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Sexual Orientation Disparities in Substance Use: Investigating Social Stress Mechanisms in a National Sample
  • Published Date:
    November 21 2019
  • Source:
    Am J Prev Med. 58(1):59-68
  • Language:
    English


Public Access Version Available on: January 01, 2021, 12:00 AM information icon
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Details:
  • Alternative Title:
    Am J Prev Med
  • 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.
  • Subject:
  • Pubmed ID:
    31761516
  • Pubmed Central ID:
    PMC6925636
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