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Wright LE, Savage B, Watts SJ. Sexuality Minority Status, Victimization, Mental Health, and Substance Use. Subst Use Misuse 2024:1-13. [PMID: 39177190 DOI: 10.1080/10826084.2024.2392522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
Background: Prior research suggests that sexual minority status is related to victimization, mental health issues, and substance use. However, few studies have sought to connect these relationships in a way supported by theory, and fewer have utilized probability and/or nationally representative samples. Objective: The current study seeks to test the relationships among these variables, guided by general strain theory (GST). Methods: One wave of the National Longitudinal Study of Adolescent to Adult Health dataset (Add Health) (N = 14,121) and path modeling in Mplus are utilized. Results: Models run separately by race/ethnicity suggest that the relationship among these variables largely support expectations from GST, but with some notable differences by race/ethnicity. Conclusion: Results suggest a relationship among these variables that concurs with criminological theorizing. Implications and limitations are discussed.
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Affiliation(s)
- Lauren E Wright
- Department of Sociology and Political Science, Tennessee Tech University, Cookeville, Tennessee, USA
| | - Brenda Savage
- School of History and Social Science, LA Tech University, Ruston, Louisiana, USA
| | - Stephen J Watts
- Department of Criminology and Criminal Justice, University of Memphis, Memphis, Tennessee, USA
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2
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Ward S, Autaubo J, Waters P, Garrett E, Batioja K, Anderson R, Furr-Holden D, Vassar M. A scoping review of health inequities in alcohol use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:27-41. [PMID: 38295346 DOI: 10.1080/00952990.2023.2296860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 12/10/2023] [Indexed: 02/02/2024]
Abstract
Background: Alcohol Use Disorder (AUD) poses a significant health burden on individuals. The burden occurs more frequently in the medically underserved, as well as racial and sexual minority populations. Ameliorating health inequities is vital to improving patient-centered care.Objectives: The objective of this scoping review is to chart the existing evidence on health inequities related to AUD and identify existing knowledge gaps to guide future equity-centered research.Methods: We performed a literature search using the Ovid (Embase) and MEDLINE (PubMed) databases for articles on AUD that were published in the 5-year period spanning from 2017 to 2021 and written in English. The frequencies of each health inequity examined were analyzed, and findings from each included study were summarized.Results: Our sample consisted of 55 studies for analysis. The most common inequity examined was by race/ethnicity followed by sex or gender. The least reported inequities examined were rural under-resourced areas and occupational status. Our findings indicate that significant research gaps exist in education, rural under-resourced populations, and LGBTQ+ communities with AUD.Conclusions: This scoping review highlights the gaps in research on inequities in AUD. To bridge the current gaps, we recommend research on the following: 1) triage screening tools and the use of telemedicine for rural, under-resourced populations; 2) interventions to increase treatment engagement and retention for women; and 3) community-based participatory methodologies for the LGBTQ+ communities.
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Affiliation(s)
- Shaelyn Ward
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Josh Autaubo
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Philo Waters
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Elizabeth Garrett
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Kelsi Batioja
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Reece Anderson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Debra Furr-Holden
- School of Global Public Health, New York University, New York, NY, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Alharbi OF, Alharbi AS, Alsubhi AA, Baalaraj FS, Alharbi AE, Basulayman SB, Fatani BZ, Babateen O, Tawakul A. Patterns and Sociodemographic Characteristics of Substance Abuse Among the Adult Population in Makkah City, Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e46573. [PMID: 37936995 PMCID: PMC10626198 DOI: 10.7759/cureus.46573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Substance abuse is a term that refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. One of the key impacts of illicit drug use on society is the negative health consequences experienced by its members. OBJECTIVE This study recorded the pattern of substance abuse and the sociodemographic characteristics of adult substance abusers in Makkah City. METHODS An online self-administered survey was provided to the general population through social media platforms between March 2023 and August 2023. Males and females living in Makkah over the age of 18 were included in it. The participants who refused to take part or those who were younger than 18 were not included in the study. RESULTS The number of participants in this study was 720; 73.5% were under the age of 30 and 424 were females (58.9%). The significant variables between substance abuse and sociodemographic data were gender (P=0.001), depression (P≤0.000), anxiety (P≤0.000), stress (P=0.025), and bad/shocking experience during childhood (P=0.004). CONCLUSION Substance abuse positively correlates with sociodemographic data, with males having a higher risk, and psychiatric neurosis is associated with childhood trauma and anxiety.
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Affiliation(s)
- Omar F Alharbi
- Department of Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Abdullah S Alharbi
- Department of Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Abdullah A Alsubhi
- Department of Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Fawaz S Baalaraj
- Department of Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Abdullah E Alharbi
- Department of Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Salem B Basulayman
- Department of Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Bayan Z Fatani
- Mental Health Department, Neuroscience Center, King Abdullah Medical City, Makkah, SAU
| | - Omar Babateen
- Department of Physiology, College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Abdullah Tawakul
- Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, SAU
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Felner JK, Haley SJ, Jun HJ, Wisdom JP, Katuska L, Corliss HL. Sexual orientation and gender identity disparities in co-occurring depressive symptoms and probable substance use disorders in a national cohort of young adults. Addict Behav 2021; 117:106817. [PMID: 33626483 PMCID: PMC8012013 DOI: 10.1016/j.addbeh.2021.106817] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/31/2020] [Accepted: 01/02/2021] [Indexed: 12/21/2022]
Abstract
This study examined sexual orientation and gender identity differences in co-occurring depressive symptoms and substance use disorders (SUDs) among young adults in the Growing Up Today Study national cohort (n = 12,347; ages 20-35; 93% non-Hispanic white). Self-administered questionnaires assessed recent co-occurring depressive symptoms and probable nicotine dependence, alcohol use disorder, and drug use disorder. Multinomial logistic regressions with generalized estimating equations quantified differences in prevalences of depressive symptoms only, SUDs only, and co-occurrence, among sexual minorities (mostly heterosexual; lesbian, gay, and bisexual [LGB]) compared to completely heterosexual participants, and gender minorities compared to cisgender participants. Analyses stratified by sex assigned at birth revealed sexual minorities evidenced greater odds of co-occurrence than their completely heterosexual counterparts (assigned female AORs: 3.11-9.80, ps < 0.0001; assigned male AORs: 2.90-4.87, ps < 0.001). Sexual orientation differences in co-occurrence were pronounced among LGB participants assigned female at birth who evidenced nearly 10 times the odds of co-occurring depressive symptoms with nicotine dependence and drug use disorders than did heterosexual participants assigned female at birth. Relationships between gender identity and co-occurrence were generally weaker, possibly due to low power. Gender minorities assigned male at birth, however, evidenced greater odds of co-occurring depressive symptoms and alcohol use disorders (AOR 2.75, p = 0.013) than their cisgender counterparts. This study adds to the limited research quantifying sexual orientation or gender identity differences in recent co-occurring depressive symptoms and SUDs among young adults and suggests sexual and gender minority young adults should be prioritized in prevention and treatment of co-occurring depression and SUDs.
