Alcohol is the most commonly used and abused drug among youths in the U.S., and prevalence of alcohol use is disproportionately higher among sexual minority youth (SMY) than among their heterosexual peers. Studies have found that alcohol use and abuse is associated with an array of negative health outcomes, including psychological distress, neurocognitive deficiencies, and acquisition of HIV. This last point is especially important for young men who have sex with men (YMSM), one of the only risk groups in which HIV incidence continues to grow. We propose to use an array of epidemiologic approaches to assess the impact that alcohol use has on the sexual, mental, and physical health of SMY living in the U.S., and the disparities that exist between SMY and their heterosexual peers. In order to conduct these secondary analyses, we will use data collected as part of the Youth Risk Behavior Survey (YRBS), a biennial survey of high school students that will assess sexual identity and behavior for the first time in the national survey in 2015. Buildin on our prior work that resulted in a special issue of the American Journal of Public Health, we will focus on jurisdictional and temporal associations with alcohol use and disparities, identify structural factors that influence alcohol use, and look at event-level associations between alcohol use and condomless sex.

Public Health Relevance

We propose to utilize the Youth Risk Behavior Survey (YRBS) to assess alcohol use disparities between sexual minority youth (SMY) and heterosexual youth across several jurisdictions and years. The national YRBS will collect information on sexual minority status for the first time in 2015, providing the opportunity to conduct innovative researc on alcohol and other health disparities on a national scale.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
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Freeman, Robert
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Northwestern University at Chicago
Public Health & Prev Medicine
Schools of Medicine
United States
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Li, Dennis H; Turner, Blair C; Mustanski, Brian et al. (2018) Sexual orientation disparities in prescription drug misuse among a nationally representative sample of adolescents: Prevalence and correlates. Addict Behav 77:143-151
Cimpian, Joseph R; Timmer, Jennifer D; Birkett, Michelle A et al. (2018) Bias From Potentially Mischievous Responders on Large-Scale Estimates of Lesbian, Gay, Bisexual, or Questioning (LGBQ)-Heterosexual Youth Health Disparities. Am J Public Health 108:S258-S265
Phillips, Gregory; Kalmin, Mariah M; Turner, Blair et al. (2018) Condom and Substance Use at Last Sex: Differences between MSMO and MSWO High School Youth. Int J Environ Res Public Health 15:
Beach, Lauren B; Turner, Blair; Felt, Dylan et al. (2018) Risk factors for diabetes are higher among non-heterosexual US high-school students. Pediatr Diabetes 19:1137-1146
Phillips 2nd, Gregory; Turner, Blair; Salamanca, Paul et al. (2017) Victimization as a mediator of alcohol use disparities between sexual minority subgroups and sexual majority youth using the 2015 National Youth Risk Behavior Survey. Drug Alcohol Depend 178:355-362