Multivariate Relations between Minority Stressors and Substance Use Involvement Among Bisexual Emerging Adult Men and Women

Background and Purpose: LGBT+ persons report higher rates of substance use compared to their heterosexual peers and research suggests that LGBT+ persons who identify as members of racial/ethnic minority groups experience added discrimination, increasing their risk for substance use problems. Bisexual individuals report higher negative health outcomes than other sexual minority groups due to stressors such as binegativity. However, research on bisexual emerging adults has generally not attended to how relations between sexual minority stressors and substance use involvement may vary by racial/ethnic group membership, limiting information needed to tailor intervention efforts or substance use treatment content. The aim of this cross-sectional study was to describe multivariate relations between minority stressors and substance use involvement, as well as the influence of racial/ethnic group membership on these relations in samples of bisexual emerging adult men and women.

Methods: Samples of bisexual women (N = 249, mean age = 23.35 years, 31.8% non-White, 18.1% Latine) and bisexual men (N = 201, mean age = 23.31 years, 33.8% non-White, 21.4% Latine) were recruited on the Internet via CloudResearch. Participants answered a 20-minute survey measuring substance use, lifetime traumas, romantic relationships, sexual-minority related stressors, and structural influences on interpersonal violence exposure. Recent substance use involvement was assessed using validated brief screeners of alcohol risk behaviors (AUDIT), substance use problems (DAST-10) and negative consequences of substance use (SIP-R). Five measures of sexual minority stressors included: degree of disclosure of sexual minority status to others, degree of concealment of sexual minority status to others, ratings of felt stigma, ratings of internalized sexual stigma, and self-reported experiences of everyday discrimination.

Results: Multivariate multiple regression was used to predict three substance use involvement variables using five sexual minority stress variables, racial group (White, non-White), and Latine ethnic identity. Among bisexual women, everyday discrimination experiences predicted scores for the AUDIT (p<.05), DAST-10 (p<.01) and SIP-R (p<.001). Racial group was associated with differences in scores for the AUDIT (p<.05), DAST-10 (p<.001) and SIP-R (p<.01). Among bisexual men, degree of disclosure of sexual minority status to others predicted scores for the AUDIT (p<.01), DAST-10 (p<.01) and SIP-R (p<.01). In addition, everyday discrimination experiences predicted scores for the AUDIT (p<.05), DAST-10 (p<.05) and SIP-R (p<.01).

Conclusions and Implications: Our study identified similarities and differences in relations between minority stressors and substance use involvement among bisexual emerging adult men and women. In addition, racial group membership appears to influence these multivariate relations among bisexual women. Our results have implications for efforts to tailor counseling or intervention services to address substance use problems among bisexual emerging adult men and women who experience multiple forms of sexual minority stress. Our findings emphasize the importance of addressing sexual minority stressors and substance use among bisexual emerging adults using intervention and treatment services that are tailored by gender and racial/ethnic group membership. Specialized training may be warranted for social work and other professionals who provide substance use intervention services to this vulnerable population.