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Affiliation(s)
- Jennifer K Felner
- San Diego State University, School of Public Health, Institute for Behavioral and Community Health, Center for Research on Sexuality and Sexual Health, 9245 Sky Park Court, Suite 224, San Diego, CA 92123, United States.
| | - Sean J Haley
- Department of Health Policy and Management, City University of New York's Graduate School of Public Health and Health Policy, 55 West 125(th) St, NY, NY 10027, United States
| | - Hee-Jin Jun
- San Diego State University, School of Public Health, Institute for Behavioral and Community Health, Center for Research on Sexuality and Sexual Health, 9245 Sky Park Court, Suite 224, San Diego, CA 92123, United States
| | | | - Laura Katuska
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States
| | - Heather L Corliss
- San Diego State University, School of Public Health, Institute for Behavioral and Community Health, Center for Research on Sexuality and Sexual Health, 9245 Sky Park Court, Suite 224, San Diego, CA 92123, United States
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Liautaud MM, Barrington-Trimis JL, Liu F, Stokes A, Krueger EA, McConnell R, Pang RD. E-cigarette, cigarette, and cannabis use patterns as a function of sexual identity in a sample of Southern California young adults. Addict Behav Rep 2021; 13:100338. [PMID: 33644294 PMCID: PMC7889792 DOI: 10.1016/j.abrep.2021.100338] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 01/02/2023] Open
Abstract
PURPOSE Sexual minority young adults report greater cigarette and cannabis use. Emerging evidence suggests this trend may extend to e-cigarettes. The current study evaluated the relationship between sexual identity and prevalence of e-cigarette, cigarette, and cannabis use and whether such associations differ by gender. METHODS Cross-sectional, regionally representative data of young adults (M[SD]age = 20.02 [0.60] years; n heterosexual = 1314; n bisexual = 77; n lesbian/gay = 28) from Wave III (2016) of the Southern California Children's Health Study were analyzed in 2019. Logistic regression analyses were conducted with sexual identity as the predictor and product use (never, prior, infrequent past 30-day [1-2 days], frequent past 30-day [3-5+ days]) as the outcome in separate models by substance (e-cigarettes, cigarettes, cannabis). RESULTS Bisexual individuals were the highest-risk sub-group for nearly all outcomes, with over five times the odds of reporting frequent past 30-day use for e-cigarettes (Odds Ratio [OR]: 6.68; 95% Confidence Interval [CI]: 2.80, 15.9), cigarettes (OR: 5.42; 95% CI: 2.37, 12.4), and cannabis (OR: 8.43; 95% CI: 4.40, 16.1) compared to heterosexual individuals. Although the sample size for lesbian/gay participants was small, bisexual (vs. lesbian/gay) participants also had greater odds of reporting prior use of nicotine products and frequent past 30-day cannabis use. A significant sexual identity × gender interaction emerged for lifetime cigarette use, wherein bisexual (vs. heterosexual) identity was only associated with greater odds of use for females (p < .01). CONCLUSIONS Sexual minority-related disparities in substance use among young adults appear to generalize to e-cigarettes, with bisexual young adults exhibiting especially high profiles of risk.
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Affiliation(s)
- Madalyn M. Liautaud
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center of the City University of New York, 365 5th Ave, New York, NY 10016, USA
| | - Jessica L. Barrington-Trimis
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Feifei Liu
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Andrew Stokes
- Department of Global Health, Boston University, 801 Massachusetts Ave Crosstown Center, Boston, MA 02118, USA
| | - Evan A. Krueger
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Rob McConnell
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Raina D. Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, 2001 N. Soto Street, Los Angeles, CA 90032, USA
- Department of Psychology, University of Southern California, 3620 South McClintock Ave, Los Angeles, CA 90089, USA
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Silva JF, Costa GMC. Health care of sexual and gender minorities: an integrative literature review. Rev Bras Enferm 2020; 73:e20190192. [PMID: 33146303 DOI: 10.1590/0034-7167-2019-0192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/10/2020] [Indexed: 02/19/2023] Open
Abstract
OBJECTIVES to describe health care practices aimed at lesbians, gays, bisexuals, transvestites, and transsexuals. METHODS an integrative literature review based on systematic steps, in MEDLINE, LILACS AND SciELO databases and/or electronic libraries. It was held from September to November 2018, with articles published between 2012 and 2017, available in full in Portuguese, English, and Spanish, addressing health care to that population group. RESULTS fourteen articles were included. Most of the articles were about the trajectory of individuals within health services and showed limitations and obstacles in the use of these services. FINAL CONSIDERATIONS there is evidence that factors related to organization of services, attitude of professionals, stigma, and discrimination experienced undermine health care practices. Therefore, it is essential to carry out educational activities in health services and educational institutions.
