Discrimination, Community Belongingness, and Substance Use Among Sexual and Gender Minority Adults

<b>Background:</b> Lesbian, gay, bisexual, transgender, queer, and other sexual/gender minority (LGBTQ+) adults experience elevated substance use risk. This study examined the independent associations of everyday discrimination and community belongingness with substance use, and whether belongingness moderated the discrimination–substance use relationship. <b>Methods:</b> Data were collected April–July 2024 among 1,578 U.S. LGBTQ+ adults. Discrimination was measured with the Everyday Discrimination Scale and belongingness with the LGBTQ+ Belongingness Attainment Scale. Outcomes included lifetime cannabis, hard drug, and cigarette use; current cigarette and electronic nicotine product use; past-year heavy drinking; and ordinal frequency measures. Binary and ordinal logistic regression tested main effects and Belongingness × Discrimination interactions, with sociodemographic adjustment. <b>Results:</b> Moderate belongingness was associated with greater current nicotine use. High belongingness predicted greater lifetime cannabis use but lower odds of heavy alcohol use, frequent cannabis, hard drug, and binge drinking. Discrimination was associated with greater odds of lifetime cigarette and hard drug use and current nicotine use. Significant interactions emerged for 8 of 10 outcomes; discrimination’s associations were generally weak or nonsignificant at low belongingness, but were stronger and more consistently harmful at high belongingness. <b>Conclusions:</b> Although LGBTQ+ community belongingness was associated with lower odds of frequent and heavy substance use, it also appeared to amplify associations between discrimination and several substance use outcomes among individuals with higher belongingness.<b></b>