Multilevel Analysis of Sociopolitical Contexts, Social Support, Mental Health, and Alcohol Use Among Partnered Sexual Minority Latino Men in the U.S.

Objective: The objective of this paper is to examine how state-level characteristics relate to social support and mental health outcomes among Latino sexual minority men in the U.S.
Methods: Multilevel linear regression analyses were used to estimate the effect of social support and contextual-level characteristics on mental health and alcohol use among Latino sexual minority men (n = 612). Individual-level data were collected via a national, online survey between November 2018 and May 2019. State-level data were drawn from the 2019 American Community Survey and the Human Rights Campaign's 2018 State Equality Index score cards.
Results: The interaction between friend support and supportive LGBTQ+ policies was associated with anxiety (B = 1.77; 95% CI 0.69, 2.85; p = 0.001) and depression (B = 2.25; 95% CI 0.99, 3.50; p<0.001). The interaction between friend support and Latino population size was associated with greater problematic alcohol use (B = 0.06; 95% CI 0.03, 0.10; p<0.001). The interaction between partner support and supportive LGBTQ+ policies were also associated problematic drinking (B = -1.72; 95% CI -3.05, -0.38; p<0.012).
Conclusions: Contextual factors can affect the everyday experiences of Latino sexual minority men. The effect of social support on mental health outcomes may depend on state-level factors. Public health efforts that seek to address the mental health and problematic drinking behaviors of Latino sexual minority men must consider the impact of macro-level policies on program and intervention development.
(© 2023. W. Montague Cobb-NMA Health Institute.)