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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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Felner JK, Wisdom JP, Williams T, Katuska L, Haley SJ, Jun HJ, Corliss HL. Stress, Coping, and Context: Examining Substance Use Among LGBTQ Young Adults With Probable Substance Use Disorders. Psychiatr Serv 2020; 71:112-120. [PMID: 31640522 PMCID: PMC7002176 DOI: 10.1176/appi.ps.201900029] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The authors qualitatively examined how lesbian, gay, bisexual, transgender, and queer (LGBTQ) young adults with probable substance use disorders conceptualized their substance use vis-à-vis their LGBTQ identities. METHODS Individual, in-depth, semistructured interviews were conducted with 59 LGBTQ young adults (ages 21-34) who were participants in a larger longitudinal cohort study and who met criteria for a probable substance use disorder. Data were analyzed via iterative, thematic analytic processes. RESULTS Participants' narratives highlighted processes related to minority stress that shape substance use, including proximal LGBTQ stressors (e.g., self-stigma and expectations of rejection) and distal LGBTQ stressors (e.g., interpersonal and structural discrimination) and associated coping. Participants also described sociocultural influences, including the ubiquitous availability of substances within LGBTQ social settings, as salient contributors to their substance use and development of substance use disorders. Participants who considered themselves transgender or other gender minorities, all of whom identified as sexual minorities, described unique stressors and coping at the intersection of their minority identities (e.g., coping with two identity development and disclosure periods), which shaped their substance use over time. CONCLUSIONS Multilevel minority stressors and associated coping via substance use in adolescence and young adulthood, coupled with LGBTQ-specific sociocultural influences, contribute to the development of substance use disorders among some LGBTQ young adults. Treatment providers should address clients' substance use vis-à-vis their LGBTQ identities and experiences with related stressors and sociocultural contexts and adopt culturally humble and LGBTQ-affirming treatment approaches. Efforts to support LGBTQ youths and young adults should focus on identifying ways of socializing outside of substance-saturated environments.
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Affiliation(s)
- Jennifer K Felner
- School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska)
| | - Jennifer P Wisdom
- School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska)
| | - Tenneill Williams
- School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska)
| | - Laura Katuska
- School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska)
| | - Sean J Haley
- School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska)
| | - Hee-Jin Jun
- School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska)
| | - Heather L Corliss
- School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego (Felner, Jun, Corliss); Wisdom Consulting, New York (Wisdom); Department of Epidemiology and Biostatistics (Williams) and Department of Health Policy and Management (Haley), Graduate School of Public Health and Health Policy, City University of New York, New York; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston (Katuska)
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Jun HJ, Webb-Morgan M, Felner JK, Wisdom JP, Haley SJ, Austin SB, Katuska LM, Corliss HL. Sexual orientation and gender identity disparities in substance use disorders during young adulthood in a United States longitudinal cohort. Drug Alcohol Depend 2019; 205:107619. [PMID: 31678835 PMCID: PMC7437659 DOI: 10.1016/j.drugalcdep.2019.107619] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/29/2019] [Accepted: 09/04/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND This study examined associations of sexual orientation and gender identity with prevalence of substance use disorders (SUDs) and co-occurring multiple SUDs in the past 12-months during young adulthood in a United States longitudinal cohort. METHODS Questionnaires self-administered in 2010 and 2015 assessed probable past 12-month nicotine dependence, alcohol abuse and dependence, and drug abuse and dependence among 12,428 participants of an ongoing cohort study when they were ages 20-35 years. Binary or multinomial logistic regressions using generalized estimating equations were used to estimate differences by sexual orientation and gender identity in the odds of SUDs and multiple SUDs, stratified by sex assigned at birth. RESULTS Compared with completely heterosexuals (CH), sexual minority (SM; i.e., mostly heterosexual, bisexual, lesbian/gay) participants were generally more likely to have a SUD, including multiple SUDs. Among participants assigned female at birth, adjusted odds ratios (AORs) for SUDs comparing SMs to CHs ranged from 1.61 to 6.97 (ps<.05); among participants assigned male at birth, AORs ranged from 1.30 to 3.08, and were statistically significant for 62% of the estimates. Apart from elevated alcohol dependence among gender minority participants assigned male at birth compared with cisgender males (AOR: 2.30; p < .05), gender identity was not associated with prevalence of SUDs. CONCLUSIONS Sexual and gender minority (SGM) young adults disproportionately evidence SUDs, as well as co-occurring multiple SUDs. Findings related to gender identity and bisexuals assigned male at birth should be interpreted with caution due to small sample sizes. SUD prevention and treatment efforts should focus on SGM young adults.
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Affiliation(s)
- Hee-Jin Jun
- School of Public Health, San Diego State University, San Diego, CA, USA,Institute for Behavioral and Community Health, San Diego State University, San Diego, CA
| | - Megan Webb-Morgan
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Jennifer K. Felner
- School of Public Health, San Diego State University, San Diego, CA, USA,Institute for Behavioral and Community Health, San Diego State University, San Diego, CA
| | | | - Sean J. Haley
- Department of Health Policy and Management, School of Public Health, City University of New York, New York, NY, USA
| | - S. Bryn Austin
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Laura M. Katuska
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Heather L. Corliss
- School of Public Health, San Diego State University, San Diego, CA, USA,Institute for Behavioral and Community Health, San Diego State University, San Diego, CA,Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
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10
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Coulter RWS, Jun HJ, Truong N, Mair C, Markovic N, Friedman MR, Silvestre AJ, Stall R, Corliss HL. Effects of familial and non-familial warmth during childhood and adolescence on sexual-orientation disparities in alcohol use trajectories and disorder during emerging adulthood. Drug Alcohol Depend 2019; 205:107643. [PMID: 31689643 PMCID: PMC6952075 DOI: 10.1016/j.drugalcdep.2019.107643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND We investigated sexual-orientation differences in typologies of self-reported familial and non-familial warmth in childhood (before age 11) and adolescence (ages 11-17); and tested whether warmth explained sexual minority emerging adults' (ages 18-25) heightened odds of having heavier alcohol use trajectories (AUTs) and heightened risk for past-year alcohol use disorder (AUD) compared to completely heterosexuals. METHODS Using self-reported data from the U.S.-based Growing Up Today Study cohort, latent class analyses identified typologies of familial and non-familial warmth during childhood and adolescence. Multivariable regression models tested our objectives. RESULTS Six warmth classes emerged, including: High-High (i.e., high familial and high non-familial warmth, respectively); High-Moderate; Moderate-Moderate; Moderate-Occasional; Occasional-Occasional; and Low-Low. Among women, sexual minorities had higher odds than completely heterosexuals of being in the Moderate-Moderate, Moderate-Occasional, and Occasional-Occasional versus the High-High warmth class. There were not significant associations between sexual orientation and warmth classes for men. Lower warmth classes were generally associated with greater past-year AUD, and mediated heightened disparities in AUD for sexual minority women versus completely heterosexual women (4.3% mediated), but not among men. Warmth classes were generally unassociated with AUTs, and did not mediate sexual-orientation differences in AUTs. CONCLUSIONS Lower warmth was associated with greater alcohol-related problems, but not alcohol use itself. Warmth explained a small proportion of AUD disparities for sexual minority women-but not for men.
