Examining the Impact of Daily Discrimination on Alcohol Use Among Racially Diverse, Trauma-Exposed Sexually Minoritized Adults: A Pilot Study

Objective: Identity-based stress and trauma are key drivers of alcohol use-related health inequities among minoritized people. Research on intersectional experiences of identity-based stress and alcohol use among trauma-exposed minoritized people is scant. This pilot study used a 30-day diary design to examine the effect of identity-based discrimination exposure on alcohol use in a racially diverse sample of trauma-exposed sexual minoritized (SM) adults (N = 47; 63.8% cisgender female; 65.2% Black, Indigenous, and People of Color [BIPOC]). Method: Multilevel logistic regression models were used to evaluate whether days marked by any (vs. no) identity-based discrimination were concurrently or prospectively associated with increased likelihood of reporting a higher (vs. lower) level of drinking-and whether these associations differed by race/ethnicity. Results: Discrimination was associated with increased likelihood of reporting a higher level of same-day drinking (B = 0.91, p = .03), but did not predict next-day drinking. BIPOC (vs. White) individuals were less likely to report a higher drinking level on or following nondiscrimination days (Bs = −2.18 to −1.52, ps ≤ .005), but more likely to do so on or following discrimination days (Bs = 1.13-1.60, ps ≤ .03). Conclusions: Results suggest that everyday discrimination may create insidious risk for coping-motivated alcohol use among SM BIPOC, a subgroup that otherwise exhibits resilience with respect to drinking. Clinical Impact Statement This study examined the effects of daily discrimination and race/ethnicity on level of daily alcohol use among trauma-exposed sexual minoritized adults. Black, Indigenous, and People of Color (BIPOC) (vs. White) participants exhibited lower drinking risk on nondiscrimination days, but higher drinking risk on or following discrimination days. Best practices for secondary prevention to curb the progression of low-risk alcohol use in this population may differ by race/ethnicity.