2 - (IOP 29) County-level Cisheterosexism, Anti-black Racism, and Alcohol Use Among Black, Other People of Color, and White Sexual and Gender Minority Adolescents

Purpose: Alcohol use is a well-documented inequity experienced by sexual and gender minority adolescents (SGMA), and these disparities exist across racial and ethnic groups. Yet, little is known about the role of structural oppression (e.g., structural racism or cisheterosexism) on SGMA alcohol use, particularly how multiple forms of structural oppression affect SGMA of different racial and ethnic identities. This study examined the relationships between county-level structural cisheterosexism, county-level structural anti-Black racism, and their interaction, and past-year alcohol use for SGMA who areBlack, other People of Color (IPOC), and White.

Methods: Participants were N = 6,956 SGMA (Black n = 596, IPOC n = 1,920) aged 13-18. County-level cisheterosexism and anti-Black racism indices were computed based on indicators of implicit and explicit prejudiced attitudes, and Black vs. White disparities in socioeconomic, education, and segregation outcomes. County-level cisheterosexism loaded onto a single factor of prejudice attitudes. County-level racism loaded onto 3 factors, a racial prejudice factor, a socioeconomic and education disparities factor, and a racial segregation factor. Multilevel logistic regression models were fitted separately to Black, IPOC and White SGMA. Models accounted for gender, sexual orientation, age, and average state-level rates of past-month alcohol use among 12-17 year olds.

Results: For Black SGMA, cisheterosexism (p = .023), racial prejudice (p = .049), and racial segregation (p = .016) were associated with greater likelihood of past-year alcohol use. The socioeconomic and education racism factor was associated with lower likelihood of past-year alcohol use (p = .033). For White SGMA, cisheterosexism and the racism factors were not associated with past-year alcohol use (p’s ≥ .188). For IPOC SGMA, racism factors were not associated with past-year alcohol use (p’s ≥ .410). Cisheterosexism was marginally associated with greater likelihood of past-year alcohol use (p = .065). There were no significant interactions between cisheterosexism and any of the racism factors on alcohol use in any of the models (p’s ≥ .116).

Conclusions: These findings suggest higher levels of structural cisheterosexism are associated with greater likelihoods of alcohol use for Black and potentially IPOC SGMA but not for White SGMA. Furthermore, structural anti-Black racism may be associated with alcohol use for Black but not IPOC or White SGMA. There may be complex and nuanced relationships among structural oppression, social inclusion, and alcohol use for racially and ethnically diverse SGMA. In particular, different forms of structural racism appear to relate to Black SGMA alcohol use in nuanced ways that warrant further explanation.