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Kratzer TB, Star J, Minihan AK, Bandi P, Scout NFN, Gary M, Riddle-Jones L, Giaquinto AN, Islami F, Jemal A, Siegel RL. Cancer in people who identify as lesbian, gay, bisexual, transgender, queer, or gender-nonconforming. Cancer 2024. [PMID: 38818898 DOI: 10.1002/cncr.35355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/04/2024] [Accepted: 04/17/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Individuals who identify as lesbian, gay, bisexual, transgender, queer, intersex, or gender-nonconforming (LGBTQ+) experience discrimination and minority stress that may lead to elevated cancer risk. METHODS In the absence of population-based cancer occurrence information for this population, this article comprehensively examines contemporary, age-adjusted cancer risk factor and screening prevalence using data from the National Health Interview Survey, Behavioral Risk Factor Surveillance System, and National Youth Tobacco Survey, and provides a literature review of cancer incidence and barriers to care. RESULTS Lesbian, gay, and bisexual adults are more likely to smoke cigarettes than heterosexual adults (16% compared to 12% in 2021-2022), with the largest disparity among bisexual women. For example, 34% of bisexual women aged 40-49 years and 24% of those 50 and older smoke compared to 12% and 11%, respectively, of heterosexual women. Smoking is also elevated among youth who identify as lesbian, gay, or bisexual (4%) or transgender (5%) compared to heterosexual or cisgender (1%). Excess body weight is elevated among lesbian and bisexual women (68% vs. 61% among heterosexual women), largely due to higher obesity prevalence among bisexual women (43% vs. 38% among lesbian women and 33% among heterosexual women). Bisexual women also have a higher prevalence of no leisure-time physical activity (35% vs. 28% among heterosexual women), as do transgender individuals (30%-31% vs. 21%-25% among cisgender individuals). Heavier alcohol intake among lesbian, gay, and bisexual individuals is confined to bisexual women, with 14% consuming more than 7 drinks/week versus 6% of heterosexual women. In contrast, prevalence of cancer screening and risk reducing vaccinations in LGBTQ+ individuals is similar to or higher than their heterosexual/cisgender counterparts except for lower cervical and colorectal cancer screening among transgender men. CONCLUSIONS People within the LGBTQ+ population have a higher prevalence of smoking, obesity, and alcohol consumption compared to heterosexual and cisgender people, suggesting a higher cancer burden. Health systems have an opportunity to help inform these disparities through the routine collection of information on sexual orientation and gender identity to facilitate cancer surveillance and to mitigate them through education to increase awareness of LGBTQ+ health needs.
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Affiliation(s)
- Tyler B Kratzer
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Jessica Star
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Adair K Minihan
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Priti Bandi
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - N F N Scout
- National LGBT Cancer Network, Providence, Rhode Island, USA
| | - Monique Gary
- Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | | | - Angela N Giaquinto
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Farhad Islami
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Rebecca L Siegel
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
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Chassin L, Sher KJ. Understanding alcohol use and alcohol use disorders from a developmental psychopathology perspective: Research advances, challenges, and future directions. Dev Psychopathol 2024:1-15. [PMID: 38655739 DOI: 10.1017/s0954579424000671] [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: 04/26/2024]
Abstract
As part of the special issue of Development and Psychopathology honoring the remarkable contributions of Dr Dante Cicchetti, the current paper attempts to describe the recent contributions that a developmental psychopathology perspective has made in understanding the development of alcohol use and alcohol-related problems over the lifespan. The paper also identifies some of the future challenges and research directions. Because the scope of this task far exceeds the confines of a journal length article this paper does not attempt a comprehensive review. Rather, it builds on an earlier review and commentary that was published in Development and Psychopathology in 2013, with a similar goal.)Building on that work and updating its conclusions and suggestions for future directions, the current paper emphasizes findings from the research areas that were identified for further study in 2013 and the findings that have been published since that time.
