Multiple diverse drinking trajectories among sexual minority women: Unique and joint prediction by minority stress and social influence risk factors

Abstract

Background: Sexual minority populations are at heightened risk for alcohol use disorders compared to heterosexual populations, and these disparities are particularly pronounced for sexual minority women (SMW). Little research has examined the diversity of drinking trajectories among sexual minorities, despite evidence that such trajectories have high predictive utility and are useful in understanding how risk factors may be uniquely associated with specific trajectories.

Method: We utilized four waves of data (12 months between waves) from a sample of 1,057 SMW ages 18-25 at Wave 1. The goals were to (a) identify multiple distinct trajectories of alcohol use; (b) examine the predictive utility of these trajectories; and (c) test associations between minority stress (e.g., discrimination) and social influence (e.g., sexual minority community involvement) risk factors and alcohol trajectories.

Results: Using growth mixture modeling, we identified five classes based on drinking patterns at Wave 1 and change over time (stable low, stable high drinking, stable high HED, low increasing, and high decreasing). These classes were differentially associated with Wave 1 levels and changes in alcohol consequences. Minority stressors uniquely predicted a low increasing trajectory, while social influences uniquely predicted a stable high trajectory. Both minority stress and social risk factors predicted high decreasing and stable high HED trajectories.

Conclusions: Findings indicate that some drinking trajectories among SMW appear similar to those found in the general population, while others appear unique. Results provide insight into how minority stress and social influence risk factors may uniquely and jointly contribute to disparities affecting this population.

Keywords: Alcohol use; Minority stress; Sexual minority; Social influences.

Figure 1.

Figures of intercepts and slopes of HED and drinking frequency by GMM class. See Table 3 for parameter estimates each class Table 4 for parameter estimates for each class.

Figure 2.

Figures of intercepts and slopes of alcohol consequences by GMM stable high heavy episodic drinking. class. See Table 4 for parameter estimates for each class.