Examining Daily Self-Efficacy, Minority Stressors, and Alcohol and Other Drug Use Among Trauma-Exposed Sexual Minority Women and Transgender and Gender-Diverse People.

BACKGROUND AND PURPOSE

This study aimed to develop and test a novel model integrating social-learning and self-medication frameworks by examining the association between self-efficacy to resist alcohol and other drug (AOD) use and daily AOD use and unhealthy drinking risk among trauma-exposed sexual minority women (SMW) and transgender and gender-diverse (TGD) people. We examined whether minority stressors moderated these associations.

METHODS

Data were from 57 trauma-exposed SMW and TGD people who participated in a 14-day daily diary study. Multilevel binary logistic models and ordinal logistic models were employed to examine associations between self-efficacy to resist AOD use and daily AOD use and unhealthy drinking risk at within- and between-person levels. We assessed same- and cross-level interactions between daily self-efficacy to resist AOD use and minority stressors in predicting AOD use and unhealthy drinking risk within the same 24-hour period (i.e., standardized as 6 pm to 6 pm; hereafter referred to as "same-day").

RESULTS

Self-efficacy to resist AOD use was associated with lower AOD use and unhealthy drinking risk. Minority stressors were associated with daily AOD use. Among those who experienced higher (vs. lower) average sexual minority stressors over the 2-week daily diary period, higher-than-usual self-efficacy to resist AOD use was less protective in decreasing risk of same-day unhealthy drinking.

CONCLUSIONS

Interventions aiming to mitigate AOD use and unhealthy drinking risk by bolstering self-efficacy to resist AOD use should consider the impact of recent cumulative exposure to sexual minority stressors in this population. Further, policy efforts are needed to reduce perpetuation of stigma.

This study explored how confidence in resisting alcohol and other drug (AOD) use relates to daily AOD use and unhealthy drinking risk among trauma-exposed sexual minority women (SMW) and transgender and gender-diverse (TGD) people. We also assessed whether experiences of minority stress, such as discrimination or stigma, influenced these relationships. Fifty-seven SMW and TGD individuals participated in a 14-day daily diary study. Results showed that higher self-efficacy was linked to lower AOD use and reduced unhealthy drinking risk. However, for those who experienced greater levels of minority stress over the 2 weeks, the protective effect of self-efficacy was weaker. In these cases, even high self-efficacy was less effective at reducing unhealthy drinking on stressful days. These findings suggest that interventions aimed at improving self-efficacy in resisting AOD use in SMW and TGD populations should address minority stressors, and policies need to focus on reducing stigma to improve health outcomes in these communities.

Informations de copyright

© Society of Behavioral Medicine 2024. All rights reserved. For commercial re-use, please contact [e-mail] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [e-mail].