{
  "abstract": "Background: Sexual and gender minorities (SGM) experience elevated rates of opioid use and overdose, yet mechanisms driving SGM overdose vulnerability remain underexamined. Utilizing a syndemics framework, this study explores how psychosocial stress and structural stigma co-occur to shape overdose vulnerability among SGM individuals who use opioids.\n\nMethods: Cross-sectional survey data were collected from U.S.-based SGM adults reporting past-year illicit opioid use (N = 331) via Prolific-Academic. Latent profile analysis identified patterns of traumatic stress, internalized stigma, heterosexist discrimination, and state-level structural stigma. Multinomial logistic regression examined sociodemographic predictors of profile membership. BCH procedures assessed between-profile differences in overdose-related outcomes.\n\nResults: A four-profile solution emerged (entropy=0.924): (1) low stress/low structural stigma (n=99), (2) low stress/high structural stigma (n=157), (3) high stress/low structural stigma (n=40), and (4) high stress/high structural stigma (n=35). Higher psychosocial stress (Profiles 3, 4) was associated with greater harm reduction engagement (e.g., naloxone possession, overdose response training; p<.01); lower-stress profiles (1, 2) showed higher overdose response knowledge/self-efficacy. Profile 4 exhibited higher overdose risk than Profile 3, including greater lifetime overdose frequency, heroin use severity (p<.01), and injection drug use (p<.001). Profile 4 was also associated with structural vulnerability, including food insecurity (OR = 3.91, 95% CI [2.23–6.84], p<.001), and racialized identity (OR > 50, p<.001).\n\nConclusions: Findings highlight a distinct pattern of overdose vulnerability in which structural stigma is associated with higher overdose risk independent of psychosocial stress and harm reduction knowledge/behaviors. Thus, structural stigma may function as an upstream determinant of SGM overdose vulnerability beyond individual-level processes.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "abstract",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "name": "E McConocha"
    },
    {
      "name": "P Granzka"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/avfb5s1zg9thq.bib",
  "cited_by": 0,
  "doi": "10.1093/eurpub/ckag169.730",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13698482/",
  "id": "avfb5s1zg9thq",
  "issns": [
    "1101-1262",
    "1464-360X"
  ],
  "landing_url": "https://doi.org/10.1093/eurpub/ckag169.730",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "4. Pecha Kucha sessions"
    ],
    [
      "heading",
      "AcademicSubjects/MED00860"
    ],
    [
      "heading",
      "AcademicSubjects/SOC01210"
    ],
    [
      "heading",
      "AcademicSubjects/SOC02610"
    ],
    [
      "openalex",
      "2739|Opioid Use Disorder Treatment"
    ]
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  "openalex": "W7223681397",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13698482/pdf/?tool=EBI",
  "pmcid": "PMC13698482",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/avfb5s1zg9thq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:21Z",
      "native_id": "PMC13698482",
      "source": "pmc",
      "url": "https://doi.org/10.1093/eurpub/ckag169.730"
    },
    {
      "first_seen": "2026-10-30T12:21:48Z",
      "native_id": "PMC:PMC13698482",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13698482"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Opioid Use Disorder Treatment",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Structural Stigma and Overdose Vulnerability Among Sexual and Gender Minorities",
  "title_text": "Structural Stigma and Overdose Vulnerability Among Sexual and Gender Minorities",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:35:20Z",
  "url": "https://research.draconitic.com/paper/avfb5s1zg9thq",
  "venue": "The European Journal of Public Health",
  "versions": []
}