Role of Alcohol Disparities in HIV Risk among Sexual Minority Youth

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. Building 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.