Sexual Orientation Disparities in Substance Use: Investigating Social Stress Mechanisms in a National Sample

Details

• Alternative Title:
  Am J Prev Med
• Personal Author:
  Krueger, Evan A. ; Fish, Jessica N. ; Upchurch, Dawn M.
• Description:
  Introduction
  
  Sexual minorities are disproportionately more likely than heterosexuals to suffer from substance use disorders (SUDs), but relatively little is known about differences in SUDs across diverse sexual minority subgroups. There is also limited understanding of how different social stressors account for sexual orientation disparities in SUDs.
  
  Methods
  
  Using nationally representative data collected in 2012–2013 (N=34,597), differences in past-year DSM-V alcohol, cannabis, and tobacco use disorders were assessed across four sexual orientation groups (heterosexuals and three sexual minority subgroups: lesbian/gay-, bisexual-, and heterosexual-identified sexual minorities). This study assessed whether stressful life events (SLEs) mediated SUD disparities between heterosexuals and each sexual minority subgroup, and whether SLEs and lesbian, gay, bisexual (LGB) discrimination events mediated these SUD differences. Analyses were conducted in 2019.
  
  Results
  
  For both men and women, SUDs and stress experiences varied by sexual identity. For example, compared with heterosexual men, larger proportions of gay and bisexual men had a past-year alcohol use disorder. Among women, all sexual minority subgroups had higher rates of each SUD, compared with heterosexuals. For each SUD, SLEs mediated disparities between heterosexuals and sexual minority subgroups, except for heterosexual-identified sexual minority men. Both SLEs and LGB discrimination mediated SUD differences between sexual minority subgroups, with stronger indirect effects through LGB discrimination for lesbians/gay men and stronger indirect effects through SLEs for bisexual adults, generally.
  
  Conclusions
  
  Sexual minority subgroups have greater prevalence of SUDs, mediated through both SLEs and LGB discrimination. More research is needed to comprehensively assess the processes underlying sexual orientation substance use disparities.
  
  
• Keywords:
  Alcoholism Female Heterosexuality Humans Male Marijuana Abuse Prevalence Sex Factors Sexual And Gender Minorities Sexual Behavior Socioeconomic Factors Stress, Psychological Substance-Related Disorders Tobacco Use Disorder United States

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• Source:
  Am J Prev Med. 58(1):59-68
• Pubmed ID:
  31761516
• Pubmed Central ID:
  PMC6925636
• Document Type:
  Journal Article
• Funding:
  P2C HD041041/HD/NICHD NIH HHSUnited States/ ; U48 DP006382/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  58
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:0add3ccc93b584e732b23cea5b89676ed47381377c57b0e4d760d830bc14ed8b
• Download URL:
  https://stacks.cdc.gov/view/cdc/83681/cdc_83681_DS1.pdf
• File Type:
  [PDF - 1009.08 KB ]