Project Summary
Bisexual and other multi-gender attracted people (e.g., pansexual, queer; “bi+”) are disproportionately
affected by adverse alcohol use outcomes (e.g., heavy episodic drinking, drinking consequences, alcohol use
disorder [AUD] symptoms) compared to both heterosexual and gay/lesbian people, and discrimination has
been implicated as a key driver of these disparities. People of color (POC) are especially likely to identify as
bi+, and bi+ POC are subjected to unique forms of discrimination at the intersection of sexual orientation and
race/ethnicity. Still, very few studies have examined risk for alcohol use outcomes among bi+ POC, leaving
critical gaps in our understanding of risk in this population. In particular, there has been a lack of attention to
the range of discriminatory experiences affecting bi+ POC (i.e., bi+, racial/ethnic, and intersectional
discrimination, such as heterosexism within one’s racial/ethnic community and racism within the LGBTQ+
community) and their associations with alcohol use outcomes. Evidence indicates that bi+ discrimination is
associated with heavy episodic drinking, drinking consequences, and AUD symptoms, but these studies have
not attended to other forms of discrimination that affect bi+ POC and their effects on alcohol use outcomes
over time. The proposed study will address these gaps by examining prospective associations between
discrimination (bi+, racial/ethnic, and intersectional) and alcohol use outcomes among bi+ POC, testing theory-
driven mediators and moderators of these associations, and identifying subgroups with the greatest risk based
on similar discrimination profiles. To do so, the proposed study will use data from a longitudinal study of 500
bi+ adults, which includes 300 bi+ POC. Participants will complete 4 surveys at 6-month intervals, including
measures of: heavy episodic drinking, drinking consequences, and AUD symptoms; bi+, racial/ethnic, and
intersectional discrimination; coping motives and identity conflict; and bi+ and racial/ethnic identity affirmation.
The primary goals of the proposed study are to: 1) examine prospective associations between discrimination,
underlying mechanisms, and alcohol use outcomes among bi+ POC; 2) test identity-related protective factors
as moderators of associations between discrimination and alcohol use outcomes; and 3) identify latent profiles
based on shared discrimination experiences to identify subgroups of bi+ POC at greatest risk. Findings from
this research will provide essential insights into risk for adverse alcohol use outcomes, underlying
mechanisms, protective factors, and who is at greatest risk among bi+ POC and establish foundational
longitudinal evidence to inform interventions to reduce disparities in this population. This award will also
provide the applicant with training in intersectional bi+ health research, alcohol use research, advanced
longitudinal statistical analysis, and grant writing necessary to launch his career as an independent scientist.
