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Gitelman J, Smith B, Warren CM, Andreacchi AT, Pabayo R, Hobin E. Sexual Identity and Heavy Drinking Among Adults in Canada by Racially Minoritized Status and Income, 2015-2020. LGBT Health 2024. [PMID: 38968343 DOI: 10.1089/lgbt.2023.0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2024] Open
Abstract
Purpose: Our objective was to estimate inequities in heavy drinking between heterosexual, gay or lesbian, and bisexual or pansexual individuals, by sex/gender, and to determine whether this association is heterogeneous across racially minoritized status and income groups in Canadians aged 15 and older. Methods: We pooled three Canadian Community Health Survey cycles (2015-2020) and used separate modified Poisson regressions to explore the sex/gender-specific association between sexual identity and heavy drinking prevalence by racially minoritized status, and income, adjusted for survey cycle, age, marital status, and region. Results: With racially minoritized status, and income categories collapsed, heavy drinking was 1.3 times higher (95% confidence interval [CI] = 1.0-1.7) among bisexual or pansexual women compared with heterosexual women, with no differences among men. Among racially minoritized women, heavy drinking was 2.9 (95% CI = 1.3-6.4) times higher among bisexual or pansexual women and 1.9 (95% CI = 0.7-5.2) times higher among gay or lesbian women compared with heterosexual women. Among racially minoritized men, heavy drinking was 1.9 (95% CI = 0.9-4.0) times higher among gay men compared with heterosexual men. No differences were observed across sexual identity in White men or women. Bisexual or pansexual women reported increased heavy drinking relative to heterosexual women across income quintiles. Conclusion: Heavy drinking is distributed heterogeneously across sexual identity, sex/gender, racially minoritized status, and income. These results encourage equity-focused interventions to reduce heavy drinking among intersecting sociodemographic groups experiencing a greater burden of heavy drinking.
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Affiliation(s)
- Julian Gitelman
- Public Health and Preventive Medicine Residency Program, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Brendan Smith
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Christine M Warren
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | | | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
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2
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Kcomt L, Boyd CJ, Evans-Polce RJ, Veliz P, Engstrom C, West BT, McCabe SE. Ethnic Discrimination, Sexual Orientation Discrimination, and DSM-5 Alcohol Use Disorder Among U.S. Latino or Hispanic Adults. JOURNAL OF HOMOSEXUALITY 2024; 71:1970-1990. [PMID: 37272895 PMCID: PMC10696128 DOI: 10.1080/00918369.2023.2217516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We aimed to assess the probability of past-year DSM-5 alcohol use disorder (AUD) and past-year moderate-to-severe DSM-5 AUD as a function of past-year ethnic discrimination among U.S. Latino/Hispanic adults and as a function of past-year discrimination types among Latino/Hispanic sexual minorities (SM). We used data from the 2012-2013 National Epidemiological Survey on Alcohol and Related Conditions-III (n = 36,309 U.S. adults aged ≥18 years). Our sample consisted of 6,954 Latino/Hispanic adults. Multivariable logistic regression analyses estimated the association of past-year ethnic discrimination with past-year AUD and past-year moderate-to-severe AUD among the overall Latino/Hispanic population. We tested the association between discrimination types (i.e. none, ethnic or sexual orientation discrimination, both) with AUD and moderate-to-severe AUD among Latino/Hispanic SM adults. Among Latino/Hispanic adults, 13.4% met criteria for past-year AUD and 6.4% met criteria for past-year moderate-to-severe AUD. Ethnic discrimination was significantly associated with AUD (AOR = 1.09, 95% CI = 1.07-1.12) and moderate-to-severe AUD (AOR = 1.10, 95% CI = 1.06-1.13). Latino/Hispanic SMs who experienced both ethnic and sexual orientation discrimination were more likely to meet criteria for AUD (AOR = 3.44, 95% CI = 1.97-6.03) and moderate-to-severe AUD (AOR = 2.69, 95% CI = 1.25-5.82) compared to those who did not experience discrimination. Discrimination is a risk factor for AUD and moderate-to-severe AUD among Latino/Hispanic overall and SM populations.
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Affiliation(s)
- Luisa Kcomt
- School of Social Work, Wayne State University, Detroit, MI
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Carol J. Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI
- Addiction Center, Department of Psychiatry, Rachel Upjohn Building, University of Michigan, Ann Arbor, MI
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
| | - Phil Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Curtiss Engstrom
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Brady T. West
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
- Institute for Social Research, University of Michigan, Ann Arbor, MI
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI
- Institute for Social Research, University of Michigan, Ann Arbor, MI
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI
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3
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Surace A, Operario D, Kahler C. The association between discrimination and drinking among sexual minorities: A daily diary study. Addict Behav Rep 2024; 19:100554. [PMID: 38827376 PMCID: PMC11140561 DOI: 10.1016/j.abrep.2024.100554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/24/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024] Open
Abstract
Background Among sexual minorities (SMs), experiencing discrimination has been associated with greater substance use at the day-level. However, variations in sample characteristics and measures of day-level discrimination limit the generalizability of findings. Furthermore, it is unknown how positive experiences due to minority identity ("Minority Strengths") may impact the association between experiencing discrimination and same day drinking. Methods The present study extends prior research on discrimination and drinking using detailed discrimination measures, Minority Strengths measures, and a gender diverse sample. Participants (N = 61) were majority White (n = 45, 73.8 %) adult (mean age 26.8 years) self-identified SMs (e.g., 44.3 % identified as "gay") who engaged in alcohol use within the past month. Participants completed up to 31 days of daily diary surveys about their experiences and drinking. Recruitment took place in the northeastern U.S. from May to December 2021. Results Multilevel model analysis indicated that experiencing discrimination was associated with increased same day drinking among Black, Indigenous, people of color (BIPOC) participants but not among White participants. A significant gender by discrimination interaction indicated that cisgender men drank more the same day they experienced discrimination compared to cisgender women and transgender/non-binary participants. Minority Strengths had no impact on these relationships. Conclusions Results highlight that the experience of discrimination and its association with drinking may be influenced by a host of contextual factors that are attached to racial and gender identities. Future research should examine how discrimination in different contexts (e.g., regions) and based on specific identities may be associated with alcohol use.
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Affiliation(s)
- A. Surace
- Public Health Institute, Alcohol Research Group, Emeryville, USA
| | - D. Operario
- Department of Behavioral and Social Sciences, Rollins School of Public Health, Atlanta, USA
| | - C.W. Kahler
- Center for Alcohol and Addictions Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, USA
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4
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Broman MJ, Grekin E, Resko SM, Agius E. Demographic, substance use, and mental well-being correlates of high-intensity drinking among college students and non-college young adults: implications for intervention. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38564777 DOI: 10.1080/07448481.2024.2334071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To assess demographic, substance use, and mental wellbeing factors associated with high-intensity drinking (HID; 10+ drinks on one occasion) among college- and non-college young adults, to inform prevention and intervention efforts. PARTICIPANTS A total of 1,430 young adults (819 in college and 611 not attending college) in a Midwestern state who reported trying alcohol at least once. METHODS Participants were recruited via social media between November 2019 and February 2020 to complete a web-based survey assessing demographics, substance use, and mental well-being. Logistic regression was conducted to assess relationships between these measures and HID among (1) college students and (2) non-college young adults. RESULTS About 14.0% of participants reported past-month HID. Among both college- and non-college young adults, men, those who perceived slight or no risk of harm from binge drinking, and those who used alcohol and marijuana simultaneously in the past year had greater odds of reporting past-month HID. Among students, past-year prescription drug misuse was also associated with HID. CONCLUSIONS High intensity-drinking is concerning given potential adverse consequences. Campus programming should address norms that may promote such drinking and other high-risk substance use associated with HID.
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Affiliation(s)
- Michael J Broman
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
| | - Emily Grekin
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Stella M Resko
- School of Social Work & Merrill, Palmer Skillman Institute, Wayne State University, Detroit, Michigan, USA
| | - Elizabeth Agius
- Center for Social Work Research, Wayne State University, Detroit, Michigan, USA
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5
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Gatanaga O, Palamar JJ, Lim S. Prevalence of Substance Use Among Asian Sexual Minority Individuals in the United States, 2015-2020. J Psychoactive Drugs 2024; 56:257-263. [PMID: 36849255 PMCID: PMC10460460 DOI: 10.1080/02791072.2023.2181242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/13/2022] [Accepted: 01/05/2023] [Indexed: 03/01/2023]
Abstract
Asian sexual minorities (SMs) are an under-researched population. SMs are at higher risk for substance use problems than heterosexuals, but little research exists specifically on Asians who are SM. This study compared the prevalence of substance use among Asian SMs and among adults by race/ethnicity and sexual identity in the US. Data were analyzed from participants in the 2015-2020 National Survey on Drug Use and Health, a nationally representative cross-sectional survey of non-institutionalized adults. Controlling for demographic characteristics, logistic regression models were used to estimate odds of substance use 1) among Asian adults by sexual identity (N = 11,079) and 2) all adults by race/ethnicity and sexual minority status (N = 223,971). Among Asians, compared to heterosexuals, identifying as gay/lesbian was associated with higher odds of past-month use of marijuana. Bisexual Asians were at higher odds of engaging in past-year prescription opioid misuse and having past-year alcohol use disorder (AUD). Compared to White heterosexuals, Asian SMs were at lower odds for past-month binge drinking and cocaine use, but not for past-month marijuana use and past-year AUD, marijuana use disorder, and prescription opioid misuse. More research is needed to understand these disparities and address sexual identity's role in substance use among Asians.
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Affiliation(s)
- Ohshue Gatanaga
- Department of Sociomedical Sciences, Columbia Mailman School of Public Health, New York, NY, USA
| | - Joseph J. Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Sahnah Lim
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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6
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Stamates AL, Schulz CT, Rothstein MC, Todaro SM, Ehlke SJ, Kelley ML. Subtypes of Alcohol Expectancies Are Differentially Associated With Alcohol Use for Bisexual and Heterosexual Women. Subst Use Misuse 2024; 59:1167-1173. [PMID: 38424725 PMCID: PMC11045303 DOI: 10.1080/10826084.2024.2321258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Background: Bisexual women, compared to heterosexual women, report greater amounts of alcohol use and heavy drinking. Alcohol expectancies (i.e., beliefs about alcohol outcomes) are a strong predictor of alcohol use, but few studies have examined the importance of alcohol expectancies in relation to alcohol use among bisexual women specifically or in comparison to heterosexual women. Objectives: The current study examined 262 heterosexual and 225 bisexual women using an online survey about alcohol use, sexual risk-taking, and alcohol expectancy subtypes (sexuality, tension reduction, and aggression). Results: Compared to heterosexual women, bisexual women reported greater sexuality and tension reduction expectancies after accounting for their level of drinking, but groups did not differ on aggression expectancies. Moreover, sexual identity status moderated the associations between sexuality and tension reduction expectancies and alcohol use, respectively. Specifically, our study findings suggested that sexuality and tension reduction alcohol expectancies were more strongly tied to alcohol use among bisexual women than heterosexual women. Conclusions: Taken together, in our study, bisexual women held stronger sexuality and tension reduction expectancies, as compared to heterosexual women. Interventions targeting alcohol expectancies may be considered when tailoring intervention content for this population.
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Affiliation(s)
- A L Stamates
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - C T Schulz
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - M C Rothstein
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - S M Todaro
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - S J Ehlke
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - M L Kelley
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
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7
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Surace A, Kang A, Kahler CW, Operario D. "I'm Gay With an Asterisk": How Intersecting Identities Influence LGBT Strengths. JOURNAL OF HOMOSEXUALITY 2024; 71:841-861. [PMID: 36480031 DOI: 10.1080/00918369.2022.2132579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Research attributes health disparities between sexual minority (those whose sexual orientation and/or practices differ from society, [SM]) and heterosexual populations to social marginalization. LGBT strengths (e.g., resiliency derived from LGBT identity) may reduce the impact of social marginalization. However, it is unclear how LGBT strengths are impacted by SMs' other identities (e.g., racial/ethnic and/or gender). To address this knowledge gap, the present study examined data from the LGBT Stress/Strength project, a qualitative research study investigating minority stress and LGBT strengths in relation to drinking. Participants (N = 22) were self-identified SMs in the northeastern U.S. Transcripts from in-depth interviews were coded using thematic analysis. Participants reported social support from other SMs and empathy toward others were forms of LGBT strength. Sampled SMs assigned female at birth had more intergenerational friendships and relied more on social support than those assigned male at birth. In addition, Black, indigenous, and people of color (BIPOC) participants described social marginalization from within the LGBT community, which reduced their reliance on social support. Our results suggest that LGBT strengths are influenced by LGBT community members intersecting identities. More research can expand upon these results by investigating how the confluence of SMs identities and LGBT strengths impact health disparities.
