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Batchelder AW, Claire Greene M, Scheer JR, Foley J, Jenny Shin HJ, Koehn KM, Kelly JF. Sexual minority disparities in psychosocial functioning following substance use recovery among a representative sample of US adults. Addict Behav Rep 2024; 19:100527. [PMID: 38226009 PMCID: PMC10788780 DOI: 10.1016/j.abrep.2024.100527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/30/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024] Open
Abstract
Purpose Sexual minority (SM; e.g., gay, lesbian, bisexual) individuals are disproportionately impacted by alcohol and other drug (AOD) use disorders and psychosocial factors that can exacerbate AOD use disorders and hinder recovery. This study examines SM sub-group differences (monosexual [gay/lesbian] versus bisexual) regarding adaptation to recovery measured by indices of psychosocial functioning. Identifying differential needs of gay/lesbian versus bisexual individuals could improve services to better meet the needs of SM individuals in recovery. Methods Using data from the National Recovery Study, a nationally representative cross-sectional sample of US adults who reported resolving an AOD problem (N = 2,002), we compared heterosexual to monosexual and bisexual SM individuals on socio-demographic characteristics, AOD use and treatment, and psychosocial variables. Results Bisexual individuals were significantly younger than heterosexual individuals (p = .002 and p ≤ 0.001 among men and women, respectively) and reported significantly fewer years since AOD problem resolution compared to heterosexual individuals (p = .004 and p = .003 among men and women, respectively). Most notably, bisexual individuals, but not gay/lesbian individuals, reported significantly lower quality of life (QOL), happiness, self-esteem, and significantly higher distress compared to heterosexual individuals. Conclusion Bisexual, but not monosexual, SM individuals in recovery from an AOD use disorder, were younger and reported worse psychosocial functioning than heterosexual individuals. Findings highlight significant differences between monosexual versus bisexual identified individuals with a notable disadvantage experienced by bisexual individuals. More needs to be learned about the challenges faced by bisexual individuals in recovery to better address their needs and support long-term AOD recovery.
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Affiliation(s)
- Abigail W. Batchelder
- Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - M. Claire Greene
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Jacklyn Foley
- Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Kyrié M. Koehn
- Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - John F. Kelly
- Psychiatry Department, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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2
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Engstrom CW, West BT, Schepis TS, McCabe SE. Does the approach used to measure sexual identity affect estimates of health disparities differently by race? A randomized experiment from the National Survey of Family Growth. Soc Sci Med 2024; 350:116887. [PMID: 38678646 DOI: 10.1016/j.socscimed.2024.116887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 04/09/2024] [Accepted: 04/13/2024] [Indexed: 05/01/2024]
Abstract
The inclusion of "something else" as a response option for survey questions about sexual identity has been shown to significantly moderate estimated differences between sexual identity subgroups in the distributions of various health outcomes in national health surveys, specifically for substance use/misuse and reproductive health. This moderation effect may be larger depending on the respondent's race, possibly due to the intersectionality of multiple minority identities and compounding minority stressors. To test this hypothesis, we conducted secondary analyses of data from five consecutive years of the National Survey of Family Growth (2015-2019) [n = 18,903 (8510 males, 10,393 females)] in the United States, where respondents were randomly assigned to receive either a four-category version of the sexual identity question that included "something else" as a response option along with lesbian/gay, bisexual, and heterosexual, or a three-category version that omitted "something else." We focused on model-based estimates of distributions of health outcomes across subgroups defined by both race and sexual identity and tested the race moderation hypothesis using three-way interactions involving sexual identity, question type received (four-category vs. three-category), and race (Black, White, and other). Based on this randomized experiment, we found evidence of significant differences between the four-category and three-category question versions of sexual identity, in terms of the associations between sexual identity and several health outcomes, along with moderation of these differences by the respondent's race. For some outcomes, such as wanting a child or another child, the magnitudes of the estimated sexual identity differences among racial minority individuals, specifically between bisexual and heterosexual women, were sensitive to the measurement of sexual identity. These results further suggest a need for improved sexual minority measurement, especially among racial minorities. These differences were also mostly found among women, suggesting further intersectionality of groups exposed to specific stressors.
