# Intersectional Approaches to Population-Level Health Research: Role of HIV Risk and Mental Health in Alcohol Use Disparities among Diverse Sexual Minority Youth

> **NIH NIH R01** · NORTHWESTERN UNIVERSITY · 2021 · $588,270

## Abstract

PROJECT SUMMARY
Alcohol is the most commonly used and abused drug among youth in the US; prevalence of alcohol use is
disproportionately higher among sexual minority youth (SMY) than among their heterosexual peers, especially
among those at the intersections of multiple marginalized identities. Alcohol use and abuse are associated with
a multiplicity of short and long-term negative health outcomes, including HIV vulnerabilities, alcohol and other
substance use dependence, neurocognitive deficiencies, and psychological distress. Despite the fact that
alcohol use and abuse during adolescence has important consequences for downstream health outcomes and
adult patterns of substance use, the majority of research among sexual minorities to date has focused on
college-aged populations. This gap in research with SMY is critical to rectify, particularly for SMY who
experience multiple, intersecting forms of marginalization based on sex, race/ethnicity, and sexual orientation.
Building on our team’s prior work in this area, we propose to use pooled data from the Local Youth Risk
Behavior Survey (YRBS), a national biennial survey of high school students that assesses sexual identity and
behavior, as well as health behaviors including alcohol use, HIV vulnerability, and mental health. Our uniquely
large dataset, which currently contains data from 2005 to 2019 (253 jurisdiction-years) and 950,295 high
school youth, will expand to include 2021, 2023, and 2025 data, resulting in an estimated 1,668,078 youth.
This will allow us to apply an array of complex epidemiologic approaches to assess the impact of alcohol use
on the sexual, mental, and physical health of SMY living in the US, and the disparities that exist between
multiply marginalized SMY and their peers. This proposal is a natural extension of our prior work (R01
AA024409) that resulted in numerous publications in high-impact peer-reviewed journals (e.g., Pediatrics,
American Journal of Public Health) and a diverse array of interdisciplinary collaborations. The current proposal
will continue these successes, incorporating an intersectional lens as well as additional advanced methods of
inquiry, including use of multilevel modeling to determine jurisdictional and temporal associations with alcohol
use and disparities in HIV risk; latent class analysis to describe alcohol use classes and their association with
minority status; and the impact of regional, school, and structural level factors that influence alcohol use and its
role in increased HIV vulnerability among diverse SMY. These approaches will allow us to continue identifying
critical pathways for intervention to ensure equitable health outcomes and minimize the risks associated with
alcohol use and abuse among notably vulnerable populations of youth.

## Key facts

- **NIH application ID:** 10325087
- **Project number:** 1R01AA029044-01A1
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Gregory L. Phillips
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $588,270
- **Award type:** 1
- **Project period:** 2021-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10325087

## Citation

> US National Institutes of Health, RePORTER application 10325087, Intersectional Approaches to Population-Level Health Research: Role of HIV Risk and Mental Health in Alcohol Use Disparities among Diverse Sexual Minority Youth (1R01AA029044-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10325087. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*