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Affiliation(s)
- Anthony Surace
- Public Health Institute, Alcohol Research Group, Emeryville, USA
| | - Augustine Kang
- Stanford University School of Medicine, Stanford, USA
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, Providence, USA
| | - Christopher W Kahler
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, Providence, USA
| | - Don Operario
- Department of Behavioral and Social Sciences, Rollins School of Public Health, Atlanta, USA
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8
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Todaro SM, Schulz CT, Rothstein M, Stamates AL, Ehlke S, Kelley M. Normative Perceptions of Sexual Behavior and Alcohol Use among Bisexual Women. Subst Use Misuse 2024; 59:785-791. [PMID: 38229244 DOI: 10.1080/10826084.2024.2302150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Background: As compared to heterosexual and lesbian women, bisexual women report higher rates of alcohol, other substance use, and risky sexual behavior, and they experience more negative outcomes from these behaviors. Descriptive norms (i.e., perceptions of others' behavior) are an important predictor of risky behaviors, but scant research has examined whether bisexual women's perceptions of other bisexual women's alcohol use and sexual behavior are associated with their own alcohol or drug use during sex. Objectives: Consequently, the present study examined (1) whether perceived sex norms were related to engagement in sex and (2) the relative influence of drinking and sex norms on engaging in sex while drinking among bisexual women. Method: Data were collected from 225 self-identified bisexual women who completed an online survey about their typical weekly alcohol use, engagement in alcohol or drug use during sex in the past 30 days, and normative perceptions of drinking and sexual behavior. Results: Regression models demonstrated both sexual norms and drinking frequency norms were positively associated with alcohol or drug use during sex. In addition, only perceived norms of other bisexual women, compared to perceived norms of lesbian and heterosexual women, predicted engagement in sex. Conclusions: Bisexual women may be susceptible to normative perceptions, given their connectedness to a marginalized social group. Thus, alcohol prevention and intervention efforts aimed at reducing risky consequences among bisexual women should specifically consider drinking and sexual norms of other bisexual women.
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Affiliation(s)
| | | | | | | | - Sarah Ehlke
- Old Dominion University, Norfolk, Virginia, USA
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9
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Gilmore AK, López CM, Mullican KN, Davis KC, Leone RM, Orchowski LM, Kaysen D, Moreland AD. Sexual Assault, Posttraumatic Stress, Alcohol Use, and Suicidality Among Diverse College Students. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:10588-10610. [PMID: 37226725 DOI: 10.1177/08862605231174698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Suicide is the second leading cause of death among college-aged populations. This study examined the association of demographics (sexual orientation, gender identity, age, and race), sexual assault, posttraumatic stress symptoms (PTSS), and alcohol use with suicidality, current urge to self-harm, and current suicidal intent among a diverse sample of college students (n = 2,160) from two universities. Over half of participants reported any suicidality (63.5%), 12% reported current urge to harm themselves, and 5% reported current suicidal intent. A linear regression indicated that participants who identified as a sexual minority, gender minority, consumed more drinks per week, and had more severe PTSS reported higher levels of suicidality. University also was associated with suicidality. A negative binomial regression demonstrated that participants who identified as a sexual minority and had more severe PTSS had more current urge to harm themselves. Further, a negative binomial regression demonstrated that first-generation college students, students with more severe sexual assault histories, and students with more severe PTSS had higher current suicidal intent. Findings suggest that risk factors may differ for college students' general suicidality, self-harm urges, and suicidal intent, suggesting that these may be separate constructs. More comprehensive models, incorporating multiple risk factors and multiple ways of assessing suicidality, are needed to better understand the range of college student suicidal behavior and risks.
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Affiliation(s)
| | | | | | | | | | - Lindsay M Orchowski
- Alpert Medical School of Brown University, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
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10
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Baams L, Kaufman TML. Sexual Orientation and Gender Identity/Expression in Adolescent Research: Two Decades in Review. JOURNAL OF SEX RESEARCH 2023; 60:1004-1019. [PMID: 37307300 DOI: 10.1080/00224499.2023.2219245] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There is a long history of research among adolescents who are minoritized and marginalized for their sexual orientation and gender identity/expression (SOGIE). However, it remains unclear how we can best conceptualize and assess SOGIE in adolescence, resulting in different subpopulations and findings across studies. Addressing this issue, we present a narrative literature review of the conceptualization and assessment of SOGIE, and provide recommendations for conceptualizing and operationalizing these concepts. Our review indicated that most research with adolescent populations still almost exclusively assesses isolated dimensions of sexuality and gender (e.g., attraction but not identity). We argue that to make research inclusive and equitable, scholars are required to make clear substantiated decisions and be transparent about the SOGIE dimensions and, thus, subpopulations they represent.
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Affiliation(s)
- Laura Baams
- Department of Pedagogy and Educational Sciences, University of Groningen
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11
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Kelly LM, Shepherd BF, Brochu PM, Zajac K. Co-occurring suicidal ideation and alcohol-related problems: An intersectional analysis of Native American and White adults with minoritized sexual identities. Addict Behav 2023; 142:107674. [PMID: 36905898 PMCID: PMC10262151 DOI: 10.1016/j.addbeh.2023.107674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 02/11/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Disparities in suicidal ideation (SI) and alcohol use disorder (AUD) are evident in both Native American and minoritized sexual identity groups, relative to non-Hispanic White and heterosexual groups. However, Native Americans report lower drinking and binge drinking rates than White adults. Persons with intersecting identities, specifically Native Americans with minoritized sexual identities, may be at greater risk for SI and drinking, binge drinking, and AUD than White and Native American heterosexual adults. METHODS Five years (2015-2019) of National Survey of Drug Use and Health data were combined (N = 130,157). Multinomial logistic regressions tested racial (Native American vs White) and sexual identity (lesbian/gay/bisexual vs heterosexual) differences in odds of SI, drinking, and co-occurring SI + drinking, versus neither SI/drinking. Subsequent analyses examined SI + binge drinking, and SI + AUD. RESULTS Compared to White heterosexual adults, Native American heterosexual adults reported lower co-occurring SI + drinking odds, whereas Native American sexual minoritized adults reported higher odds. Native American sexual minoritized groups showed greater co-occurring SI + binge drinking odds and greater co-occurring SI + AUD odds compared to White heterosexual adults. Native American sexual minoritized adults showed greater SI only compared to White sexual minoritized adults. Sexual minoritized Native Americans showed higher odds of co-occurring SI + drinking, binge drinking, and AUD than White heterosexual adults. CONCLUSIONS Native American sexual minoritized groups showed higher likelihood of co-occurring SI + drinking, binge drinking, and AUD relative to both White and Native American heterosexual adults. Disparities warrant outreach for suicide and AUD prevention for Native American sexual minoritized adults.
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Affiliation(s)
- Lourah M Kelly
- University of Connecticut, School of Medicine, United States
| | - Benjamin F Shepherd
- Nova Southeastern University, Department of Clinical and School Psychology, United States
| | - Paula M Brochu
- Nova Southeastern University, Department of Clinical and School Psychology, United States
| | - Kristyn Zajac
- University of Connecticut, School of Medicine, United States.
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12
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Balenger A, Scott LC, Swahn MH, Aneja R. Acceptability of Primary Care Counseling and Brief Educational Messages to Increase Awareness about Alcohol and Breast Cancer Risks among Bisexual and Lesbian Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4184. [PMID: 36901202 PMCID: PMC10002287 DOI: 10.3390/ijerph20054184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
This research had two aims: (1) to assess how often bisexual and lesbian women self-report screening and counseling for alcohol use in primary care settings; and (2) understand how bisexual and lesbian women respond to brief messages that alcohol increases breast cancer risk. The study sample consisted of 4891 adult U.S. women who responded to an online, cross-sectional Qualtrics survey in September-October 2021. The survey included the Alcohol Use Disorders Identification Test (AUDIT), questions about alcohol screening and brief counseling in primary care, and questions assessing awareness of the link between alcohol use and breast cancer. Bivariate analyses and logistic regression were conducted. Bisexual and lesbian women had higher odds of harmful drinking (AUDIT score ≥ 8) than heterosexual women (adjusted odds ratio [AOR] = 1.26, 95% confidence interval [CI] = 1.01-1.57 for bisexual women; AOR =1.78, 95% CI = 1.24-2.57 for lesbian women). However, bisexual and lesbian women were no more likely than heterosexual women to be advised about drinking in primary care. In addition, bisexual, lesbian, and heterosexual women had similar reactions to messages highlighting that alcohol is a risk factor for breast cancer. Women across all three sexual orientations who are harmful drinkers more often agreed to search for more information online or talk to a medical professional compared to non-harmful drinkers.
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Affiliation(s)
- Adelaide Balenger
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Lia C. Scott
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA
| | - Monica H. Swahn
- Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, GA 30144, USA
| | - Ritu Aneja
- School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
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13
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Loo S, Peretti M, Sigal M, Noe B, Grasso C, S Keuroghlian A, H Mayer K. Health Center Leadership Perspectives Regarding Barriers to and Facilitators of Providing Culturally Responsive Care for Sexual and Gender Minority Patients. LGBT Health 2023. [PMID: 36802213 DOI: 10.1089/lgbt.2022.0135] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Purpose: This study identified barriers and facilitators associated with providing culturally responsive care for sexual and gender minority (SGM) patients at federally qualified health centers (FQHCs) in the United States, from the perspective of clinical leadership. Methods: Between July and December 2018, 23 semistructured, in-depth qualitative interviews were held with clinical leaders representing six FQHCs residing in rural and urban settings. Stakeholders included Chief Executive Officer, Executive Director, Chief Medical Officer, Medical Director, Clinic Site Director, and Nurse Manager positions. Interview transcripts were analyzed using inductive thematic analysis. Results: Barriers included personnel factors related to lack of training and fear, competing priorities, and environments that focused on treating all patients similarly. Facilitators included established partnerships with external organizations, staff with prior SGM training and knowledge, and active initiatives in clinic settings targeting SGM care. Conclusions: Clinical leadership expressed strong support for evolving their FQHCs into organizations that provide culturally responsive care for their SGM patients. FQHC staff across all levels of clinical care would benefit from regularly occurring training sessions on culturally responsive care for SGM patients. To ensure sustainability, improve staff buy-in, and mitigate the impact of staff turnover, improving culturally competent care for SGM patients should be a shared goal and responsibility for leadership, medical providers, and administrative staff. CTN Registration: NCT03554785.
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Affiliation(s)
- Stephanie Loo
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA.,Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Matteo Peretti
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Maksim Sigal
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Bridget Noe
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Chris Grasso
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA
| | - Alex S Keuroghlian
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Infectious Disease Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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14
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L Gomes N, S Lopes C. Sexual Orientation Disparities in Depression and Substance Use Among Adults: Results from the Brazilian National Health Survey 2019. LGBT Health 2023. [PMID: 36809196 DOI: 10.1089/lgbt.2022.0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Purpose: We compared the prevalence of depression, hazardous alcohol use, daily tobacco use and hazardous alcohol and tobacco use (HATU) by sexual orientation and sex among Brazilian adults. Methods: Data were obtained from a national health survey conducted in 2019. This study included participants aged 18 years and older (N = 85,859). Adjusted prevalence ratios (APRs) and confidence intervals were estimated using Poisson regression models stratified by sex to examine the association between sexual orientation, depression, daily tobacco use, hazardous alcohol use, and HATU. Results: After controlling for the covariates, gay men showed a higher prevalence of depression, daily tobacco use, and HATU compared with heterosexual men (APR ranged from 1.71 to 1.92). Furthermore, bisexual men showed a higher prevalence (almost three times) of depression compared with heterosexual men. Lesbian women showed a higher prevalence of binge and heavy drinking, daily tobacco use, and HATU compared with heterosexual women (APR ranged from 2.55 to 4.44). Among bisexual women, the results were significant for all analyzed outcomes (APR ranged from 1.83 to 3.26). Conclusions: This study was the first to use a nationally representative survey to assess sexual orientation disparities related to depression and substance use by sex in Brazil. Our findings highlight the need for specific public policies aimed at the sexual minority population and for greater recognition and better management of these disorders by health professionals.