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Affiliation(s)
- Curtiss W Engstrom
- Program in Survey and Data Science, University of Michigan-Ann Arbor, Ann Arbor, MI, USA.
| | - Brady T West
- Survey Research Center, Institute for Social Research, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
| | - Ty S Schepis
- Department of Psychology, Texas State University, San Marcos, TX, USA
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3
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Osborn C, Pike Moore S, Koopman Gonzalez S, Quisenberry A, Klein E, Trapl E. Come for the Tobacco, Stay for the Flavor: Flavored Cigarillo-Use Trajectories Among Young Adult Sexual Gender Minority Women. Nicotine Tob Res 2024; 26:S112-S120. [PMID: 38817030 PMCID: PMC11140217 DOI: 10.1093/ntr/ntad168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/14/2023] [Accepted: 09/01/2023] [Indexed: 06/01/2024]
Abstract
INTRODUCTION The purpose of this research was to identify how young adult sexual gender minority (SGM) women who use cigarillos may respond to cigar flavor restrictions. AIMS AND METHODS Young adults aged 21-28 years in the United States who currently use cigarillos were recruited between October 2020 and April 2021 to participate in an online survey. Due to high prevalence of cigarillo use among individuals who identify as sexual and/or gender minority (SGM) women, their (n = 192) flavored tobacco-use behaviors and anticipated responses to cigarillo flavor restrictions were compared to cisgender heterosexual (CisHet) women (n = 110). Logistic regression was used to model cigarillo cessation and product-switching behaviors (flavored and unflavored). RESULTS SGM women were significantly less likely to report the use of flavor at the initiation of cigarillo use (61.7% vs. 86.1%) but were no different in current flavor use compared to CisHet women, with more than 80% of all women using any flavor. SGM women were 2.36 times as likely to say they would discontinue using cigarillos if flavors were unavailable. Among those who would continue using cigarillos, SGM women were 4.53 times as likely to endorse switching to an unflavored tobacco product but had the same likelihood of saying they would switch to flavored product compared to CisHet women. CONCLUSIONS Flavor restriction policies may not reduce the initiation of cigarillos among SGM women and may elicit differential cigarillo use and tobacco product substitution by SGM identity. Flavor restriction policies should be coupled with targeted cessation resources to address potential remaining disparities. IMPLICATIONS SGM US women have a unique cigarillo-use trajectory. These women are more likely to initiate cigarillos without flavor and then later integrate it into their behavior. National cigar flavor restrictions are expected to have a greater impact decreasing cigarillo initiation among CisHet women and decreasing current cigarillo use among SGM women. However, for those who would continue using unflavored cigarillos, SGM women may remain at risk for nicotine dependence due to increased product substitution. SGM women should be prioritized for cessation resources to reduce tobacco-use disparities leading up to and following the implementation of cigar flavor restrictions.
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Affiliation(s)
- Catherine Osborn
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, USA
| | - Stephanie Pike Moore
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, USA
| | - Sarah Koopman Gonzalez
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, USA
| | - Amanda Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Elizabeth Klein
- Division of Health Behavior & Health Promotion, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Erika Trapl
- Department of Population and Quantitative Health Sciences, Prevention Research Center for Healthy Neighborhoods at Case Western Reserve University, Cleveland, OH, USA
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4
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Tao X, Yip T, Fisher CB. Employment, coronavirus victimization distress, and substance use disorders among black and non-Hispanic White young adults during the COVID-19 pandemic. J Ethn Subst Abuse 2024; 23:320-339. [PMID: 35758224 DOI: 10.1080/15332640.2022.2091702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Substance abuse among young adults increased during the COVID-19 pandemic. Although pre-pandemic data indicate non-Hispanic White adults had higher levels of substance use disorder (SUD), Black adults suffered more serious consequences. The COVID-19 pandemic has introduced new stressors that may contribute to SUD, especially among Black young adults, including employment as essential workers, which may be related to victimization distress associated with the coronavirus (i.e., coronavirus victimization distress). The current study administered an anonymous, cross-sectional, online survey to a national sample of 132 Black and 141 non-Hispanic White adults 18 - 25 years to assess the relationship between health, economic disparities, employment, coronavirus victimization distress, and substance use during the first wave of the pandemic. Controlling for COVID-19 health risks and income, structural equation models indicated that coronavirus victimization distress fully accounted for the positive association between employment and SUD risk, and this association was more pronounced among Black young adults. Findings underscore the urgency of considering disease-related victimization in SUD interventions involving employed young adults during infectious disease pandemics.