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Davies EL, Ezquerra-Romano I, Thayne B, Holloway Z, Bayliss J, O'Callaghan S, Connolly DJ. Discrimination, gender dysphoria, drinking to cope, and alcohol harms in the UK trans and non-binary community. Alcohol Alcohol 2024; 59:agad060. [PMID: 37850541 DOI: 10.1093/alcalc/agad060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 10/19/2023] Open
Abstract
Transgender (trans) and non-binary people may be at increased risk of alcohol harms, but little is known about motives for drinking in this community. This study explored the relationship between risk of alcohol dependence, experience of alcohol harms, drinking motives, dysphoria, and discrimination within a United Kingdom sample of trans and non-binary people with a lifetime history of alcohol use. A cross-sectional survey was co-produced with community stakeholders and administered to a purposive sample of trans and non-binary people from 1 February until 31 March 2022. A total of 462 respondents were included-159 identified as non-binary and/or genderqueer (identities outside the man/woman binary), 135 solely as women, 63 solely as men, 15 as another gender identity, 90 selected multiple identities. Higher levels of reported discrimination were associated with higher risk of dependence and more reported harms from drinking. Coping motives, enhancement motives, and drinking to manage dysphoria were associated with higher Alcohol Use Disorders Identification Test scores. Social, coping, and enhancement motives alongside discrimination and drinking to have sex were associated with harms. The relationship between discrimination and risk of dependence was mediated by coping motives and drinking to manage dysphoria. Further to these associations, we suggest that reducing discrimination against trans and non-binary communities might reduce alcohol harms in this population. Interventions should target enhancement motives, coping motives and gender dysphoria. Social and enhancement functions of alcohol could be replaced by alcohol free supportive social spaces.
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Affiliation(s)
- Emma L Davies
- Centre for Psychological Research, Oxford Brookes University, Headington Campus, Oxford, OX3 0PB, United Kingdom
| | - Ivan Ezquerra-Romano
- Drugs and Me, 128 City Road, London, EC1V 2NX, United Kingdom
- Institute of Cognitive Neuroscience, University College London, Alexandra House, 17-19 Queen Square, London WC1N 3AZ, United Kingdom
| | - Beth Thayne
- ClimatePartner GmbH, 59 St. -Martin-Str., Munich, Bavaria, 81669, Germany
| | - Zhi Holloway
- Adero Ltd, 71-75 Shelton St, London WC2H 9JQ, United Kingdom
| | - Jacob Bayliss
- LGBT Switchboard, 113 Queens Rd, Brighton and Hove, Brighton BN1 3XG United Kingdom
| | - Stewart O'Callaghan
- OUTpatients (formerly Live Through This), LGBTIQ+ Cancer Charity, 92-94 Wallis Road London E9 5LN, United Kingdom
| | - Dean J Connolly
- Centre for Psychological Research, Oxford Brookes University, Headington Campus, Oxford, OX3 0PB, United Kingdom
- Mortimer Market Centre, Central and North West London NHS Foundation Trust, Capper St, London WC1E 6JB, United Kingdom
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Drabble LA, Munroe C, Cerezo A, Hughes TL. COVID-19 Concerns, Coping and Perceived Peer Norms: Correlates of Increased Alcohol and Marijuana Use Among Sexual Minority Women. JOURNAL OF HOMOSEXUALITY 2023:1-21. [PMID: 37976208 PMCID: PMC11098966 DOI: 10.1080/00918369.2023.2283835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
This study explored the impact of COVID-related concerns and other characteristics on alcohol and marijuana use among sexual minority women (SMW). Survey data from a racially/ethnically diverse sample of 338 SMW participants in the Chicago Health and Life Experiences of Women (CHLEW) study were used to examine correlates of three substance use outcomes: frequent intoxication (once a month or more), perceived increase in alcohol use, and perceived increase in marijuana use. Coping motives for alcohol use was positively associated with each of the substance use outcomes. Belief that peers (in terms of age, sexual identity, and gender) used alcohol often to cope was associated with higher odds of frequent intoxication. COVID-19 related financial concerns were positively associated with both frequent intoxication and increased marijuana use. Health and mental health concerns were associated with lower odds of frequent intoxication. Findings underscore the importance of enhancing coping skills, addressing perceived peer coping norms, and providing both economic and social support in intervention efforts.
