Sexual orientation, gender, and alcohol use in a cohort study of U.S. adolescent girls and boys (original) (raw)

Differential Alcohol Use Disparities by Sexual Identity and Behavior Among High School Students

Alcohol and Alcoholism, 2020

Aims Sexual minority youth (SMY) use alcohol at disproportionate rates compared to their heterosexual peers. However, sexual orientation is multidimensional. Analyzing alcohol use disparities only by one dimension of sexual orientation may result in critical disparities being obscured. Methods Data from state and local versions of the Youth Risk Behavior Survey were pooled (2009–2017), resulting in a large, diverse sample (n = 201,671). Multivariable logistic regression models were used to analyze associations between sexual identity/sexual behavior and three alcohol use outcomes among sexually active youth: age at first drink, binge drinking and current drinking. Results SMY, when categorized by sexual identity and sexual behavior, reported greater alcohol use than their heterosexual peers, though the magnitude of these disparities varied by subgroup. Both those who identified as bisexual and those who reported sexual behavior with both males and females reported the greatest level...

Sexual Orientation Disparities in Longitudinal Alcohol Use Patterns Among Adolescents

Archives of pediatrics & adolescent medicine, 2008

A total of 13 450 Growing Up Today Study participants (79.7% of the original cohort) aged 9 to 14 years at baseline in 1996 were followed up for more than 7 years. Main Exposure: Self-reported sexual orientation classified as heterosexual, mostly heterosexual, bisexual, or gay/lesbian. Main Outcome Measures: Age at alcohol use initiation, any past-month drinking, number of alcoholic drinks usually consumed, and number of binge drinking episodes in the past year.

Trends in Alcohol Use Behaviors by Sexual Identity and Behavior Among High School Students, 2007–2017

Journal of Adolescent Health, 2019

Certain groups, particularly sexual minority youth, demonstrate notable disparities in alcohol use risk. Assessing trends in alcohol use behaviors by sexual orientation over time is therefore important to the epidemiologic study of adolescent health equity. Methods: We analyzed age at first drink, lifetime drinking behavior, current drinking, and binge drinking in a large, national sample of high school youth across six time points, beginning in 2007 and biennially through 2017. We assessed trends by sex, sexual identity, and sexual behavior, controlling for race/ethnicity and age. Results: Our results demonstrated that, although overall alcohol use is decreasing among youth, disparities between heterosexual and sexual minority youth remain significant. The largest decreases were seen in current alcohol use among lesbian youth, which fell from a prevalence of 56.1% in 2007 to 38.9% in 2017, and among bisexual females (64.3% in 2007 to 41.1% in 2017). Despite this, alcohol use behaviors were still elevated among lesbian and bisexual female youth compared with heterosexual sex-matched counterparts. Heterosexual-identified male students saw significant decreases in alcohol use, whereas most alcohol use behaviors among sexual minority males decreased but not to a statistically significant degree, with the exception of binge drinking among those who identified as gay (2007: 36.0% to 2017: 12.6%) and bisexual (2007: 24.7% to 2017: 11.6%). Results by sexual behavior are presented within. Conclusions: Sexual minority youth continued to demonstrate markedly high prevalence of alcohol use behaviors compared with heterosexual peers across all time points. Downward trends in alcohol use may thus mask serious population health risks if not adequately explored. Research and health promotion efforts must consider sexual minority orientation to avoid incomplete or inaccurate representation of findings.

Predictors of substance use over time among gay, lesbian, and bisexual youths: An examination of three hypotheses

Addictive Behaviors, 2004

Gay, lesbian, and bisexual (GLB) youths report elevated levels of substance use relative to heterosexual youths, but reasons for this disparity have received scant attention. This report longitudinally examined three hypothesized explanations for cigarette, alcohol, and marijuana use among 156 GLB youths. Counter to two hypotheses, neither a history of childhood sexual abuse nor recent experiences of gay-related stressful life events were associated with increased substance use over time. However, the hypothesis concerning the coming-out process was supported by significant nonlinear associations of involvement in gay-related (recreational and social) activities with changes in alcohol use at 12 months and changes in marijuana use at 6 months and 12 months. Specifically, as involvement in gay-related activities increased, alcohol and marijuana use was found to initially increase, but then, substance use declined as involvement in gay-related activities continued to increase. These findings offer a potential explanation for high levels of substance use among GLB youths and suggest potential areas for intervention to prevent or decrease substance use among these youths. D