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Affiliation(s)
- Xiangyu Tao
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Tiffany Yip
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Celia B Fisher
- Department of Psychology, Fordham University, Bronx, NY, USA
- Center for Ethics Education, Fordham University, Bronx, NY, USA
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Romm KF, Berg CJ, Wang Y, Cohn AM. Patterns of Tobacco and Cannabis Use Among Sexual Minority Females and Males From PATH Wave 5: The Role of Sociodemographic and Psychosocial Correlates. SUBSTANCE USE & ADDICTION JOURNAL 2024:29767342231222245. [PMID: 38281150 DOI: 10.1177/29767342231222245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Although sexual minority (SM; vs heterosexual) individuals display higher rates of tobacco and cannabis use, limited research has examined sociodemographic and psychosocial correlates of single and co-use among this population. METHODS Participants were SM-identifying female (N = 2419; Mage = 27.80; 50.0% racial/ethnic minority) and male (N = 1142; Mage = 30.34; 46.1% racial/ethnic minority) adults from Wave 5 of the Population Assessment of Tobacco and Health study. Multinomial logistic regressions examined sociodemographic (ie, sexual identity, age, race/ethnicity, education, income) and psychosocial (ie, alcohol use, mental health, substance use) correlates of single and co-use (ie, no use [referent], tobacco-only, cannabis-only, co-use), controlling for state cannabis legalization, among SM females and males, separately. RESULTS The proportions of SM females reporting no use, tobacco-only, cannabis-only, and co-use were 37.9%, 24.0%, 10.5%, and 27.6%, respectively. Among males, 40.6%, 27.8%, 10.1%, and 21.5% reported no use, tobacco-only, cannabis-only, and co-use, respectively. Among females and males, substance use problems were associated with all 3 use groups (vs no use); past-month alcohol use was associated with cannabis-only and co-use; and mental health symptoms were associated with co-use (and cannabis-only in males). Sociodemographic correlates among females were: tobacco-only-identifying as bisexual (vs lesbian), White (vs Black), older, lower education, and lower income; cannabis-only-bisexual, other race (vs White); and co-use-White (vs Hispanic), lower education, and lower income. Among males, sociodemographic correlates were: tobacco-only-older, lower education, and lower income; cannabis-only-Black (vs White) and higher income. CONCLUSIONS Public health efforts to reduce tobacco and cannabis use among SM adults should target single versus co-use patterns and their corresponding sociodemographic, mental health, and substance use profiles.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Roberts K, Smith E, Sousa C, Young JE, Corley AG, Szczotka D, Sepanski A, Hartoch A. Centering persons who use drugs: addressing social determinants of health among patients hospitalized with substance use disorders. SOCIAL WORK IN HEALTH CARE 2024; 63:19-34. [PMID: 37929597 DOI: 10.1080/00981389.2023.2278777] [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: 03/30/2023] [Accepted: 09/12/2023] [Indexed: 11/07/2023]
Abstract
Social workers have emerged as leaders within Addiction Consult Services (ACS) due to their ability to provide a wide range of services, from crisis work and brief therapeutic interventions to connecting patients to community resources. Many hospitals have implemented ACS to address the overdose crisis and the sharp rise in drug use-related infections, including skin and soft tissue infections, osteomyelitis, and endocarditis; a result of unaddressed systemic social determinants of health (SDOH). Yet, despite social workers being at the forefront of inpatient substance use work, little guidance exists regarding social work's role in leading person-centered addiction care and addressing SDOH in the hospital setting. The authors of this paper are licensed clinical social workers who have worked across five different health systems, engaging persons who use drugs (PWUD) in the context of an ACS. This paper examines five practice interventions of social work practice within hospitals that represent key points for innovation. Drawing on social work's unique commitments to social justice, strengths, and person-in-environment, these interventions operate within eco-social approaches to help us grapple more effectively with ways that health - and disease - are socially and economically produced by multiple interacting factors. We provide a clinical roadmap of interventions for social workers in hospital settings with PWUD to demonstrate how social work leadership within inpatient care models can help us better address the impacts of various intersecting SDOH on the care of PWUD.
