Discrimination, Community Belongingness, and Substance Use Among Sexual and Gender Minority Adults

<b>Background:</b> Lesbian, gay, bisexual, transgender, queer, and
other sexual/gender minority (LGBTQ+) adults experience elevated substance use
risk. This study examined the independent associations of everyday
discrimination and community belongingness with substance use, and whether
belongingness moderated the discrimination–substance use relationship.

<b>Methods:</b> Data were collected April–July 2024 among 1,578
U.S. LGBTQ+ adults. Discrimination was measured with the Everyday
Discrimination Scale and belongingness with the LGBTQ+ Belongingness Attainment
Scale. Outcomes included lifetime cannabis, hard drug, and cigarette use;
current cigarette and electronic nicotine product use; past-year heavy
drinking; and ordinal frequency measures. Binary and ordinal logistic
regression tested main effects and Belongingness × Discrimination interactions,
with sociodemographic adjustment.

<b>Results:</b> Moderate belongingness was associated with greater
current nicotine use. High belongingness predicted greater lifetime cannabis
use but lower odds of heavy alcohol use, frequent cannabis, hard drug, and
binge drinking. Discrimination was associated with greater odds of lifetime
cigarette and hard drug use and current nicotine use. Significant interactions
emerged for 8 of 10 outcomes; discrimination’s associations were generally weak
or nonsignificant at low belongingness, but were stronger and more consistently
harmful at high belongingness.

<b>Conclusions:</b> Although LGBTQ+ community belongingness was
associated with lower odds of frequent and heavy substance use, it also
appeared to amplify associations between discrimination and several substance
use outcomes among individuals with higher belongingness.<b></b>