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Affiliation(s)
- Laurie A Drabble
- College of Health and Human Sciences, San José State University, San José, California, USA
| | - Cat Munroe
- Public Health Institute, Alcohol Research Group, Alcohol Research Group, Emeryville, California, USA
| | - Alison Cerezo
- Dept. of Counseling, Clinical & School Psychology, University of California Santa Barbara, Santa Barbara, California, USA
| | - Tonda L Hughes
- Center for Sexual and Gender Minority Health Research, School of Nursing, Columbia University, New York, NY, USA
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Scheer JR, Behari K, Schwarz AA, Cascalheira CJ, Helminen EC, Pirog SA, Jaipuriyar V, Sullivan TP, Batchelder AW, Jackson SD. Expressive writing treatments to reduce PTSD symptom severity and negative alcohol-related outcomes among trauma-exposed sexual minority women and transgender/nonbinary people: Study protocol for a mixed-method pilot trial. Contemp Clin Trials Commun 2023; 35:101197. [PMID: 37671246 PMCID: PMC10475481 DOI: 10.1016/j.conctc.2023.101197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/21/2023] [Accepted: 08/18/2023] [Indexed: 09/07/2023] Open
Abstract
Background Sexual minority women (SMW) and transgender and/or nonbinary (TNB) individuals report an elevated prevalence of posttraumatic stress disorder (PTSD) symptoms and negative alcohol-related outcomes compared to heterosexual women and cisgender people. SMW and TNB individuals also face barriers to utilizing treatment, which can result in delayed or missed appointments. Accessible, feasible, and effective treatment approaches, such as web-based expressive writing (EW) treatments, are needed to address PTSD and negative alcohol-related outcomes in these populations. Method We describe the design of a mixed-method pilot randomized controlled trial which will compare an EW treatment adapted for SMW and TNB people (stigma-adapted EW) and trauma (i.e., non-adapted) EW with an active (neutral-event) control to determine acceptability and feasibility of a future fully powered randomized controlled trial. The sample will include 150 trauma-exposed SMW and TNB individuals from across the United States who will be randomly assigned to stigma-adapted EW (n = 50), trauma EW (n = 50), or control (n = 50). Participants will be assessed before treatment, one-week after the first writing session, and three-months after the first writing session. This paper identifies steps for evaluating the acceptability and feasibility of the proposed study and determining changes in outcomes resulting from adapted and non-adapted EW treatments to inform refinements. This paper also highlights our strategy for testing theory-driven mediators and moderators of treatment outcomes. Conclusions This mixed-method pilot trial will inform the first fully powered, self-administered, brief web-based treatment to reduce PTSD symptom severity and negative alcohol-related outcomes among trauma-exposed SMW and TNB individuals.