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Affiliation(s)
- Kate Roberts
- Graduate School of Social Work and Social Research, Bryn Mawr College, Bryn Mawr, Pennsylvania, USA
| | - Emily Smith
- Michigan Opioid Collaboratived, University of Michigan Health, Ann Arbor, Michigan, USA
| | - Cindy Sousa
- Graduate School of Social Work and Social Research, Bryn Mawr College, Bryn Mawr, Pennsylvania, USA
| | - J Elaina Young
- School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Anna Grace Corley
- Addiction Medicine, Prisma Health Internal Medicine, Greenville, South Carolina, USA
| | - Darin Szczotka
- Michigan Opioid Collaboratived, University of Michigan Health, Ann Arbor, Michigan, USA
| | - Abby Sepanski
- Addiction Medicine, Prisma Health Internal Medicine, Greenville, South Carolina, USA
| | - Ashley Hartoch
- Psychiatry, Stanford Health Care, Palo Alto, California, USA
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7
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Maglalang DD, Hu Y, Baslock D, Daus JD, Cano M, Ahluwalia JS. Recency of Cannabis Vaping in Sexual Minorities in Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study. Subst Use Misuse 2023; 59:136-142. [PMID: 37750356 PMCID: PMC10842009 DOI: 10.1080/10826084.2023.2262024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
BACKGROUND Cannabis vaping is increasing in the United States. Among populations at-risk are sexual minorities (SM) who are more likely to vape cannabis compared to their heterosexual counterparts. Cannabis vaping has been associated with negative health outcomes and concomitant use of other substances with increased risk with more recent use. OBJECTIVES This study examined the association between SM identification and recency of cannabis vaping (the last occasion that a participant used their vape device with cannabis) and number of puffs (the count of puffs that the participant took during their most recent use of their vape device with cannabis) using Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study. RESULTS In a weighted sample of participants who reported ever vaping cannabis (N = 5,331), 15% identified as SM, about 60% vaped cannabis in the past 3 or more days, and the mean number of puffs was 2 (SE = 0.17). Using multinomial logistic regression and zero-inflated negative binomial regression, the results showed that compared to heterosexual adults who reported not recently vaping cannabis, SM had higher probabilities of vaping cannabis in the past 3 or more days, 1-2 days, and the day of interview. CONCLUSION SM individuals were more likely to recently vape cannabis, placing them at higher risk for respiratory diseases and use of other substances. Public health researchers and practitioners need to identify reasons for cannabis vaping in this population and implement targeted public health messaging to inform SM communities of the potential health effects of cannabis vaping.
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Affiliation(s)
- Dale Dagar Maglalang
- Silver School of Social Work, New York University, New York, USA
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Yuanyuan Hu
- Silver School of Social Work, New York University, New York, USA
| | - Daniel Baslock
- Silver School of Social Work, New York University, New York, USA
| | - Jeanelle Dyan Daus
- Department of Asian American Studies, San Francisco State University, San Francisco, California, USA
| | - Manuel Cano
- School of Social Work, Arizona State University, Phoenix, Arizona, USA
| | - Jasjit S. Ahluwalia
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
- Department of Medicine, Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Legoretta Cancer Center, Brown University, Providence, Rhode Island, USA
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8
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Lee TH, Duong N, Sutha K, Simonetto DA, Paul S. Liver transplantation for people of minoritised sexual and gender identities in the USA. Lancet Gastroenterol Hepatol 2023; 8:1152-1162. [PMID: 37837981 DOI: 10.1016/s2468-1253(23)00238-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 10/16/2023]
Abstract
The number of people who report to be of minoritised sexual or gender identities in the USA, including lesbian, gay, bisexual, transgender, queer, and other sexuality-diverse and gender-diverse identities, has been increasing in the past decade. This diverse and unique population continues to experience not only health disparities but also psychosocial, economic, and legal disparities in accessing and receiving health care, including liver transplantations. As liver transplantation is life-saving for people with end-stage liver disease, understanding the factors that can affect access to and quality of liver transplantation care in people of minoritised sexual and gender identities in the USA, including differential social supports, insurance coverage, and medical and psychiatric comorbidities, is crucial. Actions, such as collecting sexual orientation and gender identity data, implementing inclusive language, recognising implicit biases, building diverse teams, providing a safer environment, and supporting further research to understand the unique health challenges are needed to ensure equitable access to high-quality liver transplantation care for people of minoritised sexual and gender identities.
