The associations between subdimensions of religiosity and illicit substance use among latino sexual minority men

Highlights

• Different dimensions of religiosity are associated with substance use differently.

• Private religious activity is associated with increased substance use in this study.

• Latino sexual minority men in this sample had high levels of substance use.

Abstract

Background

Latino sexual minority men (SMM) may be a group disproportionately at risk for substance use than heterosexual Latino men and non-Latino SMM. As religiosity may be a culturally relevant factor, the current study aimed to explore the association of three subcomponents of religiosity: organizational religious activity (ORA; i.e., public religious activity), non-organizational religious activity (NORA; i.e., private religious activity), and intrinsic religiosity (IR; i.e., personal commitment to one's religion) in predicting illicit substance use.

Method

Participants were 151 Latino SMM recruited from San Diego County (M = 24.18 years of age, SD = 3.19), who completed online self-report questionnaires in English or Spanish. Binary outcome variables represented use of illicit substances in the past month vs. no use. Religiosity was assessed using the three subscales (ORA, NORA, and IR) of the Duke University Religion Index (DUREL). Acculturation was controlled for using the Bidimensional Acculturation Scale for Hispanics.

Results

ORA was associated with opiates (OR = 1.53, p = .04). NORA was associated with cocaine (OR = 1.69, p = .01), opiates (OR = 1.56, p = .04), amphetamines (OR = 1.67, p = .02), and sedatives (OR = 2.33, p = .001). IR was associated with amphetamines (OR = 1.34, p = .03).

Conclusion

NORA is positively associated with multiple illicit substances, and may represent greater internalization of anti-gay religious doctrines compared to other components of religiosity in Latino SMM. An intersectional approach addressing religious and sexual minority identity may be useful in substance use treatment for Latino SMM.

Introduction

Latinos are the fastest growing ethnic group in the United States (Census Bureau, 2010); however, scant research has examined culturally-relevant protective factors for substance use among Latino sexual minority (e.g., gay and bisexual) men. Sexual minority men (SMM) are at an increased risk for substance use in comparison to their heterosexual peers (Centers for Disease Control [CDC], 2016; Kerridge et al., 2017; Plöderl & Tremblay, 2015). Examination of the data collected through the CDC’s Youth Risk Behavior Surveillance System (2015) found young Latino SMM report the highest lifetime prevalence rates of binge drinking (30.3%), cocaine use (20.5%), methamphetamine use (13.8%), and heroin use (15.6%) compared to Latino and White heterosexual and sexual minority (SM) males. The high rate of substance use among Latino SMM suggests the possibility of unique risk factors in this population (CDC, 2015).

Religiosity may be theoretically important to consider in examining Latino SMM substance use. Religiosity may serve as a protective factor due to many religions' promotion of abstinence from alcohol and other drugs (Rostosky, Danner, & Riggle, 2010). Catholicism may serve as a buffer to U.S. acculturation in comparison to other religious affiliations, therefore decreasing the probability of substance use among Latinos (Calvillo & Bailey, 2015; Myers et al., 2009; Substance Abuse and Mental Health Services Administration [SAMHSA], 2011). Although 16.3% of U.S. citizens identify as Hispanic or Latino, Latino Americans comprise 32% of Catholics in the U.S. (Census Bureau, 2010; Pew Research Center [PRC], 2014). For heterosexuals, including Latino heterosexuals, religiosity is considered a protective factor for substance use (Drabble, Trocki, & Klinger, 2016; Escobar & Vaughan, 2014; Rostosky et al., 2010; Rostosky, Danner, & Riggle, 2007). Therefore, it would be beneficial to examine religiosity among Latino SMM due to high prevalence among Latinos (82% report being religiously affiliated; PRC, 2014; Rostosky et al., 2010). However, it is also possible religiosity may exacerbate substance use in SMM due to religious doctrines condemning same-sex relationships (Hequembourg & Dearing, 2013; PRC, 2014; Rostosky et al., 2007). One study found when comparing Latino and Black lesbian, gay, and bisexual (LGB) individuals with White LGB individuals, the Latino group had the highest levels of internalized homophobia, mediated by their increased exposure to non-affirming religious settings (Barnes & Meyer, 2012). Qualitative research of Latino sexual and gender minority men raised as Catholics also indicates many Latino men may experience conflict due to their religious and sexual or gender identities in adolescence (García, Gray-Stanley, & Ramirez-Valles, 2008). Thus, the association between religiosity and substance use among SMM remains unclear.

The effect of religiosity on substance use/SUDs in SMM may be dependent on the dimension used to measure religiosity (Drabble et al., 2016;Rostosky et al., 2007; Rostosky et al., 2010). Religiosity is a multidimensional construct with factors interacting with health outcomes differentially depending on what aspects are analyzed, such as frequency of religious attendance, private religious practice, and intrinsic/extrinsic religious motivation (Escobar & Vaughan, 2014; Hall, Meador, & Koenig, 2008). When religiosity was measured using a tripartite model as a composite of religious attendance, importance of religion, and other religious activities, religiosity was not protective against binge drinking, marijuana use, and cigarette smoking, but was protective for heavy episodic drinking (HED) among both heterosexual and gay men (Rostosky et al., 2007; Rostosky et al., 2010). However, results from a previous study of religiosity in a sample of young Black men who have sex with men (an ethnic group for which religiosity also tends to be a salient construct) found various dimensions of spirituality were associated with outcomes of substance use and HIV in various ways (Carrico et al., 2017). Due to these mixed results, religiosity should likely not be treated as a uniform construct when examining its effects on substance use among Latino SMM.

The current study seeks to build upon existing literature by measuring separate dimensions of religiosity versus a single construct. When analyzing common measures of religiosity, Hall et al. (2008) suggest the complex nature of religiosity requires the use of measures analyzing specific dimensions; measures analyzing religiosity void of a specific context should be abandoned. The Duke University Religion Index (DUREL) is frequently used for its brevity (5 items) and its ability to assess three major dimensions of religiosity: organizational religious activity (ORA; e.g., attending church or a service), non-organizational religious activity (NORA; e.g., praying by oneself, meditation, study of religious scripture), and intrinsic religiosity (IR; i.e., subjective religiosity; Koenig, Meader, & Parkerson, 1997; Koenig & Büssing, 2010). The current study will use the three dimensions of the DUREL to examine how religiosity may predict substance use among Latino SMM. It is hypothesized ORA and NORA would be associated with increased substance use, as both of these subdimensions of religiosity imply an involvement with one's religious doctrine and community. The IR dimension is hypothesized to be associated with decreased substance use, as IR is similar to religious importance, and a previous study found this to be a protective factor in alcohol use among SM women (Drabble et al., 2016).