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Affiliation(s)
- Robert W S Coulter
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA; Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261 USA; Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, 3414 Fifth Ave, Pittsburgh, PA, 15213 USA; Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15261 USA.
| | - Hee-Jin Jun
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 100, San Diego, CA, 92123 USA
| | - Nhan Truong
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 100, San Diego, CA, 92123 USA
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Nina Markovic
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261 USA; Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh, 3501 Terrace Street, Pittsburgh, PA, 15261 USA
| | - M Reuel Friedman
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261 USA; Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 3520 Fifth Avenue, Pittsburgh, PA, 15261 USA
| | - Anthony J Silvestre
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261 USA; Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 3520 Fifth Avenue, Pittsburgh, PA, 15261 USA
| | - Ron Stall
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA; Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261 USA
| | - Heather L Corliss
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 100, San Diego, CA, 92123 USA; Channing Division of Network Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA
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11
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Jacka B, Roy É, Høj S, Minoyan N, Artenie AA, Zang G, Jutras-Aswad D, Bruneau J. Sexual behaviour as a risk factor for hepatitis C virus infection among people who inject drugs in Montreal, Canada. J Viral Hepat 2019; 26:1413-1422. [PMID: 31433888 DOI: 10.1111/jvh.13194] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 01/24/2023]
Abstract
Hepatitis C virus (HCV) acquisition remains high in key risk environments including injection drug use and sex between men. However, few studies examine the independent contribution of sexual behaviour to HCV acquisition among people who inject drugs (PWID). We estimated HCV incidence and examined sexual behaviour as a time-varying predictor of HCV acquisition in a prospective cohort study of PWID in Montreal (2004-2017). Initially, HCV-negative participants completed behavioural questionnaires and HCV antibody testing (6 months until 2011, 3 months thereafter). A time-updating exposure variable (no sex, opposite-sex partner only, ≥1 same-sex partner) was generated for the previous 6/3 months. Time to HCV seroconversion was examined using Cox regression analysis, adjusted for age, unstable housing and incarceration (both past 3 months), and daily, heroin, cocaine and prescription opioid injecting (all past month). Among 440 PWID (baseline: median age 33 years, 18.9% female, 1.4% HIV-positive), 156 participants seroconverted during follow-up (overall incidence rate: 11.9/100 person-years [PY]). Incidence was lowest in the no sex group (8.70 and 2.91 cases/100 PY in males and females, respectively) and highest in the ≥1 same-sex partner group (24.14 and 21.97 cases/100 PY in males and females, respectively). Among males, HCV risk was 47% lower in those reporting no sex compared to ≥1 same-sex partner (adjusted hazard ratio: 0.53, 95% confidence interval: 0.28, 0.99). In this cohort of PWID, reporting recent same-sex partners was associated with greater risk of HCV acquisition among males, necessitating targeted harm reduction strategies that consider the complex interplay of sexual and injecting risk behaviours.
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Affiliation(s)
- Brendan Jacka
- Research Centre, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Élise Roy
- Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada.,Direction des Risques Biologiques et de la Santé au Travail, Institut National de Santé Publique du Québec, Montréal, QC, Canada
| | - Stine Høj
- Research Centre, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Nanor Minoyan
- Research Centre, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, QC, Canada
| | - Andreea Adelina Artenie
- Research Centre, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, QC, Canada
| | - Geng Zang
- Research Centre, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Didier Jutras-Aswad
- Research Centre, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.,Department of Psychiatry and Addiction, Université de Montréal, Montréal, QC, Canada
| | - Julie Bruneau
- Research Centre, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.,Department of Family and Emergency Medicine, Université de Montréal, Montréal, QC, Canada
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12
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Fish JN, Turner B, Phillips G, Russell ST. Cigarette Smoking Disparities Between Sexual Minority and Heterosexual Youth. Pediatrics 2019; 143:peds.2018-1671. [PMID: 30862728 PMCID: PMC6565340 DOI: 10.1542/peds.2018-1671] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Using a population-based sample of youth, we examined rates of cigarette use and trends in cigarette use disparities between heterosexual youth and 3 subgroups of sexual minority youth (SMY) (ie, lesbian or gay, bisexual, and unsure) from 2005 to 2015. METHODS Data are from 6 cohorts of the Youth Risk Behavior Survey, a national, biennial, school-based survey of ninth- to 12th-grade students in the United States (n = 404 583). Sex-stratified analyses conducted in 2017 examined trends in 2 cigarette-related behaviors: lifetime cigarette use and heavy cigarette use (20+ days in the past 30). RESULTS Disparities in lifetime cigarette use between lesbian and heterosexual girls were statistically smaller in 2015 relative to 2005 (adjusted odds ratio [aOR] 0.29; 95% confidence interval [CI] 0.12-0.75; P = .011). Sexual orientation disparities in heavy use were narrower for bisexual boys in 2015 compared with 2005 (aOR 0.39; 95% CI 0.17-0.90; P = .028). Girls and boys unsure of their sexual identity had wider disparities in heavy use in 2015 (aOR 3.85; 95% CI 1.39-11.10; P = .009) relative to 2005 (aOR 2.44; 95% CI 1.22-5.00; P = .012). CONCLUSIONS SMY remain at greater risk for cigarette-related behaviors despite greater acceptance of lesbian, gay, and bisexual people in the United States. Focused policies and programs aimed at reducing rates of SMY cigarette use are warranted, particularly for youth questioning their sexual identity.
