Intersectional Approaches to Population-Level Health Research: Role of HIV Risk and Mental Health in Alcohol Use Disparities among Diverse Sexual Minority Youth

人口层面健康研究的交叉方法：艾滋病毒风险和心理健康在不同性少数青少年饮酒差异中的作用

• 批准号: 10325087
• 负责人: Gregory L. Phillips
• 金额: $ 58.83万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10325087
• 关键词: Address; Adolescence; Adolescent Risk Behavior; Adult; Age; Alaska Native; Alcohol abuse; Alcohol consumption; Alcohols; American; American Indians; Anxiety; Area; Attenuated; Behavior; Bisexual; Cities; Climate; Complex; County; Critical Pathways; Data; Data Pooling; Data Set; Dependence; Development; Drug usage; Emergency department visit; Ensure; Epidemiology; Ethnic Origin; Funding; Goals; HIV; HIV risk; Health; Health Status; Health behavior; Heterosexuals; High School Student; Individual; Intervention; Investigation; Journals; Legal; Mental Depression; Mental Health; Methodology; Methods; Minority; NIH Office of AIDS Research; National Institute on Alcohol Abuse and Alcoholism; Neurocognitive; Outcome; Participant; Pathway interactions; Pattern; Pediatrics; Peer Review; Policies; Population; Positioning Attribute; Prevalence; Public Health; Publications; Race; Reporting; Research; Research Personnel; Research Priority; Role; Sample Size; Sampling; School-Age Population; Schools; Sex Behavior; Sex Orientation; Sexual Health; Social Change; Statistical Methods; Stigmatization; Stress; Structure; Suicide; Surveys; Techniques; Time; Time trend; Tobacco use; United States; Unsafe Sex; Vulnerable Populations; Work; Youth; aging population; alcohol consequences; alcohol risk; base; behavioral/social science; binge drinking; college; comparative; drug of abuse; experience; health disparity; high school; individual variation; innovation; interdisciplinary collaboration; large datasets; lens; male; multilevel analysis; non-suicidal self injury; novel; peer; physical conditioning; psychological distress; racial and ethnic; risk minimization; same-sex marriage; sex; sexual identity; sexual minority; social exclusion; social science research; social stigma; substance use; success; theories; time use; trend; young men who have sex with men

PROJECT SUMMARY Alcohol is the most commonly used and abused drug among youth in the US; prevalence of alcohol use is disproportionately higher among sexual minority youth (SMY) than among their heterosexual peers, especially among those at the intersections of multiple marginalized identities. Alcohol use and abuse are associated with a multiplicity of short and long-term negative health outcomes, including HIV vulnerabilities, alcohol and other substance use dependence, neurocognitive deficiencies, and psychological distress. Despite the fact that alcohol use and abuse during adolescence has important consequences for downstream health outcomes and adult patterns of substance use, the majority of research among sexual minorities to date has focused on college-aged populations. This gap in research with SMY is critical to rectify, particularly for SMY who experience multiple, intersecting forms of marginalization based on sex, race/ethnicity, and sexual orientation. Building on our team’s prior work in this area, we propose to use pooled data from the Local Youth Risk Behavior Survey (YRBS), a national biennial survey of high school students that assesses sexual identity and behavior, as well as health behaviors including alcohol use, HIV vulnerability, and mental health. Our uniquely large dataset, which currently contains data from 2005 to 2019 (253 jurisdiction-years) and 950,295 high school youth, will expand to include 2021, 2023, and 2025 data, resulting in an estimated 1,668,078 youth. This will allow us to apply an array of complex epidemiologic approaches to assess the impact of alcohol use on the sexual, mental, and physical health of SMY living in the US, and the disparities that exist between multiply marginalized SMY and their peers. This proposal is a natural extension of our prior work (R01 AA024409) that resulted in numerous publications in high-impact peer-reviewed journals (e.g., Pediatrics, American Journal of Public Health) and a diverse array of interdisciplinary collaborations. The current proposal will continue these successes, incorporating an intersectional lens as well as additional advanced methods of inquiry, including use of multilevel modeling to determine jurisdictional and temporal associations with alcohol use and disparities in HIV risk; latent class analysis to describe alcohol use classes and their association with minority status; and the impact of regional, school, and structural level factors that influence alcohol use and its role in increased HIV vulnerability among diverse SMY. These approaches will allow us to continue identifying critical pathways for intervention to ensure equitable health outcomes and minimize the risks associated with alcohol use and abuse among notably vulnerable populations of youth.

项目摘要 酒精是美国青年中最常用和滥用的药物；饮酒的患病率是 性少数族裔青年（SMY）的不成比例比异性恋同龄人高。 在多个边缘化身份的交集中。饮酒和滥用与 短期和长期的负面健康结果多样性，包括艾滋病毒脆弱性，酒精和其他 药物使用依赖性，神经认知缺陷和心理困扰。尽管事实 青少年期间的饮酒和滥用对下游的健康结果有重要影响 成人使用物质的模式，迄今为止的性少数群体中的大多数研究都集中在 大学时代的人口。与SMY的研究差距对于纠正至关重要，特别是对于SMY而言 基于性别，种族/种族和性取向，经历多种边缘化形式。 在我们团队在该领域的先前工作的基础上，我们建议使用当地青年风险的汇总数据 行为调查（YRB），一项针对高中生的全国性两年级调查，评估了性身份和 行为以及健康行为，包括饮酒，艾滋病毒脆弱性和心理健康。我们的独特之处 大型数据集目前包含2005年至2019年的数据（253个管辖权年）和950,295 学校青年将扩展到2021、2023和2025数据，估计有1,668,078名青年。 这将使我们能够采用一系列复杂的流行病学方法来评估酒精使用的影响 关于生活在美国的史密斯的性，心理和身体健康以及之间存在的差异 乘以边缘化的SMY及其同龄人。该提议是我们先前工作的自然延伸（R01 AA024409）导致了高影响同行评审期刊的大量出版物（例如儿科， 美国公共卫生杂志）和一系列跨学科合作阵列。当前的建议 将继续这些成功，结合了相交的镜头以及其他高级方法 查询，包括使用多层次建模来确定与酒精的管辖权和临时关联 艾滋病毒风险的使用和差异；潜在类别分析以描述酒精使用类别及其与 少数民族地位；以及影响酒精使用及其的区域，学校和结构性因素的影响 潜水员史密斯的艾滋病毒脆弱性增加中的作用。这些方法将使我们能够继续识别 干预的关键途径，以确保公平的健康结果并最大程度地降低与之相关的风险 在脆弱的青年人群中，饮酒和滥用。