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Disparities in substance use behaviors and disorders among adult sexual minorities by age, gender, and sexual identity.
Drug Alcohol Depend. 2018 08 01; 189:139-146.DA

Abstract

BACKGROUND

Sexual minorities (SMs) experience elevated rates of substance use behaviors and disorders relative to heterosexuals; minority stress is theorized to contribute to these disparities. As SMs are not a homogenous group, analyses that aggregate SMs across sexual identity, age, or gender obscure important variation among this population. To date, age- and gender-specific disparities have not been rigorously examined using a large national sample.

METHODS

Using data on 67,354 adults (ages 18-49) from the 2015 and 2016 National Survey of Drug Use and Health we examined age- and gender-specific disparities in smoking, heavy episodic drinking, marijuana use, illicit drug use, and alcohol/substance use disorder. Age groups were ages 18-25, 26-34, and 35-49. Using logistic regression, we estimated age- and gender-specific odds ratios for gay/lesbian and bisexual individuals, relative to heterosexuals; analyses adjusted for demographic characteristics.

RESULTS

Bisexual women had significantly elevated odds of all outcomes at all ages, relative to heterosexual women. Gay/lesbian individuals had significantly elevated odds for nearly all outcomes compared to same-gender heterosexuals at ages 18-25, but not consistently at older ages. For bisexual men, significant disparities compared to heterosexual men were only observed at ages 35-49 for marijuana use and alcohol/substance use disorder.

CONCLUSIONS

We found notable within-group differences regarding SM disparities. While disparities were most pronounced in young adulthood for gay/lesbian individuals and mid-adulthood for bisexual men, bisexual women uniquely experienced disparities across all ages. Minority stress experiences may vary with respect to gender, age/cohort, and sexual identity, resulting in differential risk for substance use.

Authors+Show Affiliations

RAND Corporation, 20 Park Plaza #920, Boston, MA 02116, USA. Electronic address: mschuler@rand.org.The Methodology Center, The Pennsylvania State University, 424 Health and Human Development Building, University Park, PA 16802, USA. Electronic address: cer5374@psu.edu.Institute of Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA. Electronic address: bjevans@umich.edu.RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA. Electronic address: collins@rand.org.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29944989

Citation

Schuler, Megan S., et al. "Disparities in Substance Use Behaviors and Disorders Among Adult Sexual Minorities By Age, Gender, and Sexual Identity." Drug and Alcohol Dependence, vol. 189, 2018, pp. 139-146.
Schuler MS, Rice CE, Evans-Polce RJ, et al. Disparities in substance use behaviors and disorders among adult sexual minorities by age, gender, and sexual identity. Drug Alcohol Depend. 2018;189:139-146.
Schuler, M. S., Rice, C. E., Evans-Polce, R. J., & Collins, R. L. (2018). Disparities in substance use behaviors and disorders among adult sexual minorities by age, gender, and sexual identity. Drug and Alcohol Dependence, 189, 139-146. https://doi.org/10.1016/j.drugalcdep.2018.05.008
Schuler MS, et al. Disparities in Substance Use Behaviors and Disorders Among Adult Sexual Minorities By Age, Gender, and Sexual Identity. Drug Alcohol Depend. 2018 08 1;189:139-146. PubMed PMID: 29944989.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disparities in substance use behaviors and disorders among adult sexual minorities by age, gender, and sexual identity. AU - Schuler,Megan S, AU - Rice,Cara E, AU - Evans-Polce,Rebecca J, AU - Collins,Rebecca L, Y1 - 2018/06/19/ PY - 2017/04/18/received PY - 2018/05/08/revised PY - 2018/05/08/accepted PY - 2018/6/27/pubmed PY - 2018/10/12/medline PY - 2018/6/27/entrez KW - Disparities KW - LGB KW - Sexual minorities KW - Substance use KW - Substance use disorders SP - 139 EP - 146 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 189 N2 - BACKGROUND: Sexual minorities (SMs) experience elevated rates of substance use behaviors and disorders relative to heterosexuals; minority stress is theorized to contribute to these disparities. As SMs are not a homogenous group, analyses that aggregate SMs across sexual identity, age, or gender obscure important variation among this population. To date, age- and gender-specific disparities have not been rigorously examined using a large national sample. METHODS: Using data on 67,354 adults (ages 18-49) from the 2015 and 2016 National Survey of Drug Use and Health we examined age- and gender-specific disparities in smoking, heavy episodic drinking, marijuana use, illicit drug use, and alcohol/substance use disorder. Age groups were ages 18-25, 26-34, and 35-49. Using logistic regression, we estimated age- and gender-specific odds ratios for gay/lesbian and bisexual individuals, relative to heterosexuals; analyses adjusted for demographic characteristics. RESULTS: Bisexual women had significantly elevated odds of all outcomes at all ages, relative to heterosexual women. Gay/lesbian individuals had significantly elevated odds for nearly all outcomes compared to same-gender heterosexuals at ages 18-25, but not consistently at older ages. For bisexual men, significant disparities compared to heterosexual men were only observed at ages 35-49 for marijuana use and alcohol/substance use disorder. CONCLUSIONS: We found notable within-group differences regarding SM disparities. While disparities were most pronounced in young adulthood for gay/lesbian individuals and mid-adulthood for bisexual men, bisexual women uniquely experienced disparities across all ages. Minority stress experiences may vary with respect to gender, age/cohort, and sexual identity, resulting in differential risk for substance use. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/29944989/Disparities_in_substance_use_behaviors_and_disorders_among_adult_sexual_minorities_by_age_gender_and_sexual_identity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(18)30323-5 DB - PRIME DP - Unbound Medicine ER -