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Affiliation(s)
- Jessica N. Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland;,The Population Research Center, The University of Texas at Austin, Austin, Texas
| | - Blair Turner
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and
| | - Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and
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13
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Coulter RWS, Ware D, Fish JN, Plankey MW. Latent Classes of Polysubstance Use Among Adolescents in the United States: Intersections of Sexual Identity with Sex, Age, and Race/Ethnicity. LGBT Health 2019; 6:116-125. [PMID: 30822259 DOI: 10.1089/lgbt.2018.0149] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE We aimed to estimate latent classes of concurrent polysubstance use and test for sexual orientation differences in latent class memberships with representative data from adolescents living in 19 U.S. states. We also tested whether sex, race/ethnicity, and age moderated the sexual identity differences in polysubstance use class memberships. METHODS We analyzed data from 119,437 adolescents from 19 states who participated in the 2015 Youth Risk Behavior Survey. Latent class analysis characterized polysubstance use patterns based on self-reported frequency of lifetime and past-month use of alcohol (including heavy episodic drinking), tobacco (cigarettes, cigars, and smokeless tobacco), and marijuana. Multinomial logistic regression models tested differences in latent class memberships by sexual identity. Interaction terms tested whether sex, race/ethnicity, and age moderated the sexual identity differences in polysubstance use class memberships. RESULTS A six-class model of polysubstance use fit the data best and included nonusers (61.5%), experimental users (12.2%), marijuana-alcohol users (14.8%), tobacco-alcohol users (3.8%), medium-frequency three-substance users (3.6%), and high-frequency three-substance users (4.1%). Gay/lesbian- and bisexual-identified adolescents had significantly higher odds than heterosexual-identified adolescents of being in all of the user classes compared with the nonuser class. These sexual identity differences in latent polysubstance use class memberships were generally larger for females than for males, varied occasionally by race/ethnicity, and were sometimes larger for younger ages. CONCLUSION Compared with their heterosexual peers, gay/lesbian and bisexual adolescents-especially females-are at heightened risk of engaging in multiple types of polysubstance use. Designing, implementing, and evaluating interventions will likely reduce these sexual orientation disparities.
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Affiliation(s)
- Robert W S Coulter
- 1 Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,2 Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,3 Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,4 Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Deanna Ware
- 5 Department of Medicine, Georgetown University Medical Center, Washington, District of Columbia
| | - Jessica N Fish
- 6 Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland
| | - Michael W Plankey
- 5 Department of Medicine, Georgetown University Medical Center, Washington, District of Columbia
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14
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Kelley ML, Ehlke SJ, Braitman AL, Stamates AL. Testing a Model of Binegativity, Drinking-to-Cope Motives, Alcohol Use, and Sexual Coercion Among Self-Identified Bisexual Women. JOURNAL OF BISEXUALITY 2019; 18:478-496. [PMID: 31565036 PMCID: PMC6764414 DOI: 10.1080/15299716.2018.1481482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In the present study, we tested a sequential mediation model whereby binegativity was associated with sexual coercion through drinking to cope motives and alcohol use. Data were examined from 224 self-identified bisexual women (M age = 22.79; SD = 3.44) who took part in an online survey. Participants reported binegativity, alcohol use, drinking to cope motivations, and sexual coercion experiences for the previous 30 days. A total of 48.0% of the sample (n = 108) experienced sexual coercion in the past 30 days. Sequential mediation indicated more experiences of binegativity were associated with greater drinking to cope motives, which in turn, related to greater alcohol frequency and greater likelihood of sexual coercion. Alcohol quantity was not a significant mediator. Results suggest the importance of studying the impact of binegativity on bisexual women, as well as developing prevention programs that consider how this form of discrimination may contribute to drinking to cope motives, more frequent alcohol use, and increased risk for sexual coercion.
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Affiliation(s)
- Michelle L Kelley
- 5115 Hampton Blvd -MGB Rm 250, Department of Psychology, Old Dominion University, Virginia Consortium Program in Clinical Psychology, Norfolk, VA 23529-0267, 757-683-4459,
| | - Sarah J Ehlke
- 5115 Hampton Blvd -MGB Rm 132A, Department of Psychology, Old Dominion University, Norfolk, VA 23529-0267, 757-683-6602,
| | - Abby L Braitman
- 5115 Hampton Blvd -MGB Rm 132E, Department of Psychology, Old Dominion University, Virginia Consortium Program in Clinical Psychology, Norfolk, VA 23529-0267, 757-683-3708,
| | - Amy L Stamates
- 5115 Hampton Blvd -MGB Rm 245D, Department of Psychology, Old Dominion University, Norfolk, VA 23529-0267, 757-683-4439,
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15
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Fish JN, Watson RJ, Gahagan J, Porta CM, Beaulieu-Prévost D, Russell ST. Smoking behaviours among heterosexual and sexual minority youth? Findings from 15 years of provincially representative data. Drug Alcohol Rev 2019; 38:101-110. [PMID: 30478862 PMCID: PMC6338485 DOI: 10.1111/dar.12880] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 10/25/2018] [Accepted: 10/28/2018] [Indexed: 12/26/2022]
Abstract
INTRODUCTION AND AIMS Sexual identity disparities in smoking behaviours are well established; however, there is limited research on whether these disparities have diminished as the social and political landscape has changed for lesbian, gay and bisexual people. Thus, we examined changes in prevalence and sexual identity disparities in three smoking behaviours among Canadian adolescents from 1998 to 2013. DESIGN AND METHODS Data are from the provincially representative British Columbia Adolescent Health Survey (N = 99 373). Using sex-stratified, age-adjusted logistic regression models, we estimated: (i) trends in lifetime cigarette use, early onset, and past 30-day use for heterosexual and three subgroups of sexual minority (i.e. mostly heterosexual, bisexual and gay/lesbian) youth; (ii) sexual identity disparities in these cigarette-related behaviours within each survey year (1998, 2003, 2008, 2013); and (iii) whether the size of the disparity has changed from 1998 to 2013. RESULTS Smoking has declined for all youth from 1998 to 2013, although less consistently for sexual minority youth. Within-year disparity estimates indicated elevated prevalence of cigarette use for sexual minority compared to heterosexual youth, particularly among females. Trends in sexual identity and smoking behaviours indicated that the degree of differences between heterosexual and sexual minority youth have remained stable or, in some cases, widened. Heterosexual and sexual minority youth differences widened for early onset among sexual minority boys and lifetime and past 30-day use for sexual minority girls. DISCUSSION AND CONCLUSIONS Efforts to prevent smoking behaviours among youth should continue. Tailored preventive strategies for sexual minority youth might help address existing disparities.