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Affiliation(s)
- Tzu-Hao Lee
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Division of Abdominal Transplant, Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
| | - Nikki Duong
- Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Ken Sutha
- Division of Nephrology, Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Douglas A Simonetto
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Sonali Paul
- Section of Gastroenterology, Hepatology, and Nutrition, Center for Liver Diseases and Transplant Institute, University of Chicago Medicine, Chicago, IL, USA
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Knox JR, Dolotina B, Moline T, Matthews I, Durrell M, Hanson H, Almirol E, Hotton A, Pagkas-Bather J, Chen YT, English D, Manuzak J, Rower JE, Miles C, Millar B, Jean-Louis G, Rendina HJ, Martins SS, Grov C, Hasin DS, Carrico AW, Shoptaw S, Schneider JA, Duncan DT. HIV Prevention and Care Among Black Cisgender Sexual Minority Men and Transgender Women: Protocol for an HIV Status-Neutral Cohort Study Using an Observational-Implementation Hybrid Approach. JMIR Res Protoc 2023; 12:e48548. [PMID: 38039075 PMCID: PMC10724817 DOI: 10.2196/48548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Black cisgender gay, bisexual, and other sexual minority men (SMM) and transgender women (TW) continue to be heavily affected by HIV. Further research is needed to better understand HIV prevention and care outcomes in this population. In particular, there is a need for research examining the impact of substance use and sleep health on HIV prevention and treatment outcomes among Black SMM and TW. OBJECTIVE This paper outlines the study methods being used in the recently launched follow-up study to the Neighborhoods and Networks (N2) study, which we refer to as N2 Part 2 (N2P2). N2P2 aims to address this gap in the literature, build off the findings of the original N2 study, and identify socioenvironmental determinants of health, including whether neighborhood and network factors mediate and moderate these relationships. METHODS Building on the N2 cohort study in Chicago from 2018 to 2022, N2P2 used a prospective longitudinal cohort design and an observational-implementation hybrid approach. With sustained high levels of community engagement, we aim to recruit a new sample of 600 Black SMM and TW participants residing in the Chicago metropolitan statistical area. Participants are asked to participate in 3 study visits across an 18-month study period (1 visit every 9 months). Four different forms of data are collected per wave: (1) an in-person survey, (2) biological specimen collection, (3) a daily remote ecological momentary assessment for 14 days after each study visit, and (4) data from electronic health records. These forms of data collection continue to assess neighborhood and network factors and specifically explore substance use, sleep, immune function, obesity, and the implementation of potential interventions that address relevant constructs (eg, alcohol use and pre-exposure prophylaxis adherence). RESULTS The N2P2 study was funded in August 2021 by the National Institute of Drug Abuse (R01DA054553 and R21DA053156) and National Heart, Lung, and Blood Institute (R01HL160325). This study was launched in November 2022. Recruitment and enrollment for the first wave of data collection are currently ongoing. CONCLUSIONS The N2P2 study is applying innovative methods to comprehensively explore the impacts of substance use and sleep health on HIV-related outcomes among an HIV status-neutral cohort of Black SMM and TW in Chicago. This study is applying an observational-implementation hybrid design to help us achieve findings that support rapid translation, a critical priority among populations such as Black SMM and TW that experience long-standing inequities with regard to HIV and other health-related outcomes. N2P2 will directly build off the findings that have resulted from the original N2 study among Black SMM and TW in Chicago. These findings provide a better understanding of multilevel (eg, individual, network, and neighborhood) factors that contribute to HIV-related outcomes and viral suppression among Black SMM and TW. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48548.