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Affiliation(s)
- Nayara L Gomes
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Study, Methods and Control, Brazilian Institute of Geography and Statistics, Rio de Janeiro, Brazil
| | - Claudia S Lopes
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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15
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Luk JW, Yu J, Haynie DL, Goldstein RB, Simons-Morton BG, Gilman SE. A Nationally Representative Study of Sexual Orientation and High-Risk Drinking From Adolescence to Young Adulthood. J Adolesc Health 2023; 72:222-229. [PMID: 36456451 PMCID: PMC9832524 DOI: 10.1016/j.jadohealth.2022.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 09/13/2022] [Accepted: 09/25/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine whether peer drunkenness, parental knowledge about their adolescent's whereabouts and behaviors, and depressive symptoms contribute to sexual orientation disparities in high-risk drinking behaviors; if they do, they would be potential intervention targets. METHODS Longitudinal survey data from 2,051 adolescents who participated in the NEXT Generation Health Study were analyzed. Latent growth curve and longitudinal path analyses were used to test for indirect effects linking sexual orientation in 11th grade (3.4% males and 8.4% females were sexual minorities) to past 30-day heavy episodic drinking (HED) over 6 years and past year high-intensity binge drinking at 4 years after high school. RESULTS Sexual minority males were not more likely to engage in high-risk drinking than heterosexual males. In contrast, sexual minority females were more likely than heterosexual females to engage in HED when they were in 11th grade (Odds Ratio = 2.83, 95% confidence interval = 1.43, 5.61), in part because of lower parental knowledge. Sexual minority females also had higher depressive symptoms during the transition from adolescence to young adulthood, which in turn was associated with greater risk of high-intensity binge drinking in young adulthood. Peer drunkenness was a strong risk factor for HED and high-intensity binge drinking among both males and females. DISCUSSION Sexual minority females reported lower levels of parental knowledge during adolescence and higher levels of depressive symptoms during the transition to young adulthood than heterosexual females. Both factors were associated with high-risk drinking behavior, suggesting developmentally sensitive opportunities to mitigate sexual orientation disparities in high-risk drinking.
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Affiliation(s)
- Jeremy W Luk
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland; Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
| | - Jing Yu
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Risë B Goldstein
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Bruce G Simons-Morton
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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16
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Baker E, Gilbert PA, Wheldon CW, Vanderheyden BB. Predictors of Empirically Derived Substance Use Patterns Among Sexual and Gender Minority Populations of a Rural Midwestern State. LGBT Health 2023; 10:62-71. [PMID: 35947865 DOI: 10.1089/lgbt.2022.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Purpose: The study purpose was to (1) identify latent classes of substance use behaviors among a sample of sexual and gender minority (SGM) adults living in a predominantly rural midwestern state and (2) determine the association between SGM-related discrimination and the empirically derived substance use classes. Methods: We conducted a latent class analysis on 494 responses to a state-wide survey, followed by a multinomial logistic regression to test predictors of class membership, including distal experiences of discrimination and sociodemographic variables. Results: A three-class model fit best and included (1) polysubstance use, (2) binge drinking, and (3) no/low use classes. In the adjusted model, polysubstance class membership was positively associated with cisgender male identity and negatively associated with being 60 years of age or older and college educated. Binge drinking class membership was negatively associated with bisexual/pansexual identity and non-White race/ethnicity. In contrast to hypothesized outcomes guided by the Minority Stress Model, experiences of discrimination were not associated with membership in substance-using classes. Likewise, bisexual/pansexual individuals were not more likely to be members of polysubstance use or binge drinking classes, despite published reports of greater risk of substance use. Conclusion: These contradictions warrant intersectional approaches to advance substance use research, which may provide important evidence for targeted prevention/treatment interventions, particularly among polysubstance users.
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Affiliation(s)
- Elizabeth Baker
- Department of Public Health, College of Health Sciences, Des Moines University, Des Moines, Iowa, USA
| | - Paul A Gilbert
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Brian B Vanderheyden
- Department of Public Health, College of Health Sciences, Des Moines University, Des Moines, Iowa, USA
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17
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Russell ST, Mallory AB, Fish JN, Frost DM, Hammack PL, Lightfoot M, Lin A, Wilson BD, Meyer IH. Distribution and Prevalence of Health in a National Probability Sample of Three Cohorts of Sexual Minority Adults in the United States. LGBT Health 2022; 9:564-570. [PMID: 35856801 PMCID: PMC9734014 DOI: 10.1089/lgbt.2020.0505] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose: This study examined the health profile of a national probability sample of three cohorts of sexual minority people, and the ways that indicators of health vary among sexual minority people across age cohorts and other defining sociodemographic characteristics, including sexual identity, gender identity, and race/ethnicity. Methods: The Generations Study, the first national probability sample of three age cohorts of sexual minority people (n = 1507) in the United States collected in 2016-2017, was used to examine general health profiles across several broad domains: alcohol and drug abuse; general health, physical health, and health disability; mental health and psychological distress; and positive well-being, including general happiness, social well-being, and life satisfaction. Results: There were no cohort differences in substance abuse or positive well-being. The younger cohort was physically healthier, but had worse psychological health than both the middle and older cohorts. Conclusions: Cohort differences in physical health were consistent with patterns of aging, whereas for mental health, there were distinct cohort differences among sexual minority people. Given that compromised mental health in the early life course creates trajectories of vulnerability, these results point to the need for mental health prevention and intervention for younger cohorts of sexual minority people.
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Affiliation(s)
- Stephen T. Russell
- Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, Austin, Texas, USA.,Address correspondence to: Stephen T. Russell, PhD, Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, 108 E. Dean Keeton Street, Stop A2702, Austin, TX 78712-1248, USA
| | - Allen B. Mallory
- Department of Human Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Jessica N. Fish
- Department of Family Science, Prevention Research Center, University of Maryland, College Park, Maryland, USA
| | - David M. Frost
- Social Research Institute, University College London, London, United Kingdom
| | - Phillip L. Hammack
- Department of Psychology, University of California, Santa Cruz, Santa Cruz, California, USA
| | - Marguerita Lightfoot
- School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Andy Lin
- Office of Advanced Research Computing, University of California, Los Angeles, Los Angeles, California, USA
| | - Bianca D.M. Wilson
- The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, California, USA
| | - Ilan H. Meyer
- The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, California, USA
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18
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Pérez-Romero C, Guerras JM, Hoyos J, Donat M, Barrio G, de la Fuente L, Palma D, García de Olalla P, Belza MJ. Excessive Drinking Among Men Who Have Sex With Men Recruited From Web-Based Resources: Cross-sectional Questionnaire Study. JMIR Public Health Surveill 2022; 8:e32888. [DOI: 10.2196/32888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 05/11/2022] [Accepted: 09/06/2022] [Indexed: 11/05/2022] Open
Abstract
Background
US and Northern European studies have found a higher prevalence of alcohol-related problems among men who have sex with men (MSM) than among the general population of men (GPM). However, most of them relied on traditional sampling methods, not profiting from MSM dating apps and websites for recruitment. Besides, analogous comparisons in Southern Europe are lacking.
Objective
This study aimed to compare several indicators of excessive drinking between MSM and GPM in Spain.
Methods
Overall, 5862 MSM were recruited through dating apps or websites for the Méthysos Project, and 10,349 GPM were recruited using probability sampling via the Household Survey on Alcohol and Drugs in Spain from 2018 to 2020. The outcomes were the prevalence of hazardous or harmful drinking (Alcohol Use Disorders Identification Test [AUDIT] ≥8), hazardous drinking (AUDIT-Consumption ≥4), harmful drinking (AUDIT-Problem ≥4), regular hazardous drinking (>14 standard drinks per week), and monthly binge drinking. The prevalence of excessive drinking indicators was calculated for MSM and GPM and compared using the adjusted prevalence ratio (aPR). Two different aPRs and their 95% CIs were estimated using Poisson regression models with robust variance. The first was adjusted for sociodemographic characteristics, and the second was adjusted for the aforementioned covariates plus other drug use.
Results
The prevalence of hazardous or harmful drinking was 15.6% (913/5862) among MSM versus 7.7% (902/10,349) among GPM. After adjusting for sociodemographic covariates, the risk was higher in MSM than in GPM for harmful or hazardous drinking (aPR 1.8, 95% CI 1.6-2.0), harmful drinking (aPR 2.3, 95% CI 2.0-2.7), and binge drinking (aPR 1.7, 95% CI 1.5-1.9); the same in both populations for hazardous drinking (aPR 0.9, 95% CI 0.9-1.0); and higher in GPM than in MSM for regular hazardous drinking (aPR 0.7, 95% CI 0.6-0.9). The relative excess risk of harmful drinking and binge drinking among MSM tended to increase with increasing education level and size of the place of residence, and the opposite was true for the deficit risk in regular hazardous drinking. Additional adjustment for other drug use greatly buffered the relative excess risk in harmful drinking and binge drinking in MSM, while it deepened its deficit risk in regular hazardous drinking.
Conclusions
The use of web-based resources allowed recruiting a large sample of MSM. The risk of hazardous or harmful drinking was 80% greater in MSM than in GPM, which was mainly because of the higher risk of harmful drinking and binge drinking among MSM. Nearly 1 in 6 MSM would benefit from early brief alcohol intervention procedures. The subgroup with harmful or binge drinking combined with other drug use is an important contributor to excess MSM risk in hazardous or harmful drinking and must be a priority target for harm reduction interventions.
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19
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Gilmore AK, Leone RM, Oesterle DW, Davis KC, Orchowski LM, Ramakrishnan V, Kaysen D. Web-Based Alcohol and Sexual Assault Prevention Program With Tailored Content Based on Gender and Sexual Orientation: Preliminary Outcomes and Usability Study of Positive Change (+Change). JMIR Form Res 2022; 6:e23823. [PMID: 35867393 PMCID: PMC9356330 DOI: 10.2196/23823] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 04/30/2021] [Accepted: 05/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background Alcohol use and sexual assault are common on college campuses in the United States, and the rates of occurrence differ based on gender identity and sexual orientation. Objective We aimed to provide an assessment of the usability and preliminary outcomes of Positive Change (+Change), a program that provides integrated personalized feedback to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention among cisgender heterosexual men, cisgender heterosexual women, and sexual minority men and women. Methods Participants included 24 undergraduate students from a large university in the Southwestern United States aged between 18 and 25 years who engaged in heavy episodic drinking in the past month. All procedures were conducted on the web, and participants completed a baseline survey, +Change, and a follow-up survey immediately after completing +Change. Results Our findings indicated that +Change was acceptable and usable among all participants, despite gender identity or sexual orientation. Furthermore, there were preliminary outcomes indicating the benefit for efficacy testing of +Change. Conclusions Importantly, +Change is the first program to target alcohol use, sexual assault victimization, sexual assault perpetration, and bystander intervention within the same program and to provide personalized content based on gender identity and sexual orientation. Trial Registration ClinicalTrials.gov NCT04089137; https://clinicaltrials.gov/ct2/show/NCT04089137
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Affiliation(s)
- Amanda K Gilmore
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Ruschelle M Leone
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Daniel W Oesterle
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, United States
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, AZ, United States
| | - Lindsay M Orchowski
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | | | - Debra Kaysen
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, United States
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20
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Kiekens WJ, Fish JN, Gordon AR, Russell ST. Everyday Discrimination and Alcohol use among Sexual Minority Adults in a U.S. National Probability Sample. Subst Use Misuse 2022; 57:1383-1391. [PMID: 35658825 PMCID: PMC10676011 DOI: 10.1080/10826084.2022.2083172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective: Limited research assesses how sexual orientation and gender identity and expression (SOGIE)-based discrimination affects alcohol use above and beyond non-SOGIE-related discrimination and how this may differ for sexual minority subgroups. We examined if SOGIE-related discrimination is additive in affecting alcohol use above and beyond non-SOGIE-related discrimination and examined differences in alcohol use, everyday discrimination, and the attribution of discrimination by sex and sexual identity. Methods: A national probability sample of sexual minority adults in the United States was used (N = 1311, female = 56.4%). Bivariate sexual identity and sex-based differences in drinking frequency, heavy episodic drinking (HED), everyday discrimination, and the attribution of discrimination were assessed. Sexual identity and sex-stratified logistic regression models were estimated, where everyday discrimination and the attribution of discrimination predicted drinking frequency and HED. Results: Several differences by sex assigned at birth and sexual identity in drinking frequency, HED, everyday discrimination, and the attribution of discrimination were found in bivariate analyses. In logistic regression models, experiencing SOGIE-related in addition to other types of discrimination was associated with higher odds of HED only for gay males. No other associations were found for everyday discrimination or the attribution of discrimination with drinking frequency or HED. Conclusions: Findings suggest sex and sexual identity-based differences in everyday discrimination and the attribution of discrimination.
