men; Race relations; Racism; Sexual and Gender Minorities; Social relations; Social Stigma; Stigma; Subgroups; Substance abuse; Substance use; Substance-Related Disorders; Symptoms; Young Adult; Young men; Alcohol; Marijuana; Intersectionality; Stigma; Racism; Heterosexism
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2022.109652

We investigated associations of intersectional stigma subgroups with alcohol and marijuana use among Black and Latino sexual minority young men. Subgroups included Minimal Stigma (low to no stigma), Select Social Stigma (occasional stigma in social relationships), Multiform Heterosexism (internalized and interpersonal heterosexism from family/friends), Multiform Racism (racism across diverse contexts), Compound Stigma (frequent, ubiquitous racism and heterosexism). Cohort of Black and Latino cisgender sexual minority young men (n = 414; baseline ages 16–25) surveyed semiannually 2016–2019. Generalized estimating equations integrated with latent class analysis modeled linear and quadratic age effects and association of stigma subgroups with past 6-month alcohol use, marijuana use, unhealthy drinking, and marijuana use disorder symptoms. All past 6-month substance use peaked between ages 21–23 years old. Across all ages and relative to Minimal Stigma, odds of drinking were higher in every subgroup and highest in Compound Stigma (OR=2.72, 95% CI 1.17–6.35); unhealthy drinking was higher in every subgroup and highest in Multiform Heterosexism (β = 3.31, 95% CI 1.92–3.89); marijuana use disorder symptoms were higher in most subgroups and highest in Compound Stigma (β = 1.30, 95% CI 0.76–1.85). Marijuana use odds did not differ among groups. By examining intersectional stigma subgroups, we identified subgroups for whom substance use was elevated during a development period when use tends to be highest. Young men experiencing stigma patterns characterized primarily by heterosexism or heterosexism together with racism may be especially at risk for developing unhealthy drinking behaviors and marijuana use disorder symptoms. •Cohort of Black and Latino sexual minority young men over 18-month period.•Tested drinking and marijuana use differences among intersectional stigma subgroups.•Evidence of statistically normative substance use peaks in early 20 s.•Past 6-month alcohol and, to lesser extent, marijuana use differed by subgroup.•Multiform Heterosexism, Compound Stigma subgroups had highest substance use peaks.