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Affiliation(s)
- Justin R Knox
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brett Dolotina
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Tyrone Moline
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Isabella Matthews
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Mainza Durrell
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Hillary Hanson
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Ellen Almirol
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Anna Hotton
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Jade Pagkas-Bather
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Yen-Tyng Chen
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Devin English
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Jennifer Manuzak
- Division of Immunology, School of Medicine, Tulane University, New Orleans, LA, United States
| | - Joseph E Rower
- Center for Human Toxicology, University of Utah, Salt Lake City, UT, United States
| | - Caleb Miles
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Brett Millar
- Department of Psychiatry, Rutgers University, New Brunswick, NJ, United States
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - H Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Silvia S Martins
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Christian Grov
- Einstein-CUNY-Rockefeller Center for AIDS Research, School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Deborah S Hasin
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Adam W Carrico
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| | - Steve Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, United States
| | - Dustin T Duncan
- Mailman School of Public Health, Columbia University, New York, NY, United States
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10
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Grigsby TJ, Claborn KR, Stone AL, Salcido R, Bond MA, Schnarrs PW. Adverse Childhood Experiences, Substance Use, and Self-Reported Substance Use Problems Among Sexual and Gender Diverse Individuals: Moderation by History of Mental Illness. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1089-1097. [PMID: 38045841 PMCID: PMC10689681 DOI: 10.1007/s40653-023-00560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 12/05/2023]
Abstract
Recent research has highlighted the alarmingly high rates at which sexual and gender diverse (SGD) individuals experience Adverse Childhood Experiences (ACE). ACE, in turn, are strongly related to mental illness-an important correlate of substance use. The present study explores whether mental illness moderates the relationship between ACE and substance use outcomes among SGD adults. As part of a larger community-based participatory research study, we assessed ACE, self-reported mental illness, and past-year substance use and misuse among a large and diverse sample of SGD community members in South Central Texas (n = 1,282). Multivariate logistic regression models were used to assess relationships between ACE, mental illness, substance use, and substance misuse (DAST > 3). Interaction terms between ACE and history of mental illness were created to assess moderation effects. Cumulative ACE scores were associated with a significantly higher odds of self-reported past year substance use (AOR = 1.43, 95% CI = 1.34-1.54) and substance misuse (AOR = 1.21, 95% CI = 1.11-1.32). History of mental illness was associated with an increased odds of self-reported substance misuse (AOR = 2.07, 95% CI = 1.20-3.55), but not past year substance use. There was a significant interaction of ACE and history of mental illness on the odds of past year substance use (AOR = 0.78, 95% CI = 0.69-0.89), but not for substance misuse. These results provide support for theoretical models linking ACE, mental illness, and substance use among SGD adults. Longitudinal research designs are needed to address temporality of outcomes and test mediation models of trauma, mental illness, and substance use. Future directions for prevention and intervention are discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-023-00560-y.
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Affiliation(s)
- Timothy J. Grigsby
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, 4505 S. Maryland Pkwy, Las Vegas, Nevada USA
| | - Kasey R. Claborn
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, Texas USA
- Addictions Research Institute, Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas USA
| | - Amy L. Stone
- Department of Sociology and Anthropology, Trinity University, San Antonio, Texas USA
| | | | | | - Phillip W. Schnarrs
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas USA
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11
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Watson RJ, Caba AE, Layland EK, Simon K, Morgan E, Edelman EJ, Chan PA, Eaton L. Co-occurring mental health and drug use experiences among Black and Hispanic/Latino sexual and gender diverse individuals. J Behav Med 2023; 46:986-995. [PMID: 37407904 DOI: 10.1007/s10865-023-00433-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 06/21/2023] [Indexed: 07/07/2023]
Abstract
Black and Hispanic/Latino sexual and gender diverse individuals disproportionately experience overlapping health disparities, such as drug use and elevated depressive symptoms, which are often driven by minority stressors. We sought to better understand the interaction between drug use and mental health, as it may be fruitful in developing effective interventions to address co-occurring health disparities. In a longitudinal, 5-wave sample of 300 Black and Hispanic/Latino sexual and gender diverse (SGD) individuals collected between March 2020 and March 2022, we found a within-person association between greater than average levels of psychological distress (depression and anxiety) and more frequent extra-medical use of cannabis, inhalants, methamphetamines, and opioids over the span of two years. These associations held after adjusting for the direct, within-person association of internalized homonegativity with drug use frequency. These results suggest that psychological distress explains at least some variance in drug use among Black and Hispanic/Latino SGD individuals. This highlights the importance of interventions that focus on mental health among Black and Hispanic/Latino SGD individuals who report drug use.
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Affiliation(s)
- Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA.