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Affiliation(s)
- Wouter J Kiekens
- Department of Sociology/Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Groningen, The Netherlands
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Allegra R Gordon
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Stephen T Russell
- Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
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21
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Disparities in alcohol use and heavy episodic drinking among bisexual people: A systematic review, meta-analysis, and meta-regression. Drug Alcohol Depend 2022; 235:109433. [PMID: 35395502 DOI: 10.1016/j.drugalcdep.2022.109433] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Alcohol consumption is more prevalent among sexual minorities than among heterosexuals; however, differences between minority sexual orientation groups are understudied. This systematic review and meta-analysis aimed to summarize existing evidence on the prevalence of alcohol use among bisexual people compared to their lesbian/gay and heterosexual counterparts. METHODS A systematic review of literature from 1995 to May 2020 was performed using Medline, PsycInfo, and Embase (OVID), Scopus, CINHAL and LGBT Life (EBSCO), combining keywords for bisexuality and alcohol use. Peer-reviewed publications that reported quantitative data on alcohol use among bisexual people were included. A random-effects model was used to pool the prevalence of two outcomes: any alcohol use and heavy episodic drinking (HED). Subgroup analysis and random-effects meta-regression were used to explore heterogeneity. RESULTS Of 105 studies eligible for data extraction, the overall prevalence of alcohol use was higher among bisexuals compared to lesbian/gay and heterosexual people. For example, the prevalence of past-month HED was 30.0% (28.2, 31.8) among bisexual people versus 25.5% (23.8, 27.2) among lesbian/gay and 21.3% (19.6, 23.0) among heterosexual individuals. Pooled odds ratio estimates showed that bisexual people were more likely to report alcohol use and HED compared to their counterparts. Gender was a significant effect modifier in meta-regression analysis, with greater disparities among women than among men. CONCLUSIONS These results highlight the need for additional research to understand factors underlying bisexual people's greater risk, and particularly bisexual women, as well as alcohol use interventions that are targeted towards the specific needs of bisexual people.
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22
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Silveri G, Schimmenti S, Prina E, Gios L, Mirandola M, Converti M, Fiorillo A, Pinna F, Ventriglio A, Galeazzi GM, Sherriff N, Zeeman L, Amaddeo F, Paribello P, Pinna F, Giallanella D, Gaggiano C, Ventriglio A, Converti M, Fiorillo A, Galeazzi GM, Marchi M, Arcolin E, Fiore G, Mirandola M, Schimmenti S, Silveri G, Prina E, Amaddeo F, Bragazzi NL. Barriers in care pathways and unmet mental health needs in LGBTIQ + communities. Int Rev Psychiatry 2022; 34:215-229. [PMID: 36151825 DOI: 10.1080/09540261.2022.2075256] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Lesbian, gay, bisexual, transgender, intersex, queer people and minority gender identities and sexualities (LGBTIQ+) are often stigmatized and experience discrimination in health care settings, leading to poorer mental health outcomes and unmet needs compared to heterosexual and cisgendered peers. It is thus imperative that mental health providers consider and address structural challenges in order to reduce mental health inequalities of this population. This narrative review assessed the barriers that may prevent access to care and the pathways for care in LGBTIQ + communities. PubMed, PsycInfo, Embase, and Scopus were searched for papers published between December 2021 and February 2022. A total of 107 papers were included with studies reflecting five themes: (1) Unmet mental health needs; (2) Young people; (3) Substance abuse and addiction; (4) Barriers and pathways to care; and (5) Interventions. Findings demonstrate that LGBTIQ + people experience stigmatization and higher rates of substance misuse and mental ill health, which may lead to barriers in accessing health care services, and fewer tailored interventions being provided. These findings have implications for policy, health care screening, and how specialist services are structured. Substantial gaps in the evidence-base exist, and future research should examine how mental health care providers can challenge social issues that maintain discriminatory and stigmatizing practices, and support LGBTIQ + individuals to sustain their resilience.
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Affiliation(s)
- Giada Silveri
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Simone Schimmenti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy.,School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of integrated activity of Mental Health and Pathological Dependencies, USL-IRCSS company of Reggio Emilia, Reggio Emilia, Italy
| | - Nigel Sherriff
- School of Sport and Health Sciences, University of Brighton, Brighton, UK.,Centre for Transforming Sexuality and Gender, University of Brighton, Brighton, UK
| | - Laetitia Zeeman
- School of Sport and Health Sciences, University of Brighton, Brighton, UK.,Centre for Transforming Sexuality and Gender, University of Brighton, Brighton, UK
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Pasquale Paribello
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniela Giallanella
- Department of Clinical and Experimental, University di Foggia, Foggia, Italy
| | - Costanza Gaggiano
- Department of Clinical and Experimental, University di Foggia, Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental, University di Foggia, Foggia, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisa Arcolin
- Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Gianluca Fiore
- Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Simone Schimmenti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giada Silveri
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
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23
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Scheer JR, Batchelder AW, Bochicchio LA, Kidd JD, Hughes TL. Alcohol use, behavioral and mental health help-seeking, and treatment satisfaction among sexual minority women. Alcohol Clin Exp Res 2022; 46:641-656. [PMID: 35318685 PMCID: PMC9018513 DOI: 10.1111/acer.14789] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sexual minority women (SMW) report higher rates of heavy episodic drinking (HED) and adverse alcohol-related outcomes, including poor mental health, than heterosexual women. These disparities indicate a greater need for behavioral and mental health treatment for SMW. This study examined associations among alcohol outcomes, behavioral and mental health help-seeking, and treatment satisfaction among SMW by age, sexual identity, race/ethnicity, and income. METHODS Participants included a community sample of 695 SMW (Mage = 40.0, SD = 14.1; 74.1% lesbian, 25.9% bisexual; 37.6% White, 35.8% Black, 23.2% Latinx; 26.3% annual income $14,999 or less). We used bivariate analyses to characterize the sample's demographic characteristics and multivariable logistic regression analyses to examine associations among variables. RESULTS SMW subgroups based on age, race/ethnicity, and annual income differed in alcohol outcomes (i.e., HED, DSM-IV alcohol dependence, alcohol-related problem consequences, alcohol problem recognition, and motivation to reduce drinking); help-seeking; and treatment satisfaction. SMW who engaged in help-seeking for alcohol-related concerns were more likely than those who did not to meet criteria for DSM-IV alcohol dependence (adjusted odds ratio [aOR] = 7.13; 95% CI = 2.77; 18.36), endorse alcohol-related problem consequences (aOR = 11.44; 95% CI = 3.88; 33.71), recognize problematic drinking (aOR = 14.56; 95% CI = 3.37; 62.97), and report motivation to reduce drinking (aOR = 5.26; 95% CI = 1.74; 15.88). SMW's alcohol outcomes did not differ based on their satisfaction with treatment or with providers. CONCLUSIONS This study's findings confirm SMW's elevated risk for HED and other alcohol-related outcomes and underscore the importance of identity-affirmative and accessible behavioral and mental health treatment for young, Black, and low-income SMW. Clinicians and intervention scientists should develop or enhance existing brief behavioral and mental health treatments for SMW engaging in HED who may not recognize that their drinking is problematic or who are not motivated to reduce drinking.
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Affiliation(s)
| | - Abigail W. Batchelder
- Harvard Medical School, Harvard University, Boston, MA
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- The Fenway Institute, Fenway Health, Boston, MA
| | - Lauren A. Bochicchio
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY
| | - Jeremy D. Kidd
- Columbia University Irving Medical Center, New York, NY
- New York State Psychiatric Institute, New York, NY
| | - Tonda L. Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY
- Columbia University Irving Medical Center, New York, NY
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Norris AL, López G, Orchowski LM. Directionality of Dating Violence Among High School Youth: Rates and Correlates by Gender and Sexual Orientation. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP3954-NP3980. [PMID: 32886010 PMCID: PMC10811593 DOI: 10.1177/0886260520951308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sexual minority adolescents are at greater risk for experiencing teen dating violence (TDV) in their dating relationships. Although adolescents in dating relationships often report experiencing and perpetrating various forms of TDV, the directionality of TDV based on youth's reported gender and sexual orientation is not known. A sample of 10th-grade students (N = 1,622) recruited from high schools in the Northeastern United States completed assessments of TDV victimization and perpetration and reported their past-month heavy alcohol use and marijuana use. Sexual minority girls (58%) and boys (36%) were more likely to experience TDV than heterosexual girls (38%) and boys (25%), respectively. Sexual minority boys were less likely, although the confidence intervals included one, to engage in dual-role physical TDV (odds ratio [OR] = 0.14, 95% confidence interval [CI] [0.00, 1.26]) and threatening TDV (OR = 0.14, 95% CI [0.00, 1.02]), and instead were more likely to be victimized. In contrast, the profiles of TDV were similar for girls, with sexual minority girls only being more likely than heterosexual girls to report dual-role physical TDV (OR = 2.23, 95% CI [1.07, 4.66]). Compared with unidirectional TDV, bidirectional TDV was significantly associated with sexual minority girls' substance use, but not with heterosexual girls' substance use. Sexual minority youth report higher rates of TDV, with sexual minority boys being distinctly at-risk for being victimized within their dating relationships. Engagement in both TDV victimization and perpetration was distinctly associated with substance use for sexual minority girls, highlighting the need for integrated prevention efforts and support.
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Affiliation(s)
- Alyssa L. Norris
- The Miriam Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Gabriela López
- Alpert Medical School of Brown University, Providence, RI, USA
- The University of New Mexico, Albuquerque, NM, USA
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Amos N, Bourne A, Hill AO, Power J, McNair R, Mooney-Somers J, Pennay A, Carman M, Lyons A. Alcohol and tobacco consumption among Australian sexual minority women: Patterns of use and service engagement. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 100:103516. [PMID: 34753044 DOI: 10.1016/j.drugpo.2021.103516] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sexual minority women consume both alcohol and tobacco at higher rates than heterosexual women. However, various sociodemographic and cultural factors associated with these practices among sexual minority women in Australia are not well understood, nor are the factors associated with seeking alcohol-related support. METHODS This study utilised data from cisgender sexual minority women respondents of Private Lives 3: a national, online, cross-sectional survey of the health and wellbeing of LGBTIQ adults in Australia aged 18+ conducted in 2019. Multivariable analyses were performed to identify co-existing smoking and alcohol use, sociodemographic factors associated with smoking, alcohol consumption and seeking alcohol-related support. RESULTS Of 2,647 sexual minority women respondents, 16.90% were currently smoking tobacco, 7.67% smoking tobacco daily and 60.50% reported potentially risky patterns of alcohol consumption. Tobacco and potentially risky alcohol consumption were found to frequently co-occur. Women who identified as queer were more likely than lesbian identifying women to currently smoke tobacco and to smoke tobacco daily. Tobacco consumption was associated with increased age, unemployment, low-mid range income and secondary-school education, while potential risky drinking was associated with living in outer urban or rural areas and being Australian born . Self-reporting having struggled with alcohol in the past twelve months was associated with residential location. Less than 3% of the sample has sought help for alcohol use. Seeking support was more likely as women aged, and with potentially risky drinking, and much more likely with self-perceived struggles with alcohol. CONCLUSIONS The findings highlight the need for future alcohol and tobacco use health promotion strategies focussing on sexual minority women to attend to within group differences that relate to risk of higher consumption. They also highlight the need for approaches that empower sexual minority women to self-identify when they are struggling with alcohol use and encourage seeking support with organisations that are affirming of sexual minority women.
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Affiliation(s)
- Natalie Amos
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia.
