Associations Between Drinking Contexts, Minority Stress, and Problematic Alcohol Use Among Sexual Minority Individuals Assigned Female at Birth

Public Significance Statement Results indicate that four subgroups of sexual minority individuals assigned female at birth (including cisgender women, transgender men, and nonbinary individuals) can be identified based on where and with whom they tend to drink: (a) drinking in private settings (i.e., at home alone and with friends, partners, and family); (b) drinking in social settings (i.e., with friends at their homes and parties); (c) drinking in social and private settings (i.e., at houses and parties alone and with friends, partners, and family); and (d) drinking in multiple contexts (i.e., at houses, parties, and bars/restaurants alone and with friends, partners, and family). Individuals who drank in more locations tended to experience more problematic alcohol use at the same time point and six months later. However, drinking context did not predict subsequent changes in problematic alcohol use. A critical next step will be to examine mechanisms underlying associations between drinking contexts and problematic use to inform future interventions to reduce problematic alcohol use among sexual minority individuals assigned female at birth. Sexual minority individuals assigned female at birth (SM-AFAB) are at increased risk for problematic alcohol use compared to heterosexual women. Despite evidence that drinking locations and companions play an important role in problematic alcohol use among heterosexuals, few studies have examined these social contexts of alcohol use among SM-AFAB. To address this gap, the current study examined two aspects of social contexts in which SM-AFAB drink (locations and companions). We utilized two waves of data (6 months between waves) from an analytic sample of 392 SM-AFAB ages 17-33 from a larger longitudinal study. The goals were (a) to identify classes of SM-AFAB based on the contexts in which they drank; (b) to examine the associations between drinking contexts, minority stressors, and problematic alcohol use; and (c) to examine changes in drinking contexts over time. Using latent class analysis, we identified four classes based on drinking locations and companions (private settings, social settings, social and private settings, multiple settings). These classes did not differ in minority stress. Drinking in multiple settings was associated with more problematic alcohol use within the same timepoint and these differences were maintained six months later. However, drinking in multiple settings did not predict subsequent changes in problematic alcohol use when problematic alcohol use at the prior wave was controlled for. Based on these findings, SM-AFAB who drink in multiple settings may be an important subpopulation for interventions to target. Interventions could focus on teaching SM-AFAB strategies to limit alcohol consumption and/or minimize alcohol-related consequences.

Automated summary

This study identified four subgroups of sexual minority individuals assigned female at birth based on their drinking contexts. Individuals who drank in multiple settings were more likely to experience problematic alcohol use at the same time point and six months later. However, drinking context did not predict subsequent changes in problematic alcohol use. This study highlights the importance of further research on the associations between drinking contexts and problematic alcohol use, and provides guidance for interventions targeting sexual minority individuals assigned female at birth.