O4360: Moderating Effects of LGBTQ+ Community Connectedness and Positive Sexual Identity on Alcohol Misuse Over Time Among Young Lesbian and Bisexual Women

Background: Young lesbian and bisexual women demonstrate increased risk of alcohol misuse, compared to their heterosexual peers, and bisexual women demonstrate increased risk, compared to lesbian women. However, limited research exists regarding factors that may reduce alcohol misuse over time among young lesbian and bisexual women/nonbinary individuals assigned female at birth (LBWNB). Therefore, we sought to examine longitudinal effects of LGBTQ+ community connectedness and positive sexual identity on alcohol misuse among young LBWNB.

Methods: Participants from across the U.S. (46 states) were recruited in 2023-2024 into an 18-month longitudinal study via paid social media advertisements. The analytic sample included 765 participants aged 14 to 30 (M=22 years; 98% of the total study sample) who completed the first six surveys over a 15-month period. The analytic sample included 50% lesbian and 50% bisexual participants, and was racially/ethnically diverse (e.g., 25% Hispanic, 24% Black, 11% Asian). Participants completed a longitudinal Qualtrics survey every 3 months assessing positive sexual identity (feelings of authenticity, affirmation, and self-awareness regarding one’s sexual identity) and LGBTQ+ community connectedness, and alcohol misuse (i.e., AUDIT-C). We performed linear regression analysis to examine moderating effects of positive sexual identity and LGBTQ+ community connectedness on alcohol misuse over time.

Results: Positive sexual identity was not significantly associated with alcohol misuse over time for lesbian or bisexual participants. For bisexual participants, there was a modest, though non-significant decline in alcohol misuse across time (B=-.11, p=.06), and this did not vary by trajectories of LGBTQ+ community connectedness (B=.08, p=.79). However, for lesbian participants, the linear trajectory of alcohol misuse varied across time by LGBTQ+ community connectedness (B=-.94, p=.007). For those with steeper positive trajectories of LGBTQ+ community connectedness, there was a significant decline in alcohol misuse across time (B=-.30, p<.001), indicating that lesbian participants with higher LGBTQ+ community connectedness showed a significant decline in alcohol use over time. Conversely, for lesbian participants with less steep trajectories of LGBTQ+ community connectedness, results showed no significant change in alcohol misuse across time (B=-.11, p=.08). There were observed differences in LGBTQ+ community connectedness between lesbian and bisexual participants, t(616)=5.02, p<.001, d=.39, such that LGBTQ+ community connectedness was higher among lesbian women (M=4.10, SD=0.77) than bisexual women (M=3.77, SD=0.86).

Conclusion: Efforts to reduce alcohol misuse disparities among lesbian young people should focus on enhancing LGBTQ+ community connectedness, given the strong negative associations between feelings of connectedness to the LGBTQ+ community and alcohol misuse over time. However, bisexual individuals may experience decreased feelings of belonging within the LGBTQ+ community due to experiences of anti-bisexual discrimination from other members within the community. Research is needed to identify if interventions that address anti-bisexual discrimination and enhance LGBTQ+ community connectedness among bisexual women/AFAB nonbinary individuals are protective for this population.