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Adam O Hill
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Jennifer Power
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Ruth McNair
- Department of General Practice, The University of Melbourne, Level 3, 780 Elizabeth St, Melbourne, Victoria, 3004, Australia
| | - Julie Mooney-Somers
- University of Sydney, Faculty of Medicine and Health, Sydney Health Ethics, Level 1 Medical Foundation Building, 91-97 Parramatta Road, Camperdown, NSW, 2050, Australia
| | - Amy Pennay
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Building NR1, Bundoora, Victoria, 3086, Australia
| | - Marina Carman
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Building NR6, Bundoora, Victoria, 3086, Australia
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Ruth-Sahd LA, Schneider MA. Alcohol use and binge drinking in baccalaureate nursing students: A descriptive study. J Prof Nurs 2022; 38:114-120. [PMID: 35042584 DOI: 10.1016/j.profnurs.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Current literature validates that drinking is a problem on many college and university campuses. While educators are aware that drinking negatively impacts learning, it is imperative that nursing educators understand why this behavior exists and recognize strategies and opportunities to mitigate drinking for students in the nursing major. PURPOSE The purposes of this study were to understand the prevalence of and reasons for alcohol use and binge drinking in undergraduate baccalaureate nursing students in the United States and identify ways faculty may promote a healthy learning environment to decrease the incidence of alcohol use and binge drinking. METHOD This descriptive study used a web-based survey methodology. The survey contained a demographic questionnaire, alcohol use survey, and open-ended questions to address reasons for drinking and stressors. The survey was randomly distributed to baccalaureate nursing programs throughout the United States. RESULTS The final sample included 937 participants. Nursing students abuse alcohol for a variety of reasons including lack of understanding of binge drinking, peer pressure, dealing with mental health issues, and as a way to cope with multifaceted life stressors. Slightly over half (51%) of these participants reported drinking behavior that would be considered hazardous and 3% were in the alcohol dependent category on the alcohol use survey. CONCLUSION These findings are consistent with social concerns about alcohol use. Nursing students yearned for help and support from faculty regarding how to handle stress and desired faculty to be role models. Faculty who form collaborative partnerships with students, foster healthy coping strategies which may promote academic success and more importantly favorable outcomes as future practicing nurses.
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Affiliation(s)
- Lisa A Ruth-Sahd
- York College of Pennsylvania and Georgetown University, United States.
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Plawecki MH, Boes J, Wetherill L, Kosobud AEK, Stangl BL, Ramchandani VA, Zimmermann US, Nurnberger JI, Schuckit M, Edenberg HJ, Pandey G, Kamarajan C, Porjesz B, Foroud T, O'Connor S. Binge and high-intensity drinking-Associations with intravenous alcohol self-administration and underlying risk factors. Addict Biol 2022; 27:e13228. [PMID: 36301209 PMCID: PMC9786574 DOI: 10.1111/adb.13228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/06/2022] [Accepted: 08/14/2022] [Indexed: 01/24/2023]
Abstract
Some styles of alcohol consumption are riskier than others. How the level and rate of alcohol exposure contribute to the increased risk of alcohol use disorder is unclear, but likely depends on the alcohol concentration time course. We hypothesized that the brain is sensitive to the alcohol concentration rate of change and that people at greater risk would self-administer faster. We developed a novel intravenous alcohol self-administration paradigm to allow participants direct and reproducible control over how quickly their breath alcohol concentration changes. We used drinking intensity and the density of biological family history of alcohol dependence as proxies for risk. Thirty-five alcohol drinking participants aged 21-28 years provided analytical data from a single, intravenous alcohol self-administration session using our computer-assisted alcohol infusion system rate control paradigm. A shorter time to reach 80 mg/dl was associated with increasing multiples of the binge drinking definition (p = 0.004), which was in turn related to higher density of family history of alcoholism (FHD, p = 0.04). Rate-dependent changes in subjective response (intoxication and stimulation) were also associated with FHD (each p = 0.001). Subsequently, given the limited sample size and FHD range, associations between multiples of the binge drinking definition and FHD were replicated and extended in analyses of the Collaborative Study on the Genetics of Alcoholism database. The rate control paradigm models binge and high-intensity drinking in the laboratory and provides a novel way to examine the relationship between the pharmacokinetics and pharmacodynamics of alcohol and potentially the risk for the development of alcohol use disorders.
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Affiliation(s)
- Martin H. Plawecki
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
| | - Julian Boes
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Leah Wetherill
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Ann E. K. Kosobud
- Department of NeurologyIndiana University School of MedicineIndianapolisIndianaUSA
| | - Bethany L. Stangl
- Human Psychopharmacology Laboratory, Division of Intramural Clinical and Biological ResearchNIAAABethesdaMarylandUSA
| | - Vijay A. Ramchandani
- Human Psychopharmacology Laboratory, Division of Intramural Clinical and Biological ResearchNIAAABethesdaMarylandUSA
| | - Ulrich S. Zimmermann
- Department of Psychiatry and PsychotherapyUniversity Hospital Carl Gustav Carus of the Technische Universität DresdenDresdenGermany,Department of Addiction Medicine and Psychotherapykbo Isar‐Amper‐Klinikum Haar/MunichMunichGermany
| | - John I. Nurnberger
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
| | - Marc Schuckit
- Department of PsychiatryUniversity of California San DiegoSan DiegoCaliforniaUSA
| | - Howard J. Edenberg
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA,Department of Biochemistry and Molecular BiologyIndiana University School of MedicineIndianapolisIndianaUSA
| | - Gayathri Pandey
- Henri Begleiter Neurodynamics LaboratoryState University of New York Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Chella Kamarajan
- Henri Begleiter Neurodynamics LaboratoryState University of New York Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics LaboratoryState University of New York Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Tatiana Foroud
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Sean O'Connor
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
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Paschen-Wolff MM, Putney JM, Corbeil T, Tse-Hwei C, Hughes TL. The Association between Hazardous Drinking Indicators and Drinking Problem Concerns among Sexual Minority Women. ANNALS OF LGBTQ PUBLIC AND POPULATION HEALTH 2021; 2:317-335. [PMID: 37920249 PMCID: PMC10621598 DOI: 10.1891/lgbtq-2020-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Sexual minority women (SMW) report high rates of hazardous drinking (HD), treatment utilization that is not commensurate with need, and low perceived alcohol use severity. This study examined SMW's drinking problem concerns by sexual identity and other demographic characteristics, and the strength of associations between endorsement of unique HD indicators and drinking problem concerns. Data were from a supplemental sample of SMW added in Wave 3 of the longitudinal, community-based Chicago Health and Life Experiences of Women (CHLEW) study. HD was measured using a validated 13-item HD Index (HDI). Multivariable logistic regression models examined independent associations between past-five-year drinking problem concerns and each HD indicator. Twelve HD indicators were significantly associated with past-five-year drinking problem concerns, adjusting for age and sexual identity. Adjusted odds ratios varied from 2.44 for driving drunk to 15.52 for drinking first thing in the morning. After adjusting for number of HD indicators endorsed, associations were no longer significant, indicating that number of endorsed indicators was a more important predictor of drinking problem concerns than were individual HD indicators. Early intervention and harm reduction strategies could support SMW in addressing salient aspects of HD before progression to alcohol use disorder.
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Affiliation(s)
- Margaret M. Paschen-Wolff
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA
- Columbia University Irving Medical Center, Department of Psychiatry, New York, NY, USA
| | | | - Thomas Corbeil
- Columbia University Irving Medical Center, Department of Psychiatry, Mental Health Data Science Division, New York, NY, USA
| | - Choo Tse-Hwei
- Columbia University Irving Medical Center, Department of Psychiatry, Mental Health Data Science Division, New York, NY, USA
| | - Tonda L. Hughes
- Columbia University Irving Medical Center, Department of Psychiatry, New York, NY, USA
- Columbia University School of Nursing, New York, NY, USA
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West BT, McCabe SE. Choices Matter: How Response Options for Survey Questions about Sexual Identity Affect Population Estimates of Its Association with Alcohol, Tobacco, and Other Drug Use. FIELD METHODS 2021; 33:335-354. [PMID: 34880713 PMCID: PMC8651075 DOI: 10.1177/1525822x21998516] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study presents results from a randomized experiment in the 2015-2017 National Survey of Family Growth, where a large national sample of U.S. individuals aged 15-49 was randomly assigned to one of two different versions of a survey question about sexual identity (one with three response options, including heterosexual, gay/lesbian, and bisexual, and one adding the option "something else"). Analyses of changes in the associations of sexual identity with alcohol, tobacco, and other drug use across these treatments revealed evidence of significant differences in the associations that remained robust after adjusting for socio-demographics. The results suggest that when individuals choose their sexual identity from a more limited number of response options, the heterogeneity of the sexual identity subgroups increases, weakening estimated associations of sexual identity with these behaviors. Open-ended questions may therefore be necessary to measure sexual identity and estimate its associations with substance use behaviors accurately in surveys.
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Affiliation(s)
- Brady T. West
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Sean Esteban McCabe
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Lewis RJ, Romano KA, Ehlke SJ, Lau-Barraco C, Sandoval CM, Glenn DJ, Heron KE. Minority stress and alcohol use in sexual minority women's daily lives. Exp Clin Psychopharmacol 2021; 29:501-510. [PMID: 34096757 PMCID: PMC8511332 DOI: 10.1037/pha0000484] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Sexual minority women (i.e., women who identify as lesbian, bisexual, or other non-heterosexual orientations) report more hazardous drinking compared to heterosexual women. Sexual minority stress (SMS), or experiences related to sexual orientation-based discrimination and marginalization, have been implicated as contributing to these disparities. The association between sexual minority stress and alcohol use has been supported in cross-sectional, and to a limited extent, longitudinal studies. Few studies, however, have examined associations between SMS and alcohol use in sexual minority women's daily lives. Young sexual minority women (age 18-35; N = 321) were recruited to participate in a 14-day daily diary study in which they reported each morning on their SMS and alcohol use (drinking or not; drinking quantity; alcohol consequences) from the previous day. SMS was operationalized in four ways (global negative SMS experiences, specific SMS events, concealment of identity, discrimination). Results from concurrent multilevel models revealed that on days when sexual minority women experienced more global negative SMS, any specific SMS event, or discrimination, they were more likely to drink. Further, prospective models indicated that participants drank more and were more likely to report binge drinking on the day after they experienced at least one SMS event. These findings extend prior research by demonstrating that the association between SMS and alcohol use extends to the daily level of analysis among sexual minority women. Understanding the connection between SMS and alcohol use among sexual minority women is imperative to developing culturally tailored interventions to improve the health and well-being of this at-risk group. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - Sarah J Ehlke
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center
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31
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Greene N, Johnson RM, Rosen J, German D, Cohen JE. Exploring the relationship between the alcohol policy environment and nondiscrimination laws: Implications for binge drinking disparities among LGB adults in the United States. Drug Alcohol Depend 2021; 225:108749. [PMID: 34049096 PMCID: PMC8282708 DOI: 10.1016/j.drugalcdep.2021.108749] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Alcohol policies reduce population-level binge drinking; however, they may not reduce binge drinking disparities between different populations. We examined the association between the alcohol policy environment and binge drinking among Lesbian, Gay and Bisexual (LGB) and heterosexual adults in the presence and absence of state laws protecting LGB people from discrimination. METHODS The 2015-2018 Behavioral Risk Factor Surveillance System (BRFSS) provided information about individual-level binge drinking, sexual identity, and individual-level covariates. The Alcohol Policy Scale (APS) score measures the strength of the alcohol policy environment. Presence of state-level nondiscrimination protections based on sexual orientation came from the Movement Advancement Project. Logistic regression models were used to test whether nondiscrimination statutes modified the association between the alcohol policy environment and binge drinking and whether this interaction differed for LGB and heterosexual adults. RESULTS Among women, a 10 percentage-point increase in APS score was significantly associated with 7% lower odds of binge drinking in states with inclusive nondiscrimination laws (aOR: 0.93 [95% CI: 0.89-0.97; p = 0.0003]) but was not associated with binge drinking in states without inclusive laws (aOR: 0.98 [95% CI: 0.93-1.03] p = 0.4781). Moreover, binge drinking disparities comparing lesbian/bisexual women with heterosexual women were narrower in states with inclusive nondiscrimination laws. No significant association was found among men. CONCLUSIONS Binge drinking disparities between lesbian and heterosexual women are negligible in states with inclusive laws and strong alcohol policy environments. Inclusive nondiscrimination laws are an indicator of less structural stigma directed at lesbian and bisexual women.
