Divergent Pathways: Real-Time Effects of Minority Stressors on Alcohol Urges Among Hispanic and White Sexual Minority Youth

Background and Purpose: Sexual minority youth (SMY) are at elevated risk for alcohol use compared to their heterosexual peers. Minority stress theory posits that this disparity is driven, in part, by coping with negative affect. However, these processes may differ for SMY of color due to intersecting marginalized identities. Competing hypotheses within minority stress theory suggest either "double jeopardy," whereby compounded stress increases risk, or "resilience," whereby prior exposure to racial/ethnic stress confers protective effects. Notably, recent data indicate that Hispanic adolescents now report higher alcohol use than white peers, potentially increasing risk among Hispanic SMY. Despite this, little is known about these relationships in real time. This study hypothesized that: (1) negative affect would mediate the association between minority stress and alcohol urges, and (2) ethnicity would moderate this pathway. Understanding these real-time pathways is critical for developing culturally responsive, real-time social work interventions.

Methods: Ecological momentary assessment (EMA) was used to collect intensive longitudinal data from 89 Hispanic and non-Hispanic white SMY (ages 15-19) over 21 days. Eligibility criteria included sexual minority status, US residence, ≥1 discriminatory event in the past 30 days, and current alcohol use (≥1 drink in the past month). Participants completed four random daily surveys assessing alcohol urges, negative affect (8 items), and minority stress since the previous report (7 items). A multilevel generalized structural equation model (M-GSEM) with lagged mediation (T1→T2→T3) was estimated in Stata to test our hypotheses. Models included random intercepts and interaction terms to test moderation by ethnicity, controlling for age, day, and time.

Results: Participants had a mean age of 18 years; 66% were assigned female at birth, and 88% were US-born. In sensitivity testing, ethnicity was not associated with differences in alcohol urges or use in the moment. Minority stress significantly predicted increased negative affect (Path a: B = 0.16, 95% CI [0.04, 0.29], p<.05), though it did not predict alcohol urges. Negative affect, in turn, predicted higher alcohol urge rates (Path b: IRR = 1.17, 95% CI [1.03, 1.32], p<.05) and fully mediated the association between minority stress and alcohol urges (Path c’: B = 0.03, 95% CI [0.01, 0.25], p<.05). Moderation analysis indicated that ethnicity significantly moderated this indirect path (B = -0.02, 95% CI [-0.06, 0.02], p<.05) with the mediated effect statistically significant only among non-Hispanic SMY (B = 0.04, 95% CI [0.01, 0.08], p<.05).

Conclusion and Implications: Findings provide preliminary support for the resilience hypothesis, suggesting that Hispanic SMY may be less likely to engage in alcohol use as a coping response to minority stress-related negative affect. However, generalizability is limited by the modest sample size and the focus on US-born youth. Future research should replicate these findings in larger and more diverse samples and examine alternative strengths-based mechanisms (e.g., coping strategies, social support) that may buffer the effects of minority stress on negative affect among Hispanic SMY. Amid rising racial profiling, identifying these mechanisms is critical for school and community social workers providing counseling and crisis intervention to Hispanic SMY.