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Affiliation(s)
- Jillian R. Scheer
- Department of Psychology, Syracuse University, Syracuse, NY, 414 Huntington Hall, Syracuse, NY, 13244, USA
| | - Kriti Behari
- Department of Psychology, Syracuse University, Syracuse, NY, 414 Huntington Hall, Syracuse, NY, 13244, USA
| | - Aubriana A. Schwarz
- Department of Psychology, Syracuse University, Syracuse, NY, 414 Huntington Hall, Syracuse, NY, 13244, USA
| | - Cory J. Cascalheira
- Department of Counseling and Educational Psychology, New Mexico State University, Las Cruces, NM, 88003, USA
- VA Puget Sound Health Care System, Seattle, WA, 98108, USA
| | - Emily C. Helminen
- Department of Psychology, Syracuse University, Syracuse, NY, 414 Huntington Hall, Syracuse, NY, 13244, USA
| | - Sophia A. Pirog
- Department of Psychology, Syracuse University, Syracuse, NY, 414 Huntington Hall, Syracuse, NY, 13244, USA
| | - Virinca Jaipuriyar
- Department of Psychology, Syracuse University, Syracuse, NY, 414 Huntington Hall, Syracuse, NY, 13244, USA
| | - Tami P. Sullivan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06501, USA
| | - Abigail W. Batchelder
- Harvard Medical School, Harvard University, Boston, MA, 02114, USA
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA
- The Fenway Institute, Fenway Health, Boston, MA, 02115, USA
| | - Skyler D. Jackson
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, 06501, USA
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Lauckner C, Haney K, Sesenu F, Kershaw T. Interventions to Reduce Alcohol Use and HIV Risk among Sexual and Gender Minority Populations: a Systematic Review. Curr HIV/AIDS Rep 2023; 20:231-250. [PMID: 37225923 PMCID: PMC10436179 DOI: 10.1007/s11904-023-00660-2] [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] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE OF REVIEW Sexual and gender minority (SGM) individuals are diagnosed with HIV at disproportionate rates, and hazardous alcohol use can increase their HIV risk. This review assessed the state of the literature examining interventions for addressing alcohol use and sexual HIV risk behaviors among SGM individuals. RECENT FINDINGS Fourteen manuscripts from 2012 to 2022 tested interventions that address both alcohol use and HIV risk behaviors among SGM populations, with only 7 randomized controlled trials (RCTs). Virtually all the interventions targeted men who have sex with men, with none focused on transgender populations or cisgender women. While they demonstrated some evidence of effectiveness in reducing alcohol use and/or sexual risk, the outcomes varied widely between studies. More research is needed that tests interventions in this area, particularly for transgender individuals. The use of larger-scale RCTs with diverse populations and standardized outcome measures are needed to strengthen the evidence base.
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Affiliation(s)
- Carolyn Lauckner
- Center for Health Equity Transformation, University of Kentucky, 465 Healthy Kentucky Research Bldg, 760 Press Ave., Lexington, KY, 40536, USA.
| | - Kimberly Haney
- Center for Health Equity Transformation, University of Kentucky, 465 Healthy Kentucky Research Bldg, 760 Press Ave., Lexington, KY, 40536, USA
| | - Fidelis Sesenu
- Center for Health Equity Transformation, University of Kentucky, 465 Healthy Kentucky Research Bldg, 760 Press Ave., Lexington, KY, 40536, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Dimova DED, O'Brien DR, Elliott PL, Frankis DJ, Emslie PC. Exploring the experiences of alcohol service use among LGBTQ+ people in Scotland: A qualitative study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 109:103859. [PMID: 36166958 DOI: 10.1016/j.drugpo.2022.103859] [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] [Received: 06/14/2022] [Revised: 09/02/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND People who identify as LGBTQ+ are more likely to drink excessively compared to heterosexual and cisgender people. Perceived barriers to accessing alcohol services may further increase the potential for alcohol related harm for LGBTQ+ people. This qualitative study explores the experiences of LGBTQ+ people who have used alcohol services, including peer support groups, in Scotland and their suggestions for how alcohol services could be improved. METHODS Participants were recruited using social media adverts, dating websites, organisations that work with LGBTQ+ clients and snowball sampling. Participants' (n = 14) experiences of alcohol services and peer support groups were explored through semi-structured interviews. Data were analysed using the Framework Approach and thematic analysis. RESULTS Many participants thought their drinking was closely associated with their LGBTQ+ identity, as a response to shame, stigma, or family rejection. Some service users had positive experiences of alcohol services. However, participants were rarely asked about their sexuality / gender identity and some reported a lack of discussion about how identity might impact drinking. There were common views across the sample that barriers experienced by others in the LGBTQ+ community were amplified for trans people. Service users recommended that services need to signal LGBTQ+ inclusivity and provide a safe space to discuss multiple issues (e.g., alcohol use, mental health, gender identity). Participants highlighted the importance of alcohol-free spaces in the LGBTQ+ communities. CONCLUSION The study has clear practice and policy implications. Alcohol services should provide a safe space for LGBTQ+ people and clearly indicate that. Service providers should be trained to discuss potential connections between LGBTQ+ identity and substance use. At a broader level, alcohol-free social spaces would help reduce alcohol-related harm in LGBTQ+ communities.