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Affiliation(s)
- Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, USA
| | - Ryan J Watson
- Department of Human Development and Family Studies, University of Connecticut, Storrs, USA
| | - Jacqueline Gahagan
- Health Promotion Division, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Carolyn M Porta
- School of Nursing, University of Minnesota, Minneapolis, USA
| | | | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, USA
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16
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Kelley ML, Ehlke SJ, Lewis RJ, Braitman AL, Bostwick W, Heron KE, Lau-Barraco C. Sexual Coercion, Drinking to Cope Motives, and Alcohol-Related Consequences among Self-Identified Bisexual Women. Subst Use Misuse 2018; 53:1146-1157. [PMID: 29278972 PMCID: PMC5935574 DOI: 10.1080/10826084.2017.1400565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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
BACKGROUND Given higher sexual victimization and greater alcohol use among bisexual women, a critical public health challenge is to understand within-group variation that may heighten or explain these associations in bisexual women. OBJECTIVES The present study tested a moderated-mediation model in which sexual coercion was hypothesized to be associated with alcohol-related consequences via drinking to cope motives in self-identified bisexual women who reported at least occasional binge drinking. Negative affect was hypothesized to moderate the sexual coercion-drinking to cope motives association. METHODS Participants were a community sample of 107 self-identified bisexual women (age M = 20.97, SD = 2.11) who completed an online survey and reported at least one binge drinking episode as well as engaging in sexual activity in the past 30 days. RESULTS Of these participants, 57 (53.3%) reported one or more experiences of sexual coercion in the past 30 days. Sexual coercion was associated with negative alcohol-related consequences via drinking to cope motives. Negative affect moderated the association between sexual coercion and drinking to cope motives such that the association was stronger among women with greater negative affect. Conclusions/Importance: Methods of addressing vulnerability to sexual coercion and educating young bisexual women about the association between sexual coercion and potentially problematic affective coping through alcohol use are needed.
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Affiliation(s)
- Michelle L. Kelley
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Sarah J. Ehlke
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Robin J. Lewis
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Abby L. Braitman
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Wendy Bostwick
- Health Systems Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kristin E. Heron
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Cathy Lau-Barraco
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
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17
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Coulter RWS, Jun HJ, Calzo JP, Truong NL, Mair C, Markovic N, Charlton BM, Silvestre AJ, Stall R, Corliss HL. Sexual-orientation differences in alcohol use trajectories and disorders in emerging adulthood: results from a longitudinal cohort study in the United States. Addiction 2018; 113:10.1111/add.14251. [PMID: 29679419 PMCID: PMC6667315 DOI: 10.1111/add.14251] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 10/26/2017] [Accepted: 04/06/2018] [Indexed: 01/12/2023]
Abstract
AIMS We estimated sexual-orientation differences in alcohol use trajectories during emerging adulthood, and tested whether alcohol use trajectories mediated sexual-orientation differences in alcohol use disorders (AUDs). DESIGN Longitudinal self-reported survey data from the Growing Up Today Study. SETTING United States. PARTICIPANTS A total of 12 493 participants aged 18-25 during the 2003, 2005, 2007 or 2010 surveys. MEASUREMENTS Stratified by gender, longitudinal latent class analyses estimated alcohol use trajectories (using past-year frequency, quantity and binge drinking from 2003 to 2010). Multinomial logistic regression tested differences in trajectory class memberships by sexual orientation [comparing completely heterosexual (CH) participants with sexual-minority subgroups: mainly heterosexual (MH), bisexual (BI) and gay/lesbian (GL) participants]. Modified Poisson regression and mediation analyses tested whether trajectories explained sexual-orientation differences in AUDs (past-year DSM-IV abuse/dependence in 2010). FINDINGS Six alcohol use trajectory classes emerged for women and five for men: these included heavy (23.5/36.9% of women/men), moderate (31.8/26.4% of women/men), escalation to moderately heavy (9.7/12.0% of women/men), light (17.0% for women only), legal (drinking onset at age 21; 11.1/15.7% of women/men) and non-drinkers (7.0/9.1% of women/men). Compared with CH women, MH and BI women had higher odds of being heavy, moderate, escalation to moderately heavy and light drinkers versus non-drinkers (odds ratios = 2.02-3.42; P-values < 0.01-0.04). Compared with CH men, MH men had higher odds of being heavy, moderate and legal drinkers versus non-drinkers (odds ratios = 2.24-3.34; P-values < 0.01-0.01). MH men and women, BI women and GLs had higher risk of AUDs in 2010 than their same-gender CH counterparts (risk ratios = 1.34-2.17; P-values < 0.01). Alcohol use trajectories mediated sexual-orientation differences in AUDs for MH and GL women (proportion of effect mediated = 30.8-31.1%; P-values < 0.01-0.02), but not for men. CONCLUSIONS In the United States, throughout emerging adulthood, several sexual-minority subgroups appear to have higher odds of belonging to heavier alcohol use trajectories than completely heterosexuals. These differences partially explained the higher risk of alcohol use disorders among mainly heterosexual and gay/lesbian women but not among sexual-minority men.
