A mixed-methods investigation of alcohol use among immigrant sexual and gender minority Latinos in North Carolina

Background: Heavy alcohol use has the potential for multiple direct and indirect harmful effects; however, little is known about drinking patterns among immigrant sexual and gender minority Latinos. I conducted a mixed qualitative-quantitative study to investigate alcohol use among this population in North Carolina.;Qualitative Study: I sought to identify and describe salient social stressors, coping strategies, and the role of alcohol use through 15 semi-structured interviews with foreign-born sexual and gender minority Latinos. Following Grounded Theory methods, I produced an inductive model of alcohol use. Drinking was fundamentally a social behavior, embedded in cultural, social, and individual contexts. Nearly half of participants reported at least one binges episode per month. Among stressors, being a sexual minority was indirectly linked to alcohol use through drinking venues (e.g., gay bars) and companions, and being an undocumented immigrant dissuaded drinking for that sub-set of participants. I confirmed inferences in four member-check interviews and three key informant interviews.;Quantitative Study: Using cross-sectional survey data obtained in a study of HIV risk and protective factors among foreign-born sexual and gender minority Latinos (n=190), I tested theoretically derived hypotheses about the association of select stressors and social support with alcohol use (any drinking; drinking frequency; binges). Although 55% of participants reported no alcohol use, the majority of current drinkers reported at least one binge episode in the past 30 days. Ethnic discrimination was associated with any drinking and binges, consistent with a stress-reactive drinking. Social support moderated two relationships, consistent with the stress buffering hypothesis.;Conclusion: Because current drinkers in both qualitative and quantitative studies reported high levels of binges, sexual and gender minority Latinos should be a priority population for alcohol risk-reduction interventions. There was some support for drinking as a coping behavior; however, drinking as a social behavior emerged as a second key dimension. Interventions that fail to account for drinking as a social behavior as well as a coping response are likely to have limited effectiveness. Further research is necessary to refine the conceptual model and better understand the relationships between social stressors, social contexts, and risky drinking among this population.