Longitudinal Disparities of Hazardous Drinking Between Sexual Minority and Heterosexual Individuals from Adolescence to Young Adulthood

Journal of Youth and Adolescence, 2014

Sexual minority (lesbian and gay, bisexual, mostly heterosexual) individuals are at an increased risk for hazardous drinking than heterosexual individuals, but little is known about the nature of the disparities as adolescents reach adulthood. We used four waves of a nationally representative data set, the National Longitudinal Study of Adolescent Health (Add Health), to examine disparities of hazardous drinking outcomes between sexual minority and heterosexual men and women from adolescence to young adulthood. Participants were 14-18 years old at the first assessment (N = 12,379; 53 % female) and 27-31 years old at the fourth assessment. At the fourth assessment, 13 % self-identified as sexual minority individuals, 16 % were Hispanic, and 36 % were of minority race, including primarily African Americans (60 %) and Asian Americans (18 %). There were clear hazardous drinking disparities between sexual minority individuals and heterosexual individuals over time. During adolescence, sexual minority individuals, particularly females, reported higher levels of hazardous drinking. As study participants reached adulthood, the magnitude of the hazardous drinking disparities increased among sexual minorities, sexual minority men in particular. Additional research is needed to better understand the developmental mechanisms that underlie the emerging sexual orientation related disparities of hazardous drinking in young adulthood.

Gender differences in health and risk behaviors among bisexual and homosexual adolescents

Journal of Adolescent …, 1998

Methods: Respondents included 182 girls and 212 boys; girls were significantly younger than boys (p < 0.001), so respondents were further grouped as younger ( < ؊ 14 years) and older ( > ؊ 15 years) for analysis. Chi-square was used to test for gender differences in health perceptions and risk behaviors. Items included general health perceptions and health care access, body image and disordered eating behaviors, sexual behaviors, alcohol use, and emotional health measures including mood, life satisfaction, and suicidal ideation and attempts.

Sexual orientation and drug use in a longitudinal cohort study of U.S. adolescents

Addictive Behaviors, 2010

Adolescents with a minority sexual orientation (e.g., lesbian, gay, bisexual) are more likely to use substances than their heterosexual peers. This study aimed to increase understanding of the development of drug use in this vulnerable population by: 1) comparing longitudinal patterns of pastyear illicit drug use (e.g., marijuana, cocaine, ecstasy) and misuse of prescription drugs among minority sexual orientation youth relative to heterosexual youth and, 2) examining how sexual orientation subgroup, gender, and age relate to variation in risk of drug use. Data come from the Growing Up Today Study, a community-based cohort of adolescents who were assessed three times between 1999-2005 with self-administered questionnaires when they ranged in age from 12 to 23 years (N=12,644; 74.9% of the original cohort). Multivariable repeated measures generalized estimating equations using modified Poisson regression was used to estimate relative risks. Participants indicating their sexual orientation was mostly heterosexual, bisexual, or lesbian/gay were more likely than completely heterosexual youth to report past-year illicit drug use and misuse of prescription drugs. Gender was an important modifier; bisexual females were most likely to report drug use. Age was also an important modifier of risk; differences in drug use between minority sexual orientation and heterosexual youth were larger during adolescence (12-17 years) than during emerging adulthood (18-23 years). Research must focus on identifying reasons why minority sexual orientation youth are at disproportionate risk for drug use. Such information is essential for developing interventions that are critically needed to reduce drug use in this population. Efforts need to begin early because large sexual orientation disparities in drug use are evident by adolescence.

Review of Literature on Sexual Minority Youth and Substance Abuse

It is fairly well know that risk for substance abuse is heightened in lesbian, gay, and bisexual (LGB) individuals, especially during adolescence and early adulthood. However, research is only beginning to understand the reasons beyond the concept of minority stress. Studies have shown that there are many potential factors, including perceived social support, earlier childhood events, and atypical experiences during transition to adulthood. Research has also found that rates of substance use and cultural experiences vary across subgroups of LGB youth depending on race, gender, and specific sexual identity. As researchers began to look into these disparities, they found that subgroup differences can have major implications on the efficacy of treatment. They almost all suggested further research into the special needs of LGB youth as a whole and subgroups within this population, emphasizing the importance of tailoring treatment plans accordingly.