# Sexual Fluidity and Longitudinal Changes in Alcohol Misuse and Associated Health Consequences

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $292,882

## Abstract

PROJECT SUMMARY/ABSTRACT
In response to the Notices of Special Interest on Research on the Health of Sexual and Gender Minority
Populations (NOT-MD-19-001) and Public Policy Effects on Alcohol-, Cannabis-, Tobacco-, and Other Drug-
Related Behaviors and Outcomes (NOT-AA-21-028), this project will identify trajectories of alcohol misuse by
sexual orientation and their associated health consequences. We will also examine risk and protective factors
across individual, social, and policy domains. Sexual minorities are at heightened risk of alcohol misuse;
however, existing research is often based on a static and unidimensional construct of sexual orientation rather
than a fluid and multidimensional construct of sexual orientation, despite evidence indicating sexual orientation
fluidity is common, especially among sexual minorities. Prior work has shown alcohol misuse and alcohol use
disorder (AUD) symptoms are more prevalent and more severe among sexual minorities than heterosexuals.
There is a lack of population-based longitudinal studies of alcohol misuse trajectories and related negative
health consequences based on a fluid and multidimensional construct of sexual orientation. Additionally,
studies examining risk and protective factors for alcohol misuse among sexual minorities have largely focused
on individual-level factors and neglected factors at the social and policy level. There is a need to expand this
research and draw on concepts from the Social Ecological Model to include upstream risk and protective
factors, such as those at the social and policy level. To address these gaps, this project will use longitudinal
data from a sample of U.S. adolescents and adults based on six waves of the Population Assessment of
Tobacco and Health study (n=45,971; 2013-2021). This study design will allow us to explore changes in
alcohol misuse based on sexual orientation before and after COVID-19 onset. Our study aims to: (1) Identify
alcohol misuse trajectories over an 8-year period and determine if these associations differ by sexual
orientation (a) concordance vs. discordance, and (b) stability vs. fluidity. We will also examine potential
heterogeneity in risk by age, sex, race, ethnicity, and gender identity and compare changes in alcohol misuse
before and after COVID-19 onset by sexual orientation. (2) Examine (a) how variation in alcohol misuse
trajectories shape negative health-related consequences (e.g., AUD symptoms, other substance use disorder
symptoms, polysubstance use, and negative physical health consequences) and (b) whether this differs across
sexual orientation subgroups, by sexual orientation discordance vs. concordance, and sexual identity fluidity
vs. stability. (3) Examine longitudinal relationships of individual- (e.g., internalizing symptoms), social- (e.g.,
degree of social interaction), and policy-level (e.g., antidiscrimination laws) protective/risk factors with
trajectories of alcohol misuse and negative alcohol-related health c...

## Key facts

- **NIH application ID:** 10498031
- **Project number:** 1R01AA030243-01
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Rebecca J Evans-Polce
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $292,882
- **Award type:** 1
- **Project period:** 2022-09-10 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10498031

## Citation

> US National Institutes of Health, RePORTER application 10498031, Sexual Fluidity and Longitudinal Changes in Alcohol Misuse and Associated Health Consequences (1R01AA030243-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10498031. Licensed CC0.

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