The Association Between Sexual Orientation Discrimination and Drinking Among Men Who Have Sex With Men: Results From an Ecological Momentary Assessment Study

Research has shown that experiencing discrimination increases substance use, including alcohol, among men who have sex with men (MSM). The goal of the present research was to replicate and expand upon this work to test whether perceptions of sexual orientation discrimination predict drinking among MSM on the same day as well as later in the same week. Data from this study came from an ecological momentary assessment study examining MSM sexual decision-making (N = 100). Participants were adult, sexually active, HIV-negative, cisgender MSM who engaged in recent alcohol use. Recruitment took place in the northeastern United States from January 2016 to October 2018. Mixed-effects models indicated that perceived sexual orientation discrimination was not significantly associated with the number of standard drinks consumed nor with the odds of heavy drinking at either the day or week level. In addition, we found a significant negative interaction between race/ethnicity and perceived discrimination: Black, Indigenous, and people of color (BIPOC) participants who perceived being discriminated against due to their sexual orientation drank less on days they did not perceive such discrimination. Our results suggest that the effect of discrimination on drinking in MSM is moderated by race, but these data cannot explain why. One possibility is that BIPOC MSM experience sexual orientation discrimination in different contexts or respond to discrimination differently than White MSM. Future research should expand upon how the intersection of identities, for example gender and BIPOC identities, further moderates the relationship between discrimination and drinking. Public Significance Statement The current study suggests that Black, Indigenous, and other men of color who have sex with men (MSM) may drink less alcohol after experiencing sexual-orientation-based discrimination compared to White MSM. Our findings suggest interventions designed to reduce drinking among MSM should consider the association between social marginalization and behavior.