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Boyle SC, LaBrie JW, Trager BM, Costine LD. A Gamified Personalized Normative Feedback App to Reduce Drinking Among Sexual Minority Women: A Randomized Controlled Trial and Feasibility Study (Preprint). J Med Internet Res 2021; 24:e34853. [PMID: 35559854 PMCID: PMC9143770 DOI: 10.2196/34853] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 01/04/2023] Open
Abstract
Background Sexual minority women disproportionately engage in heavy drinking and shoulder the burden of alcohol dependence. Although several intensive interventions are being developed to meet the needs of treatment-seeking sexual minority women, there remains a lack of preventive interventions to reduce drinking and its consequences among women not yet motivated to reduce their alcohol consumption. Objective We aimed to examine the feasibility and efficacy of reducing alcohol-related risks via personalized normative feedback (PNF) on alcohol use and coping delivered within LezParlay, a social media–inspired digital competition designed to challenge negative stereotypes about lesbian, bisexual, and queer (LBQ)–identified sexual minority women. Methods Feasibility was assessed by examining engagement with LezParlay outside the context of an incentivized research study, assessing the characteristics of the LBQ women taking part, and examining the competition’s ability to derive risk-reducing actual norms as well as levels of acceptability and perceived benefits reported by participants. Intervention efficacy was examined by randomizing a subsample of 499 LBQ alcohol consumers (ie, drinkers) already taking part in the competition to receive sexual identity–specific PNF on alcohol use and coping, alcohol use only, or control topics over only 2 rounds of play. Changes in alcohol use and negative consequences were examined 2 and 4 months after the delivery of treatment PNF. Results A total of 2667 diverse LBQ women played ≥1 round of LezParlay. The competition attracted large numbers of moderate and heavy drinkers; however, risk-reducing actual norms could still be derived from competition rounds and featured in PNF. Efficacy results revealed that drinkers who received PNF on alcohol use and both alcohol use and coping had similar reductions in their weekly drinks (P=.003; P<.001), peak drinks (P<.001; P<.001), and negative consequences (P<.001; P<.001) relative to those who received PNF on control topics at the 2-month follow-up. However, at the 4-month follow-up, reductions in alcohol consumption outcomes faded among those who received alcohol PNF only (weekly: P=.06; peak: P=.11), whereas they remained relatively robust among those who received PNF on both alcohol use and coping (weekly: P=.02; peak: P=.03). Finally, participants found the competition highly acceptable and psychologically beneficial as a whole. Conclusions The LezParlay competition was found to be a feasible and efficacious means of reducing alcohol-related risks in this population. Our findings demonstrate the utility of correcting sexual identity–specific drinking and coping norms to reduce alcohol-related risks among LBQ women and suggest that this approach may also prove fruitful in other stigmatized health disparity populations. To engage these populations in the real world and expand the psychological benefits associated with PNF, our findings also point to packaging PNF within a broader, culturally tailored competition designed to challenge negative group stereotypes. Trial Registration ClinicalTrials.gov NCT03884478; https://clinicaltrials.gov/ct2/show/NCT03884478 International Registered Report Identifier (IRRID) RR2-10.2196/24647
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Affiliation(s)
- Sarah C Boyle
- HeadsUp Labs, Department of Psychology, Loyola Marymount University, Los Angeles, CA, United States
| | - Joseph W LaBrie
- HeadsUp Labs, Department of Psychology, Loyola Marymount University, Los Angeles, CA, United States
| | - Bradley M Trager
- HeadsUp Labs, Department of Psychology, Loyola Marymount University, Los Angeles, CA, United States
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