Center for Latino Health Research Opportunities (CLaRO)

PI: Kathryn Nowotny, PhD
Primary Mentor: Bryan Page, PhD
Title: Assistant Professor, Department of Sociology, University of Miami

Study Title: Minority Stress and Sexual Identity across the Life Course of Mexican-American Women Who Have Sex with Women and Men: An examination of Stressful Life Events, Social Support and Substance Use

Abstract: The Institute of Medicine report of sexual and gender minority health documents that bisexual-identified women and women who have sex with women and men (WSWM) have substantially worse health, including substance use behaviors (e.g., drinking, smoking),than women who engage in exclusively lesbian and heterosexual behaviors. Yet, there are important gaps in knowledge concerning how intersecting minority statuses (e.g., Hispanic ethnicity, sexual minority) contribute to high-risk substance use (e.g., injecting drug use, binge drinking, overdose) among WSWM, especially for those who live in socioeconomically disadvantaged communities. The minority stress model posits that stigmatized minority statuses are associated with discrimination (e.g., overt, internalized) and disproportionate exposure to stressful life events(e.g., violence, incarceration). These factors are predicted to increase psychological distress and, subsequently, high-risk substance use. Social support from an individual’s family of origin (e.g., parents, siblings) and chosen family (e.g., partner, children, “fictive kin”), however, can buffer the negative health effects of discrimination and stressful life events. The goal of the proposed study is to identify qualitatively the risk (discrimination, stressful life events) and protective (social support) factors for high-risk substance use among WSWM from the perspective of socioeconomically disadvantaged Latinas, and how these factors are influenced by their multiple minority identity statuses. Theoretically guided by the minority stress model and the life course perspective, life history interviews will be conducted with 30 Mexican-American WSWM previously identified in a NIDA-funded longitudinal cohort study (Proyecto SALTO; R01 DA039269; PI: Cepeda). The specific aims of this study are: (1)characterize qualitatively WSWM’s sexual identity development and determine how multiple minority identity statuses (e.g., Hispanic ethnicity) shape experiences of discrimination and stressful life events, in the context of a low-income and marginalized Latino community; and (2) describe and explain the social interaction processes connecting discrimination and stressful life events, social support, and high-risk substance use across the life course of WSWM. The proposed study is among the first to examine the health of an exclusively Mexican-American female sexual minority population. This study is also aligned with the mission of the Center for Latino Health Research Opportunities in its examination of substance use, violence/trauma, psychological distress, and related factors among a vulnerable Latino population. This research project will have a sustained positive impact by identifying how potential risk and protective factors for high-risk substance use are associated with stigmatized minority statuses from the perspective of WSWM.