| | - Antonia E Caba
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA
| | - Eric K Layland
- College of Education & Human Development, University of Delaware, Newark, DE, USA
| | - Kay Simon
- College of Education and Human Development, University of Minnesota, Minneapolis, MN, USA
| | - Ethan Morgan
- College of Nursing, The Ohio State University, 1585 Neil Ave, Columbus, OH, 43210, USA
| | - E Jennifer Edelman
- Yale School of Medicine and Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
| | - Philip A Chan
- Department of Medicine, Brown University, Providence Rhode, Island
| | - Lisa Eaton
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, CT, 06269, USA
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12
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Morgan E, Mallory A, Albright N, Dyar C. Alcohol and inflammation: Examining differences at the intersection of sexual identity and race/ethnicity. Alcohol 2023; 118:1-7. [PMID: 37952785 PMCID: PMC11090082 DOI: 10.1016/j.alcohol.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Abstract
Sexual minorities (SMs; e.g., lesbian, gay, bisexual, and other non-heterosexual individuals) are more likely to be current alcohol drinkers than their heterosexual peers while separately experiencing elevated inflammation. Yet, little research has assessed the association between alcohol use and inflammation among subgroups of SMs, let alone potential differences among people with multiple marginal identities (e.g., race/ethnicity and sexual identity). Data came from the National Health and Nutrition Survey 2015-2016. Survey-weighted multivariable linear regression analysis was used to assess the relationship between alcohol use categories, heavy episodic drinking, and log-CRP (C-reactive protein). Models were stratified by sexual identity to determine whether associations between alcohol use and inflammation or between race/ethnicity and inflammation differed by sexual identity. Among 3220 participants, 1000 (36.8%) reported light alcohol use, 870 (32.0%) reported moderate use, and 483 (17.8%) reported heavy use. Mean raw CRP was 4.1 mg/L (SD = 8.1). The association between race/ethnicity and CRP differed in stratified relative to non-stratified models with key differences in CRP among individuals with multiple marginalized identities. We also observed that while the "classic" J-shaped relationship between alcohol use and systemic inflammation persists among heterosexuals in this sample, it does not hold among subgroups of sexual minorities. In particular, bisexuals who report heavy alcohol use, compared to non-users, experience significantly elevated CRP. Finally, we did not observe any association between heavy episodic drinking and CRP among subgroups of sexual minorities. Future studies assessing alcohol and biomarker data need to strive to include subgroups of sexual minorities and people with multiple marginal identities to better target behavioral and biomedical interventions aimed at reducing health disparities.
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Affiliation(s)
- Ethan Morgan
- College of Nursing, The Ohio State University, Columbus, OH, United States; College of Public Health, The Ohio State University, Columbus, OH, United States.
| | - Allen Mallory
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH, United States
| | - Nathaniel Albright
- College of Nursing, The Ohio State University, Columbus, OH, United States
| | - Christina Dyar
- College of Nursing, The Ohio State University, Columbus, OH, United States
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13
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Ezell JM. Opioid and polydrug use among rural sexual and gender minorities: Current knowledge and future directions. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 121:104211. [PMID: 37801911 DOI: 10.1016/j.drugpo.2023.104211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Affiliation(s)
- Jerel M Ezell
- Community Health Sciences, University of California Berkeley, Berkeley, CA, USA; Center for Cultural Humility, University of California Berkeley, Berkeley, CA, USA.
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14
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Houghtaling LM, Manning WD, Dush CMK. Coping Patterns During the COVID-19 Pandemic by Sexual and Gender Identity. JOURNAL OF HOMOSEXUALITY 2023:1-21. [PMID: 37782080 PMCID: PMC10985047 DOI: 10.1080/00918369.2023.2260920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
National polls have shown that COVID-19 has been highly stressful, negatively affecting well-being and life satisfaction overall, but few studies have focused on individuals with sexual and gender diverse identities. Pandemic-related stress may increase engagement in adverse or negative health-related coping behaviors and decrease engagement in positive coping strategies, potentially exacerbating existing LGBTQ+ health disparities. Relying on a nationally representative population-based sample, we examine disparities in rates of negative and positive COVID-19 coping behaviors by sexual and gender identities. Using Poisson regression models adjusted for key sociodemographic and pandemic related factors, we found higher rates of negative and positive coping behaviors among certain sexual and gender diverse groups compared to their heterosexual and cisgender counterparts. Specifically, we find that lesbian and gay respondents reported more positive and negative coping strategies compared to heterosexual persons. We also found higher rates of negative coping behaviors among plurisexual (bisexual, pansexual, omnisexual) and noncisgender adults (transgender or other nonbinary gender identity) compared to heterosexual and cisgender adults, respectively. We contribute to prior studies by focusing on both negative and positive pandemic related coping among sexually and gender diverse populations. These responses to the pandemic may have long-term implications for the health and well-being of sexual and gender diverse individuals.