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Affiliation(s)
- Naomi Greene
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Renee M. Johnson
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 624 N. Broadway Street, Baltimore, MD 21205
| | - Joanne Rosen
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Danielle German
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway Street, Baltimore, MD, 21205, United States.
| | - Joanna E. Cohen
- Department of Health, Behavior and Society; Bloomberg School of Public Health, Johns Hopkins University; 624 N. Broadway Street, Baltimore, MD 21205
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Addiction among women and sexual minority groups. HANDBOOK OF CLINICAL NEUROLOGY 2021. [PMID: 33008541 DOI: 10.1016/b978-0-444-64123-6.00028-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
Gender-related alcohol and drug abuse problems are related not only to biologic differences but also to social and environment factors, all of which can influence the clinical presentation, consequences of use, and treatment approaches. The number of women becoming addicted to alcohol or drugs of abuse has significantly increased with women becoming the fastest-growing group of substance abusers in the United States. Given that women experience a more rapid progression of their addiction than men, it is important that we understand and address the differences to help develop prevention and treatment programs that are tailored for women, incorporating trauma assessment and management, comorbidities, financial independence, pregnancy, and child care.
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Drabble LA, Mericle AA, Wootton AR, Munroe C, Li L, Trocki KF, Hughes T. Measuring the impact of legal recognition of same-sex marriage among sexual minority women. JOURNAL OF GLBT FAMILY STUDIES 2021; 17:371-392. [PMID: 34840535 PMCID: PMC8612071 DOI: 10.1080/1550428x.2021.1935382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Reductions in structural stigma, such as gaining access to legalized same-sex marriage, is associated with positive psychological and physical health outcomes among sexual minority adults. However, these positive outcomes may be less robust among sexual minority women (SMW; e.g., lesbian, bisexual, queer) than sexual minority men and new measures are needed to develop a more nuanced understanding of the impact of affirming policies on the health and well-being of SMW. This study assessed the psychometric properties of measures developed to assess the psychosocial impacts of legalized same-sex marriage on the lives of SMW. Participants (N=446) completed an online survey assessing the psychosocial impact of legalized same-sex marriage in five domains: 1) personal impact, 2) stigma-related concerns, 3) couple impact, 4) LGBTQ community impact, and 5) political/social environment. Psychometric properties of the scales were examined using traditional and Rasch analyses. Personal, concerns, couple, and political/social environment scales demonstrated high internal consistency (α > 0.80), and acceptable levels of reliability even when scales reduced to five items each. The LGBTQ community scale demonstrated adequate internal consistency (α = 0.79) and could only be reduced to 9 items. These scales may be useful in future studies of SMW health and well-being.
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Affiliation(s)
- Laurie A. Drabble
- College of Health & Human Sciences, San José State University, San José, CA
| | | | - Angie R. Wootton
- School of Social Welfare, University of California Berkeley, Berkeley, CA
| | | | - Libo Li
- Alcohol Research Group, Emeryville, CA
| | | | - Tonda Hughes
- School of Nursing & Department of Psychiatry, Columbia University, New York, NY
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Drabble LA, Mericle AA, Gómez W, Klinger JL, Trocki KF, Karriker-Jaffe KJ. Differential Effects of State Policy Environments on Substance Use by Sexual Identity: Findings From the 2000-2015 National Alcohol Surveys. ACTA ACUST UNITED AC 2021; 2:53-71. [PMID: 34396364 DOI: 10.1891/lgbtq-2020-0029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction This study explored whether structural stigma, defined by U.S. state policies related to sexual minority rights, moderated the relationship between sexual identity identity and heavy drinking, alcohol problems, and marijuana use among men and women. Methods Using combined data from the National Alcohol Survey (NAS) series (2000, 2005, 2010, and 2015), the sample included 11,115 men (421 sexual minority and 10,694 heterosexual) and 14,395 women (413 sexual minority and 13,982 heterosexual). State policy environment was assessed using a time-varying dichotomous indicator of comprehensive protections for sexual minorities (4-6 protections vs. limited or no protections). Gender-stratified logistic regression analyses examined the differential effect of the policy environment by sexual identity on three past-year substance use outcomes: high-intensity drinking (8+ drinks/day), any DSM-5 alcohol use disorder, and marijuana use. Results Among women, sexual minority status was associated with increased odds of all alcohol and marijuana use outcomes. Among men, sexual minority status was associated with decreased odds of high-intensity drinking but increased use of marijuana. Comprehensive policy protections were associated significantly decreased odds of high-intensity drinking among sexual minority men and marginally significant decreases among women. Conclusions Comprehensive policy protections appear to be protective for high-intensity drinking among sexual minority men and women. Findings underscore the importance of supportive policies in reducing risk of alcohol-related problems among sexual minorities.
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Affiliation(s)
- Laurie A Drabble
- College of Health and Human Sciences, San Jose State University, San Jose, CA, USA
| | - Amy A Mericle
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Walter Gómez
- Jane Addams College of Social Work, University of Illinois, Chicago, IL, USA
| | - Jamie L Klinger
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Karen F Trocki
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
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Trocki KF, Mericle AA, Drabble LA, Klinger JL, Veldhuis CB, Hughes TL, Karriker-Jaffe KJ. Investigating differential protective effects of marriage on substance use by sexual identity status. INTERNATIONAL JOURNAL OF ALCOHOL AND DRUG RESEARCH 2020; 8:69-80. [PMID: 33510823 PMCID: PMC7837608 DOI: 10.7895/ijadr.267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Research suggests that marriage is protective against substance use. However, few studies have examined whether this protective effect differs for sexual minorities, a population at increased risk for substance use. Using data from four waves of the cross-sectional U.S. National Alcohol Survey (NAS; 2000, 2005, 2010, and 2015), we investigated whether the protective effects of marriage varied by sexual identity. METHODS Sex-stratified logistic regression models were used to examine independent and interactive effects of current marital status (being married vs. not) and sexual minority status (lesbian/gay/bisexual vs. heterosexual) on high-intensity drinking, alcohol use disorder, and marijuana use in the past year. RESULTS Among both women and men, sexual minority status was generally associated with higher odds of these outcomes and marriage was consistently associated with lower odds. Differential effects of marriage by sexual identity with respect to marijuana use were found only among men; marriage was significantly associated with decreased odds of marijuana use among heterosexual men but increased odds among sexual minority men. CONCLUSIONS Marriage may be less consistently protective against hazardous drinking and marijuana use among sexual minorities than heterosexuals. Findings underscore the importance of both quantitative and qualitative studies designed to better understand disparities in substance use across both sexual identity and relationship statuses.
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Affiliation(s)
- Karen F. Trocki
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Amy A. Mericle
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Laurie A. Drabble
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
- San José State University College of Health and Human Sciences, One Washington Square, San Jose, CA 95192-0049, USA
| | - Jamie L. Klinger
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Cindy B. Veldhuis
- School of Nursing, Columbia University, 630 West 168 Street, Mail Box Code 6, New York, NY 10032, USA
| | - Tonda L. Hughes
- School of Nursing, Columbia University, 630 West 168 Street, Mail Box Code 6, New York, NY 10032, USA
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Hoetger C, Rabinovitch AE, Henry RS, Aguayo Arelis A, Rabago Barajas BV, Perrin PB. Characterizing substance use in a sample of lesbian, gay, bisexual, and transgender adults in Mexico. J Addict Dis 2020; 39:96-104. [PMID: 33118855 DOI: 10.1080/10550887.2020.1826102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Research from high-income countries on substance use among lesbian, gay, bisexual, and transgender (LGBT) adults is growing; however, limited empirical research exists on LGBT adults in Mexico. Filling this gap is critical as LGBT adults experience unique stressors that may place them at risk for substance use-related health outcomes. Objectives: This study sought to characterize substance use prevalence and magnitude among a convenience sample of Mexican LGBT adults. Methods: A cross-sectional online survey was conducted using a sample of Spanish-speaking, self-identified LGBT adults (n = 92) residing in Mexico who were recruited through online forums of LGBT-focused organizations. Descriptive and frequency analyses were conducted. Results: Participants predominantly identified as cisgender men (n = 44) and gay/lesbian (n = 68). Participants reported high rates of past 90-day legal substance use (>93% for alcohol and >57% for tobacco). The most commonly reported illicit drug used in the past 90 days was marijuana (>29%). Conclusions: While the sample reported lower prevalence and magnitude of substance use relative to other Mexican or United States LGBT samples, the findings highlight that legal and illicit substance use presents health risks for Mexican LGBT individuals. LGBT identity-affirming substance use treatment may reduce substance use-related health burden among this population.
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Affiliation(s)
- Cosima Hoetger
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Annie E Rabinovitch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Richard S Henry
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Adriana Aguayo Arelis
- Department of Neurosciences, CUCS, University of Guadalajara, Guadalajara, JAL, Mexico.,Department of Psychology, Enrique Diaz de Leon University, Guadalajara, JAL, Mexico
| | | | - Paul B Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Abstract
Over the past century, differences in alcohol use and related harms between males and females in the United States have diminished considerably. In general, males still consume more alcohol and experience and cause more alcohol-related injuries and deaths than females do, but the gaps are narrowing. Among adolescents and emerging adults, gaps in drinking have narrowed primarily because alcohol use among males has declined more than alcohol use among females. Among adults, alcohol use is increasing for women but not for men. Rates of alcohol-related emergency department visits, hospitalizations, and deaths all have increased among adults during the past two decades. Consistent with the changing patterns of alcohol use, increases in these outcomes have been larger for women. Recent studies also suggest that females are more susceptible than males to alcohol-induced liver inflammation, cardiovascular disease, memory blackouts, hangovers, and certain cancers. Prevention strategies that address the increases in alcohol consumption and unique health risks for women are needed.
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Affiliation(s)
- Aaron M White
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
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38
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Fish JN, Russell BS, Watson RJ, Russell ST. Parent-child Relationships and Sexual Minority Youth: Implications for Adult Alcohol Abuse. J Youth Adolesc 2020; 49:2034-2046. [PMID: 32772330 PMCID: PMC7487049 DOI: 10.1007/s10964-020-01299-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/18/2020] [Indexed: 12/17/2022]
Abstract
Sexual minority (lesbian, gay, bisexual, and same-sex attracted) youth and adults report elevated rates of alcohol use and abuse relative to their heterosexual peers; these differences are strongest for sexual minority girls and women. Although preliminary evidence suggests that unsupportive parenting and maladaptive parent-child relationship qualities are associated with concurrent substance use among sexual minority youth, questions remain about the long-term implications of these early familial experiences on drinking behaviors among sexual minority youth and adults. Nationally-representative prospective data (n = 14,800; 53.1% female; Wave 1 Mean age = 15.61; Wave 4 Mean age = 28.51) were used to test the longitudinal association between parent-child relationships and parental autonomy granting between the ages of 13-18, and sexual-orientation-related disparities in alcohol abuse during adulthood. The findings showed that adolescent same-sex attraction was associated with alcohol abuse during adulthood for sexual minority women and that deficits in parent-child relationship quality statistically mediated this association. No sexual orientation differences in alcohol abuse were found among men. The findings suggest that the quality of relationships with parents in early adolescence has long-lasting impact on sexual minority women's vulnerability for alcohol abuse. Early interventions that bolster supportive parent-child relationship qualities may have enduring consequences for sexual minority women's alcohol use across the life course.