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Affiliation(s)
- Robert W. S. Coulter
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Division of Adolescent and Young Adult Medicine, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hee-Jin Jun
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Jerel P. Calzo
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Nhan L. Truong
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nina Markovic
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brittany M. Charlton
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Anthony J. Silvestre
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ron Stall
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Heather L. Corliss
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA, USA
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18
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Li P, Huang Y, Guo L, Wang W, Xi C, Lei Y, Luo M, Pan S, Deng X, Zhang WH, Lu C. Sexual attraction and the nonmedical use of opioids and sedative drugs among Chinese adolescents. Drug Alcohol Depend 2018; 183:169-175. [PMID: 29268185 DOI: 10.1016/j.drugalcdep.2017.10.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/13/2017] [Accepted: 10/22/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The nonmedical use of prescription drugs (NMUPD) is attracting public attention. We aimed to explore the association between sexual attraction and NMUPD among Chinese adolescents. METHOD A school-based survey was conducted in seven Chinese provinces, and a multi-stage stratified cluster sampling method was used in this study. A total of 150,822 students from seven Chinese provinces completed the questionnaire; the response rate was 95.93%. All data were collected between November 2014 and January 2015. RESULTS Overall, 8.8%, 4.4%, and 2.2% of the students reported lifetime, past-year, and past-month NMUPD, respectively. Compared with heterosexual students (8.2%), sexual minority and unsure students were more likely to report lifetime NMUPD (14.4% and 10.0%, respectively; χ2 = 244.34, P < 0.001). In addition, sexual minority and unsure students were more likely to admit past-year and past-month use of NMUPD. After adjusting for social demographics and lifestyle covariates, sexual minority and unsure students were at an increased risk of lifetime NMUPD (adjusted odds ratio [AOR] = 1.68, 95% confidence interval [CI] = 1.54-1.83 and AOR = 1.33, 95% CI = 1.26-1.41, respectively). CONCLUSIONS Our study suggested that sexual minority and unsure adolescents have a higher risk of NMUPD. Moreover, our study suggested that sexual minority and unsure students are more likely to both try and continue to use prescription drugs. Further studies focusing on the mechanism of substance abuse and appropriate interventions among sexual minority and unsure adolescents are warranted.
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Affiliation(s)
- Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yeen Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chuhao Xi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yiling Lei
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Min Luo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Siyuan Pan
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China
| | - Wei-Hong Zhang
- Epidemiology, Biostatistics and Clinical Research Center, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China.
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19
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Fish JN, Watson RJ, Porta CM, Russell ST, Saewyc EM. Are alcohol-related disparities between sexual minority and heterosexual youth decreasing? Addiction 2017; 112:1931-1941. [PMID: 28678415 PMCID: PMC5633511 DOI: 10.1111/add.13896] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/26/2017] [Accepted: 05/26/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND AIMS Although sexual orientation-related alcohol use disparities are well established, researchers have not identified whether disparities are diminishing as societal attitudes towards lesbian/gay and bisexual (LGB) people become more accepting. We examined changes in four alcohol-related disparities between heterosexual and LGB youth from 1998 to 2013 by (1) estimating the prevalence of these behaviors; (2) estimating disparities in alcohol-related outcomes between heterosexual and LGB youth within each wave year; and (3) testing whether the degree of difference in alcohol-related disparities between heterosexual and LGB youth has changed. DESIGN Logistic regression models and year × sexual orientation interactions with repeated, cross-sectional, provincially representative data. SETTING British Columbia, Canada. PARTICIPANTS Students (ages 12-19) from the 1998 (n = 22 858), 2003 (n = 29 323), 2008 (n = 25 254) and 2013 (n = 21 938) British Columbia Adolescent Health Survey (total n = 99 373, 48.7% male, mean age = 14.84). MEASUREMENTS We modeled age-adjusted differences in life-time alcohol use, age of onset, past 30-day drinking and past 30-day heavy episodic drinking between heterosexual and three subgroups of sexual minority youth (i.e. mostly heterosexual, bisexual and lesbian/gay). FINDINGS Generally, alcohol use declined for all youth, although less so among LGB youth [average adjusted odds ratio (aOR) = 0.58 and aOR = 0.53 for heterosexual males and females and aOR = 0.71 and aOR = 0.57 for sexual minority males and females, respectively). Within-year comparisons demonstrated elevated rates of alcohol use among LGB compared with heterosexual youth for each of the four survey years, especially among females. Findings indicate few changes over time; however, results show an increase in risky alcohol use from 1998 to 2013 among mostly heterosexual (aOR = 1.58 for life-time alcohol use, aOR = 1.58 for 30-day alcohol use and aOR = 1.34 for 30-day heavy episodic drinking), and bisexual (aOR = 1.95 for life-time alcohol use) females. CONCLUSION Despite the general decline in the prevalence of alcohol use among young people in Canada since 1998, lesbian/gay and bisexual youth in Canada continue to show elevated rates of alcohol use compared with heterosexual youth.
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Affiliation(s)
- Jessica N. Fish
- Corresponding Author, Population Research Center, University of
Texas at Austin, 305 E. 23 St., Stop G1800, Austin, TX 78712,
, PH: 512-471-4270, F:
512-471-4886
| | - Ryan J. Watson
- Department of Human Development and Family Studies, University of
Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | - Carolyn M. Porta
- School of Nursing, University of Minnesota, School of Nursing, Mail
Stop 1331 5-140 WDH, 308 Harvard St. SE, Minneapolis, MN 55455
| | - Stephen T. Russell
- Human Development and Family Sciences, University of Texas at
Austin, 108 E. Dean Keeton St., Stop A2702, Austin, TX, 78712
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Valenti M, Campetti R, Schoenborn N, Quinlan K, Dash K. Building evaluation capacity of local substance abuse prevention programs serving LGBQ populations. EVALUATION AND PROGRAM PLANNING 2017; 63:101-108. [PMID: 28456016 DOI: 10.1016/j.evalprogplan.2017.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 04/04/2017] [Accepted: 04/15/2017] [Indexed: 06/07/2023]
Affiliation(s)
| | | | | | | | - Kim Dash
- Education Development Center, Inc., United States
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Wilson SM, Gilmore AK, Rhew IC, Hodge KA, Kaysen DL. Minority stress is longitudinally associated with alcohol-related problems among sexual minority women. Addict Behav 2016; 61:80-3. [PMID: 27249806 PMCID: PMC4915988 DOI: 10.1016/j.addbeh.2016.05.017] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/28/2016] [Accepted: 05/19/2016] [Indexed: 11/22/2022]
Abstract
Compared to sexual minority men and heterosexual women, sexual minority women report elevated alcohol use in young adulthood. Heavy alcohol use and alcohol use disorders disproportionately affect sexual minority women across the lifespan, yet there is limited research investigating reasons for such associations. The present study investigates longitudinal associations between minority stress and both alcohol use as well as self-rated drinking consequences. Participants (N=1057) were self-identified lesbian (40.5%) and bisexual (59.5%) women between the ages of 18 to 25 recruited from across the U.S. using online advertisements. Participants completed four annual surveys. Hurdle mixed effects models were used to assess associations between minority stress and typical weekly drinking and drinking consequences one year later. Minority stress was not significantly associated with subsequent typical drinking. However, minority stress was significantly associated with having any alcohol consequences as well as the count of alcohol consequences one year later after controlling for covariates. Consistent with extant literature, this study provides evidence for a prospective association between minority stress experienced by sexual minority women and drinking consequences. This study also provides support for the potential impact of efforts to reduce minority stress faced by sexual minority women.
