PROBLEM SUBSTANCE USE AMONG BISEXUAL EMERGING ADULT MEN AND WOMEN: A PERSON-CENTERED STUDY

Introduction: Substance use problems are highly prevalent among bisexual emerging adults, due to their unique minority stressors (biphobia, marginalization, invisibility). However, bisexuals are understudied, often treated as a homogenous group, or combined with other sexual minorities, ignoring their unique experiences. The main goal of this study was to compare descriptive profiles of bisexual emerging adult men and women to identify differences in modifiable variables (minority stress, social support, connection to LGBTQ+ community, self-esteem), based on substance use classification schemes.

Methods: Bisexual women (N=249, Mage=23.35, 31.8% non-White, 18.1% Latine) and men (N=201, Mage=23.31, 33.8% non-White, 21.4% Latine) were recruited on the Internet via CloudResearch. Participants answered a 20-minute survey measuring substance use, lifetime traumas, romantic relationships, sexual-minority related stressors, and structural influences on interpersonal violence exposure. Substance use was measured using three screeners (i.e., the AUDIT, DAST, SIP-R). Minority stressors included everyday discrimination, felt sexual stigma, internalized sexual stigma, degree of outness, and degree of concealment.

Results: Cluster analysis (Ward’s Method) was used to classify each sample, based on self-reported substance use variables. Optimal cluster solutions for bisexual men and women included three and four groups, respectively. Each solution included (a) small groups (nmen=23, nwomen=20) of participants reporting very high levels of substance use and (b) large groups (nmen=114, nwomen=115) of participants reporting low scores for substance use. Each solution included one or two medium-sized groups of participants reporting more moderate levels of substance use. Among bisexual women, self-esteem was the only variable that differed significantly between the low and high substance use groups. Among bisexual men, the high substance use group reported significantly higher scores for felt sexual stigma, everyday discrimination, internalized sexual stigma, and the lowest scores for self-esteem compared to the other groups with large effect sizes.

Conclusions: Cluster analysis identified substantial heterogeneity in multivariate patterns of substance use among bisexual emerging adults. Cluster membership was associated with more modifiable psychosocial variables among bisexual men, compared to bisexual women, potentially reflecting the cumulative burden of gender-based structural stigma experienced by some bisexual men. Our findings provide important information for tailoring selected prevention initiatives among bisexual men and emphasize the importance of screening sexual minority emerging adults for both risky substance use and sexual minority stressors.