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Affiliation(s)
- Jessica N Fish
- University of Maryland, Family Science, School of Public Health, 4200 Valley Drive, Suite 1142, College Park, MD, 20742, USA.
| | - Beth S Russell
- University of Connecticut, Human Development & Family Sciences, 348 Mansfield Rd., U-1058, Storrs, CT, 06269-1058, USA
| | - Ryan J Watson
- University of Connecticut, Human Development & Family Sciences, 348 Mansfield Rd., U-1058, Storrs, CT, 06269-1058, USA
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX, 78712, USA
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Solazzo AL, Austin SB, Rosario M, Corliss HL, Charlton BM. Maternal Comfort with Lesbian, Gay, and Bisexual People and Their Children's Drinking, Smoking, and Disordered Weight Control Behaviors as Adults. LGBT Health 2020; 7:375-384. [PMID: 32877268 DOI: 10.1089/lgbt.2019.0315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: We investigated associations between maternal comfort with lesbian, gay, and bisexual (LGB) people during the participant's adolescence and their health indicators in adulthood. Methods: Data came from a prospective cohort, Growing Up Today Study (N = 7476), limited to men and women who provided information during their adulthood about recent binge drinking, cigarette smoking, or disordered weight control behaviors (DWCB) and whose mothers provided information during the participant's adolescence about her comfort with LGB people. Results: Increased maternal comfort with LGB people was associated with increased engagement in health indicators for heterosexual but not sexual minority adults (binge drinking, cigarette smoking, and DWCB for women; binge drinking for men). No association existed between maternal comfort with LGB people and binge drinking or cigarette smoking for sexual minority women, and binge drinking for sexual minority men. This resulted in statistically smaller differences across sexual orientation in cigarette smoking for women when their mothers were highly comfortable with LGB people compared with those whose mothers were uncomfortable with LGB people. There were no differences in binge drinking (women and men) and DWCB (women only) across sexual orientation when mothers were highly comfortable with LGB people. Conclusion: Maternal comfort with LGB people is associated with certain sexual orientation-related disparities in health indicators through adulthood, due to increased engagement in health indicators by heterosexual adults. Exposure to sexual orientation stigma in adolescence, measured as maternal comfort with LGB people, possibly drives well-known differences in drinking, smoking, and DWCB during adulthood between heterosexual and sexual minority adults.
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Affiliation(s)
- Alexa L Solazzo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Margaret Rosario
- Department of Psychology, City College and The Graduate Center, City University of New York, New York, New York, USA
| | - Heather L Corliss
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University, San Diego, California, USA
| | - Brittany M Charlton
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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40
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Fish JN, Exten C. Sexual Orientation Differences in Alcohol Use Disorder Across the Adult Life Course. Am J Prev Med 2020; 59:428-436. [PMID: 32713615 PMCID: PMC7483372 DOI: 10.1016/j.amepre.2020.04.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/14/2020] [Accepted: 04/14/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Sexual orientation‒related disparities in alcohol use disorder are well-established. Yet, the degree to which sexual orientation differences in alcohol use disorder vary across the life course is poorly understood. There is also a limited understanding of how exposure to minority stressors and their relationship with alcohol use disorder vary as a function of age. METHODS Using nationally representative data collected in 2012-2013, authors used sex-stratified time-varying effect models to estimate age-specific prevalence rates of alcohol use disorder among heterosexual and sexual minority adults aged 18-60 years (N=28,090). Among sexual minority adults (n=1,050), authors also assessed age-specific associations between exposure to lesbian, gay, and bisexual‒related discrimination and alcohol use disorder. Analyses were conducted in 2019. RESULTS Gay and bisexual male participants aged 18-45 years demonstrated the highest prevalence rates of alcohol use disorder (e.g., >45% at age 25 years), whereas lesbian, gay, and bisexual female participants were most likely to meet the criteria for alcohol use disorder between ages 45 and 55 years. Sexual minority adults who experienced discrimination in the past year had greater odds of alcohol use disorder between ages 23 and 34 years and again from ages 42 to 53 years; the association between discrimination and alcohol use disorder was strongest among sexual minority men. CONCLUSIONS Sexual orientation-related disparities in alcohol use disorder are dynamic across the life course and point to critical times for screening and intervention. Developmental perspectives of sexual minority health inequities demand focused research attention as findings will help to identify strategies for promoting sexual minority health at distinct points in the life course.
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Affiliation(s)
- Jessica N Fish
- Department of Family Science, University of Maryland Prevention Research Center, School of Public Health, University of Maryland, College Park, Maryland.
| | - Cara Exten
- College of Nursing, Pennsylvania State University, University Park, Pennsylvania
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41
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Simenson AJ, Corey S, Markovic N, Kinsky S. Disparities in Chronic Health Outcomes and Health Behaviors Between Lesbian and Heterosexual Adult Women in Pittsburgh: A Longitudinal Study. J Womens Health (Larchmt) 2020; 29:1059-1067. [PMID: 32639182 PMCID: PMC7462012 DOI: 10.1089/jwh.2019.8052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: Compared to heterosexual women, lesbian women experience higher rates of many chronic diseases, including depression, obesity, hypertension, and diabetes. Lesbian women report higher rates of risky health behaviors such as hazardous drinking and cigarette smoking. However, little longitudinal research has been done to examine changes in disparities between lesbian and heterosexual adult women. Methods: A total of 1,084 women were initially recruited from Pittsburgh, PA to participate in the Epidemiologic Study of HEalth Risk in Women (ESTHER) study and completed a baseline survey between 2003 and 2006. In 2015 or 2016, N = 483 women, 270 of whom were lesbian, completed a follow-up survey. Participants completed a questionnaire at both baseline and follow-up and completed a clinic visit for the baseline study to provide biometric data. Results: At baseline, lesbian participants reported higher rates of obesity (p = 0.03), depression (p = 0.02), and smoking (p = 0.04). Lesbian participants had elevated measured C-reactive protein levels (p = 0.05). By the time of the follow-up survey 10 years later, lesbian women continued to have higher rates of smoking (p = 0.04), but the disparity in depression (p = 0.53) and obesity (p = 0.24) rates had resolved. We found no differences in any other outcomes of interest. Conclusions: To our knowledge, this is the first study to report a resolution in obesity or depression disparities between lesbian and heterosexual women. Future research is necessary to determine if other disparities, such as respiratory conditions, appear over time and how lesbian women's health may continue to improve relative to heterosexual women and stem this public health inequity.
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Affiliation(s)
- Ashley J. Simenson
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Stephanie Corey
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nina Markovic
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Suzanne Kinsky
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for High-Value Health Care, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
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42
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Greene N, Jackson JW, Dean LT. Examining Disparities in Excessive Alcohol Use Among Black and Hispanic Lesbian and Bisexual Women in the United States: An Intersectional Analysis. J Stud Alcohol Drugs 2020; 81:462-470. [PMID: 32800082 PMCID: PMC7437553 DOI: 10.15288/jsad.2020.81.462] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVE Sexual minority (i.e., lesbian, bisexual) women and racial-ethnic minority groups in the United States are disproportionately harmed by excessive alcohol use. This study examined disparities in excessive alcohol use at the intersection of race-ethnicity and sexual identity for non-Hispanic Black and Hispanic sexual minority women. METHOD Using data from the 2015 National Survey on Drug Use and Health, we compared the age-adjusted prevalence of binge drinking and heavy alcohol use among sexual minority women of color, sexual minority White women, and heterosexual women of color with that of White heterosexual women. The joint disparity is the difference in the prevalence of excessive alcohol use between sexual minority women of color and White heterosexual women. The excess intersectional disparity is the portion of the joint disparity that is due to being both a racial-ethnic minority and a sexual minority woman. RESULTS Black and Hispanic sexual minority women reported the highest prevalence of binge drinking (45.4% and 43.4%, respectively), followed by White sexual minority women (35.7%) and White heterosexual women (23%). Black and Hispanic heterosexual women reported the lowest prevalence of binge drinking (20.8% and 20.2%, respectively). The joint disparity in binge drinking between Black sexual minority women and White heterosexual women was 21.2%, and the excess intersectional disparity was 17.7%. The joint disparity in binge drinking between Hispanic sexual minority women and White heterosexual women was 16.8%, and the excess intersectional disparity was 10.8%. CONCLUSIONS Disparities in excessive alcohol consumption for Black and Hispanic sexual minority women, compared with White heterosexual women, were larger than what would be expected when considering differences by race or sexual identity individually.
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Affiliation(s)
- Naomi Greene
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - John W Jackson
- Departments of Epidemiology and Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lorraine T Dean
- Departments of Epidemiology and Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland
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43
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Greene N, Jackson JW, Dean LT. Examining Disparities in Excessive Alcohol Use Among Black and Hispanic Lesbian and Bisexual Women in the United States: An Intersectional Analysis. J Stud Alcohol Drugs 2020; 81:462-470. [PMID: 32800082 PMCID: PMC7437553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 03/19/2020] [Indexed: 11/13/2023] Open
Abstract
OBJECTIVE Sexual minority (i.e., lesbian, bisexual) women and racial-ethnic minority groups in the United States are disproportionately harmed by excessive alcohol use. This study examined disparities in excessive alcohol use at the intersection of race-ethnicity and sexual identity for non-Hispanic Black and Hispanic sexual minority women. METHOD Using data from the 2015 National Survey on Drug Use and Health, we compared the age-adjusted prevalence of binge drinking and heavy alcohol use among sexual minority women of color, sexual minority White women, and heterosexual women of color with that of White heterosexual women. The joint disparity is the difference in the prevalence of excessive alcohol use between sexual minority women of color and White heterosexual women. The excess intersectional disparity is the portion of the joint disparity that is due to being both a racial-ethnic minority and a sexual minority woman. RESULTS Black and Hispanic sexual minority women reported the highest prevalence of binge drinking (45.4% and 43.4%, respectively), followed by White sexual minority women (35.7%) and White heterosexual women (23%). Black and Hispanic heterosexual women reported the lowest prevalence of binge drinking (20.8% and 20.2%, respectively). The joint disparity in binge drinking between Black sexual minority women and White heterosexual women was 21.2%, and the excess intersectional disparity was 17.7%. The joint disparity in binge drinking between Hispanic sexual minority women and White heterosexual women was 16.8%, and the excess intersectional disparity was 10.8%. CONCLUSIONS Disparities in excessive alcohol consumption for Black and Hispanic sexual minority women, compared with White heterosexual women, were larger than what would be expected when considering differences by race or sexual identity individually.
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Affiliation(s)
- Naomi Greene
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - John W. Jackson
- Departments of Epidemiology and Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lorraine T. Dean
- Departments of Epidemiology and Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland
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Glick JL, Lim S, Beckham SW, Tomko C, Park JN, Sherman SG. Structural vulnerabilities and HIV risk among sexual minority female sex workers (SM-FSW) by identity and behavior in Baltimore, MD. Harm Reduct J 2020; 17:43. [PMID: 32539784 PMCID: PMC7296724 DOI: 10.1186/s12954-020-00383-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 05/26/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Research suggests sexual minority female sex workers (SM-FSW) face elevated structural vulnerability and HIV risk compared to their heterosexual counterparts. Structural vulnerabilities reflect societal level factors (e.g., sexism, homophobia, racism) that constrain an individual's agency, particularly related to health outcomes. This study examines the association between SM status by identity and behavior, structural vulnerability, and HIV risk among a sample of street-based FSW. METHODS The current study utilizes baseline data from the SAPPHIRE study, a prospective cohort of cis gender and transgender FSW in Baltimore, MD, recruited through targeted time-location sampling from April 2016 to January 2017. The current analysis focuses on cisgender women. The baseline survey ascertained demographics, substance use, intimate partner violence (IPV), and sex work characteristics. Multivariable models were constructed using self-identity and behaviorally defined SM status as independent variables with vulnerability outcomes (e.g., injection drug use, injection speedball, binge drinking, homelessness, physical IPV, ever had a pimp, and being a minor at sex work entry (age < 18)) as dependent variables. RESULTS Of the participants (n = 247), 25.5% (n = 63) self-identified as a SM by identity (e.g., gay or bisexual), and 8.5% (n = 21) reported SM behavior (e.g., same-gender sexual behavior) in the past 3 months. In multivariable logistic regression models, SM status by identity was associated with increased odds of injection drug use, binge drinking, homelessness, physical IPV, and being a minor at sex work entry. SM status by behavior was associated with increased odds of binge drinking, homelessness, ever having a pimp, and being a minor at sex work entry. CONCLUSION The study indicates disproportionate structural vulnerability and heightened HIV risk among SM-FSW, as compared to their heterosexual counterparts, with differences in their profile by sexual identity and behavior. Findings suggest a need for nuanced interventions tailored to these populations.