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Affiliation(s)
- Sarah M Wilson
- VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, United States.
| | - Amanda K Gilmore
- Medical University of South Carolina, Department of Psychiatry & Behavioral Sciences, National Crime Victims Research and Treatment Center, United States
| | - Isaac C Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, United States
| | - Kimberley A Hodge
- Department of Psychiatry and Behavioral Sciences, University of Washington, United States
| | - Debra L Kaysen
- Department of Psychiatry and Behavioral Sciences, University of Washington, United States
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Talley AE, Gilbert PA, Mitchell J, Goldbach J, Marshall BDL, Kaysen D. Addressing gaps on risk and resilience factors for alcohol use outcomes in sexual and gender minority populations. Drug Alcohol Rev 2016; 35:484-93. [PMID: 27072658 PMCID: PMC4930390 DOI: 10.1111/dar.12387] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/30/2015] [Accepted: 01/06/2016] [Indexed: 12/11/2022]
Abstract
ISSUES In 2011, the Institute of Medicine released a report that constituted the first comprehensive effort by a federal body to understand the current state of science pertinent to the health needs of sexual and gender minority populations. This mini-review summarises recent empirical, methodological and theoretical advances in alcohol-related research among to lesbian, gay, bisexual and transgender (LGBT) populations and highlights progress towards addressing gaps, with a particular interest in those identified by the Institute of Medicine report. APPROACH Articles published since 2011 were identified from PsycINFO and PubMed database searches, using various combinations of keyword identifiers (alcohol, alcohol abuse, substance abuse, LGBT, lesbian, gay, bisexual, transgender). Reference sections of included articles were also examined for additional citations. KEY FINDINGS Recent empirical work has contributed to a greater understanding of sub-group differences within this diverse population. Evidence has supported theorised influences that can account for alcohol-related disparities, yet important gaps remain. Studies that examine the role of gender identity and its intersection with sexual identity within transgender and gender non-conforming sub-populations are lacking. Methodological advances in this literature have begun to allow for examinations of how minority-specific and general risk factors of alcohol misuse may contribute to patterns of alcohol involvement over time and within social-relational contexts CONCLUSIONS The recommendations made in the current mini-review are meant to facilitate future collaborative efforts, scale development, thoughtful methodological design and analysis and theoretically driven nuanced hypotheses to better understand, and ultimately address, alcohol-related disparities among sexual and gender minority populations. [Talley AE, Gilbert PA, Mitchell J, Goldbach J, Marshall BDL, Kaysen D. Addressing gaps on risk and resilience factors for alcohol use outcomes in sexual and gender minority populations. Drug Alcohol Rev 2016;35:484-493].
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Affiliation(s)
- Amelia E. Talley
- Psychological Sciences, Texas Tech University, Lubbock, United States
| | - Paul A. Gilbert
- Community and Behavioral Health, University of Iowa, Iowa City, United States
| | - Jason Mitchell
- University of Miami Miller School of Medicine, Miami, United States
| | - Jeremy Goldbach
- School of Social Work, University of Southern California University of Southern California, Los Angeles, United States
| | - Brandon D. L. Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, United States
| | - Debra Kaysen
- Center for the Study of Health and Risk Behaviors, University of Washington, Seattle, United States
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Strutz KL, Herring AH, Halpern CT. Health disparities among young adult sexual minorities in the U.S. Am J Prev Med 2015; 48:76-88. [PMID: 25241194 PMCID: PMC4274226 DOI: 10.1016/j.amepre.2014.07.038] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 06/20/2014] [Accepted: 07/21/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Emerging research suggests that young adult sexual minorities (identifying as lesbian, gay, or bisexual or engaging in same-sex attractions or behaviors) experience poorer health than their majority counterparts, but many measures of health inequity remain unexamined in population-based research. PURPOSE To describe a wide range of health status and healthcare access characteristics of sexual minorities in comparison with those of the majority population in a national sample of U.S. young adults. METHODS Binary and multinomial logistic regression analyses of Wave IV data (2008) from the National Longitudinal Study of Adolescent Health (participants aged 24-32 years, n=13,088) were conducted. Health measures were self-rated health; diagnosis of any of several physical or mental illnesses or sexually transmitted infections; measured BMI; depression classified from self-reported symptoms; use of antidepressant and anxiolytic medication; uninsured; forgone care; and receipt of physical, dental, and psychological services. Analyses were conducted in 2012-2013. RESULTS Sexual minority women had elevated odds of most adverse health conditions and lower odds of receiving a physical or dental examination. Sexual minority men had elevated odds of fewer adverse health conditions. CONCLUSIONS Young adult sexual minorities are at higher risk of poor physical and mental health. The results highlight the multidimensionality of sexual minority status and respond to calls for greater understanding of the health of this population.
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Affiliation(s)
- Kelly L Strutz
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan.
| | - Amy H Herring
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Carolyn Tucker Halpern
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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