(PS1-C57) Compound Risk for Substance Use: Adverse Childhood Experiences and Sexual and Gender Minorities

Research has indicated that adverse childhood experiences (ACEs) are associated with a wide variety of health outcomes in adulthood, including increased risk for substance use (e.g., Felitti et al., 1998; Rothman et al., 2008). One reason for this connection may be that individuals who have experienced childhood adversity turn to substances to cope with their negative experiences. Moreover, some studies have identified individuals belonging to sexual and gender minority (SGM) groups as being at increased risk for substance use problems (Parent et al., 2019). SGM refers to diverse groups of people who do not identify as heterosexual or cisgender, and may include Lesbian, Gay, Bisexual, and Transgender (LGBT) individuals as well as people of other sexual orientations and gender identities. Given that SGM communities are disproportionately affected by substance use disorders, it is important to examine factors that may contribute to the development of substance use problems. 
The social-ecological model of health is a tiered framework that approaches health risk from a holistic approach. It assumes that an individual’s health conditions are the result of many factors including individual, interpersonal, communal, and societal levels of impact (Brofenbrenner, 1979). Using this conceptual framework, experiencing ACEs could be an important interpersonal risk factor for SGM individuals who develop substance use problems. SGM individuals are more likely to experience peer and family related victimization as well as ACEs than non-SGM individuals (Schnarrs et al., 2019). Therefore, examining the interaction effect of belonging to an SGM group and experiencing ACEs may be important in understanding compounding risk factors for developing substance use problems. 

Multiple regression analyses were used to examine the relationship between ACEs and substance use, as well as the interaction between number of ACEs and being a member of an SGM group. Results indicated that the main effect of number of experienced ACEs predicting if an individual had smoked at least cigarettes was significant (B = 0.181, p < .001). The interaction between number of experienced ACEs and SGM membership was also significant (B = -0.48, p < .001). In contrast, although the main effect of number of experienced ACEs predicting if an individual had ever used marijuana was significant (B = 0.269, p < .001), the interaction between number of experienced ACEs and SGM membership was not significant (B = -0.22, p = .387). These results suggest that the combined stressors of ACEs and SGM membership may be differentially related to various forms of substance use. The results of the present study have implications for substance use interventions for SGM individuals. It is recommended that interventions with the SGM community include components that reflect the unique and diverse experiences of SGM communities. Additional findings and implications of these compound risks will be discussed.