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Affiliation(s)
- Jennifer L Glick
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
| | - Sahnah Lim
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - S Wilson Beckham
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Catherine Tomko
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Ju Nyeong Park
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Susan G Sherman
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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45
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Fish JN, Krueger EA. Reconsidering Approaches to Estimating Health Disparities Across Multiple Measures of Sexual Orientation. LGBT Health 2020; 7:198-207. [PMID: 32315572 DOI: 10.1089/lgbt.2019.0182] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Purpose: We propose a new theoretically grounded approach for estimating sexual orientation-related health risk that accounts for the unique and shared variance of sexual identity across other measures of sexual orientation (i.e., attraction and behavior). We argue and illustrate that this approach provides specificity not demonstrated by approaches that independently estimate and compare health risk based on sexual identity, attraction, and behavior. Methods: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III, collected in 2012-2013 (N = 36,309, ages 18 and older). The Karlson-Holm-Breen method tested the degree to which attraction- and behavior-based disparities in mental health and substance use disorders change after adjusting for sexual identity. Results: Sexual attraction- and behavior-based disparities in mental health and substance use disorders statistically varied when comparing models that did and did not adjust for sexual identity. Adjusting for sexual identity appeared to have a larger influence on attraction- and behavior-based health associations among men; sexual minority and majority differences were attenuated on nearly every outcome after adjusting for sexual identity. This attenuation was less common among women. Among women, some behavior-based disparities were wider in sexual identity-adjusted models relative to unadjusted models. Conclusion: We demonstrate more accurate approaches to capturing and comparing sexual orientation-related health disparities across multiple measures of sexual orientation, which account for the shared variance between sexual identity and measures of attraction and behavior. Adjusted estimates provide more specificity regarding relative health risk across specific subgroups of sexual minority people, and the intervention and prevention strategies needed to address them.
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Affiliation(s)
- Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Evan A Krueger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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46
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Jung J, Rosoff DB, Muench C, Luo A, Longley M, Lee J, Charlet K, Lohoff FW. Adverse Childhood Experiences are Associated with High-Intensity Binge Drinking Behavior in Adulthood and Mediated by Psychiatric Disorders. Alcohol Alcohol 2020; 55:204-214. [PMID: 31895420 PMCID: PMC7082493 DOI: 10.1093/alcalc/agz098] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 12/19/2022] Open
Abstract
AIM High-intensity binge drinking (HIBD), defined as two or more times the gender-specific binge threshold, is rapidly increasing in the USA; however, the underlying contributing factors are poorly understood. This study investigated the relationship of adverse childhood experiences (ACEs) and HIBD. METHODS Two independent, cross-sectional samples were analysed: (a) past 12-month drinkers in the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III; n = 25,552) and (b) the National Institute on Alcohol Abuse and Alcoholism (NIAAA) clinical sample (n = 1303). Multinomial logistic regressions were utilized to estimate adjusted odds ratios (AORs) of ACEs on HIBD. Mediation analysis was performed to examine the relationship between the past 12-month psychiatric disorders, ACEs, and HIBD. RESULTS In the NESARC-III sample, prevalence of ACEs increased across all binge levels with the highest prevalence in extreme HIBD; ACEs were associated with higher odds for HIBD (level II, odds ratio (OR) = 1.2-1.4; P = 0.03-0.001; level III, OR = 1.3-1.9; P < 0.001). Prevalence of DSM-5 diagnoses also increased across all binge levels. Substance use disorders (SUD), mood, personality and post-traumatic stress disorders (PTSD) conferred the highest odds with extreme HIBD (SUD: OR = 21.32; mood: 1.73; personality: 2.84; PTSD: 1.97; all Ps < 0.001). Mediation analyses showed that the association between ACEs and HIBD was fully mediated through SUD (proportion mediated: 70-90%) and partially through other psychiatric disorders (20-80%). In the NIAAA sample, ACEs were 2-5 times more prevalent in extreme HIBD with higher odds (ORs = 3-8, P < 0.001) compared with non-bingers. CONCLUSION ACEs were associated with significantly increased odds of HIBD and the relationship may be mediated by psychiatric disorders.
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Affiliation(s)
- Jeesun Jung
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10CRC/2-2352), Bethesda, MD 20892-1540, USA
| | - Daniel B Rosoff
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10CRC/2-2352), Bethesda, MD 20892-1540, USA
| | - Christine Muench
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10CRC/2-2352), Bethesda, MD 20892-1540, USA
| | - Audrey Luo
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10CRC/2-2352), Bethesda, MD 20892-1540, USA
| | - Martha Longley
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10CRC/2-2352), Bethesda, MD 20892-1540, USA
| | - Jisoo Lee
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10CRC/2-2352), Bethesda, MD 20892-1540, USA
| | - Katrin Charlet
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10CRC/2-2352), Bethesda, MD 20892-1540, USA
| | - Falk W Lohoff
- Section on Clinical Genomics and Experimental Therapeutics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 10 Center Drive (10CRC/2-2352), Bethesda, MD 20892-1540, USA
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Variations in Gambling Disorder Symptomatology Across Sexual Identity Among College Student-Athletes. J Gambl Stud 2020; 35:1303-1316. [PMID: 30771148 DOI: 10.1007/s10899-019-09838-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Gambling disorder has serious negative consequences for individual health and wellbeing, while being more prevalent among college student-athletes compared to the general college population. While previous research reports that sexual minority (i.e., gay, lesbian and bisexual) populations have higher rates of addictive behaviors such as alcohol and drug abuse, no previous research has explored risk for gambling disorder symptomatology by sexual identity status. The aim of the current study is to identify differences in the severity of gambling disorder symptomatology between sexual minority and heterosexual student-athletes. A stratified random sample of 19,299 National Collegiate Athletic Association college student-athletes participated in an anonymous survey assessing gambling disorder symptomatology. Student-athletes completed measures assessing their past 12-month problem gambling as measured by the DSM-5 diagnostic criteria for gambling disorder and provided information on their sexual identity. Gay and bisexual men had disordered gambling scores 3.42 times higher than heterosexual men (p < .01), when adjusting for race/ethnicity, and years in college. Gay/lesbian and bisexual women reported disordered gambling scores 2.57 higher than heterosexual women (p < .01) when adjusting for race/ethnicity and years in college. This is the first study to compare the prevalence of gambling disorder symptomatology across sexual identity status. The higher number of gambling disorder symptoms observed among sexual minorities in the current study underlines the need for more research on this topic, and supports the exploration of intervention efforts designed to better address problem gambling among sexual minority communities.
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Krueger EA, Fish JN, Upchurch DM. Sexual Orientation Disparities in Substance Use: Investigating Social Stress Mechanisms in a National Sample. Am J Prev Med 2020; 58:59-68. [PMID: 31761516 PMCID: PMC6925636 DOI: 10.1016/j.amepre.2019.08.034] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Sexual minorities are disproportionately more likely than heterosexuals to suffer from substance use disorders, but relatively little is known about differences in substance use disorders across diverse sexual minority subgroups. There is also limited understanding of how different social stressors account for sexual orientation disparities in substance use disorders. METHODS Using nationally representative data collected in 2012-2013 (n=34,597), differences in past-year DSM-5 alcohol, cannabis, and tobacco use disorders were assessed across 4 sexual orientation groups (heterosexuals and 3 sexual minority subgroups, lesbian/gay-, bisexual-, and heterosexual-identified sexual minorities). This study assessed whether stressful life events mediated substance use disorder disparities between heterosexuals and each sexual minority subgroup, and whether stressful life events and lesbian, gay, and bisexual discrimination events mediated these substance use disorder differences. Analyses were conducted in 2019. RESULTS For both men and women, substance use disorders and stress experiences varied by sexual identity. For example, compared with heterosexual men, larger proportions of gay and bisexual men had a past-year alcohol use disorder. Among women, all sexual minority subgroups had higher rates of each substance use disorder than heterosexuals. For each substance use disorder, stressful life events mediated disparities between heterosexuals and sexual minority subgroups, except for heterosexual-identified sexual minority men. Both stressful life events and lesbian, gay, and bisexual discrimination mediated substance use disorder differences between sexual minority subgroups, with stronger indirect effects through lesbian, gay, and bisexual discrimination for lesbians/gay men and stronger indirect effects through stressful life events for bisexual adults, generally. CONCLUSIONS Sexual minority subgroups have a greater prevalence of substance use disorders, mediated through both stressful life events and lesbian, gay, and bisexual discrimination. More research is needed to comprehensively assess the processes underlying sexual orientation substance use disparities.
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Affiliation(s)
- Evan A Krueger
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California.
| | - Jessica N Fish
- Department of Family Science, University of Maryland School of Public Health, College Park, Maryland
| | - Dawn M Upchurch
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California
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Veliz PT, McCabe SE, Hughes TL, Everett BG, Caceres BA, Arslanian-Engoren C. Sexual Orientation and Hypertension Risk Reduction Behaviors Among Adults with High Blood Pressure. ANNALS OF LGBTQ PUBLIC AND POPULATION HEALTH 2020; 1:115-127. [PMID: 34179889 DOI: 10.1891/lgbtq-2019-0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Introduction Hypertension is a significant modifiable risk factor for cardiovascular disease (CVD), the leading cause of death in the U.S. Evidence is emerging showing disparities in CVD risk between sexual minorities and heterosexuals. Engagement in CVD risk reduction behaviors may account for differences. We examined CVD risk reduction for hypertension between sexual minorities and heterosexuals using data from the 2017 Behavioral Risk Factor Surveillance System. Methods Using bivariate and multivariable logistic regression analyses, we compared medical advice and actions taken (taking medicine, changing eating habits, cutting down on sale, reducing alcohol and exercising) to control blood pressure in sexual minority and heterosexual respondents. Analyses were conducted in 2019. Results Approximately 35% of the sample indicated being told by a health professional they had high blood pressure. Sexual minorities were less likely to report reduced alcohol intake to lower their blood pressure (AOR=.515, 95% CI=.300, .883). One sex specific difference between sexual minority women and heterosexual women was found; sexual minority women were less likely to indicate being advised by a health professional to take medications to lower blood pressure when compared to heterosexual women. Conclusions Strategies are needed to reduce alcohol consumption in sexual minority individuals. Uncovering the reasons for the lack of adherence by both sexual minority patients and health care providers can guide future interventions to improve adherence and reduce hypertension as a CVD risk.
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Affiliation(s)
- Philip T Veliz
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Sean Esteban McCabe
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan Ann Arbor, Michigan
| | - Tonda L Hughes
- School of Nursing, Columbia University, New York, New York
| | | | | | - Cynthia Arslanian-Engoren
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan Ann Arbor, Michigan
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50
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Lewis RJ, Ehlke SJ, Shappie AT, Braitman AL, Heron KE. Health Disparities Among Exclusively Lesbian, Mostly Lesbian, and Bisexual Young Women. LGBT Health 2019; 6:400-408. [PMID: 31738644 DOI: 10.1089/lgbt.2019.0055] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Health disparities have been identified between groups of diverse young sexual minority women (SMW) and heterosexual women. This approach may generate sufficient group sizes for statistical analyses but obscures important differences. Moreover, some young women may not identify as "lesbian" or "bisexual" but somewhere in between. This study examined health and sexual minority identity-specific outcomes among three groups of SMW-women who identify as "exclusively lesbian," "mostly lesbian," and "bisexual." Methods: Participants were 990 young (18-30 years old) SMW (exclusively lesbian: n = 305, mostly lesbian: n = 133, bisexual: n = 552) who completed an online survey, including information about mental and physical health symptoms, hazardous drinking, and identity uncertainty. Those who reported alcohol use in the past 30 days responded to questions about their alcohol use and alcohol-related negative consequences. Results: Controlling for demographic differences, health outcomes varied significantly by identity. Mostly lesbian and bisexual women reported the most depression, anxiety, and physical health symptoms; mostly lesbian women reported the highest levels of hazardous drinking. Among those who reported drinking, mostly lesbian women drank the most frequently and reported the most alcohol-related consequences. Mostly lesbian women reported the most identity uncertainty. Conclusion: Mostly lesbian women were similar to bisexual women on several health outcomes. They appear unique, however, in drinking behavior and identity uncertainty. Collapsing across identities in health research may affect outcomes.
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Affiliation(s)
- Robin J Lewis
- Department of Psychology, Old Dominion University, Norfolk, Virginia.,Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia
| | - Sarah J Ehlke
- Department of Psychology, Old Dominion University, Norfolk, Virginia
| | | | - Abby L Braitman
- Department of Psychology, Old Dominion University, Norfolk, Virginia.,Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia
| | - Kristin E Heron
- Department of Psychology, Old Dominion University, Norfolk, Virginia.,Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia
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