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Affiliation(s)
- Laura M. Houghtaling
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 300 West Bank Office Building, 1300 S. 2 St., Minneapolis, MN 55454, USA
| | - Wendy D. Manning
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Williams Hall, Bowling Green, Ohio 43408, USA
| | - Claire M. Kamp Dush
- Department of Sociology, University of Minnesota, 1031 Social Sciences Building, 267 19 Ave S., Minneapolis, MN 55455, USA
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15
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Adams J, Asiasiga L, Neville S. The alcohol industry-A commercial determinant of poor health for Rainbow communities. Health Promot J Austr 2023; 34:903-909. [PMID: 36103136 DOI: 10.1002/hpja.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Alcohol use is an area of challenge for health promotion internationally. The alcohol industry operates as a key commercial determinant of health in that its actions contribute to alcohol misuse, resulting in a range of health and social harms to individuals, families and communities. Rainbow people (including those who identify as lesbian, gay, bisexual, transgender or gender diverse) are one group experiencing considerable harm from alcohol use. METHODS Data from 24 focus groups involving 131 people held in six cities in New Zealand during 2018, were used to explore local understandings of the ways in which the alcohol industry operates as a commercial determinant of health for Rainbow communities. The focus group discussions were analysed thematically. RESULTS Three key themes were identified. First, the alcohol industry was identified as present in the 'everyday', through targeted alcohol promotion to Rainbow people, and due to the centrality of bars to their social and cultural landscapes. Second, participants recognised the benefits of alcohol industry support for Rainbow communities. Last, an opposing view was articulated, with the alcohol industry and its commercial activities viewed negatively. CONCLUSIONS These findings highlight that alcohol as a commodity and the alcohol industry are successfully and firmly embedded within Rainbow communities. Overall, given alcohol is widely regarded in a positive way, this is likely to create difficulties for health promotion efforts to reduce alcohol related harm in these communities.
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Affiliation(s)
- Jeffery Adams
- SHORE & Whāriki Research Centre, Massey University, Auckland, New Zealand
| | - Lanuola Asiasiga
- SHORE & Whāriki Research Centre, Massey University, Auckland, New Zealand
| | - Stephen Neville
- Department of Nursing, Auckland University of Technology, Auckland, New Zealand
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16
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Zollweg SS, Belloir JA, Drabble LA, Everett B, Taylor JY, Hughes TL. Structural stigma and alcohol use among sexual and gender minority adults: A systematic review. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 8:100185. [PMID: 37663525 PMCID: PMC10474584 DOI: 10.1016/j.dadr.2023.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 08/06/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023]
Abstract
Background Sexual and gender minority (SGM) people are more likely than their cisgender, heterosexual counterparts to report negative alcohol-related outcomes. Although the association between individual- and interpersonal-level minority stressors and negative alcohol-related outcomes among SGM people is well-established, structural-level minority stressors are understudied. This systematic review examined structural-level stigma and alcohol-related outcomes among SGM people to inform future research, interventions, and policy. Methods We used five electronic databases to search for studies published between January 2010 and May 2022 that examined associations between structural stigma and alcohol use among SGM adults in the United States. Peer-reviewed, quantitative studies available in English were included. We conducted quality appraisal using the Joanna Briggs Institute checklist. Results The final sample included 11 studies. Overall, there was moderate to strong support for a positive association between structural stigma and negative alcohol-related outcomes among SGM people, with differences by gender, sexual identity, race, and ethnicity. All studies used cross-sectional designs, and nearly half utilized non-probability samples. Transgender and nonbinary people, SGM people of color, and sexual identity subgroups beyond gay, lesbian, and heterosexual were underrepresented. Structural stigma was most commonly measured as a state-level index. Alcohol measures were heterogeneous. Multilevel stigma and resiliency factors were understudied. Conclusions Addressing structural stigma is critical in reducing negative alcohol-related outcomes and inequities among SGM people. Research is needed that includes probability samples, longitudinal designs, and samples that reflect the diversity of SGM people. Future studies should examine the influence of multilevel stigma and resiliency factors on alcohol-related outcomes.
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Affiliation(s)
- Sarah S. Zollweg
- Columbia University School of Nursing, 560 W. 168th St., New York, NY, 10032, USA
- National Clinician Scholars Program, David Geffen School of Medicine, University of California, Los Angeles, CA, 1100 Glendon Ave, Suite 900, Los Angeles, CA 90024
| | - Joseph A. Belloir
- Columbia University School of Nursing, 560 W. 168th St., New York, NY, 10032, USA
| | - Laurie A. Drabble
- San Jose State University College of Health and Human Sciences, One Washington Square, San Jose, CA, 95192, USA
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., #450, Emeryville, CA, 94608, USA
| | - Bethany Everett
- University of Utah, Department of Sociology, 380 S. 1530 E, Salt Lake City, UT, 84112, USA
| | - Jacquelyn Y. Taylor
- Columbia University School of Nursing, 560 W. 168th St., New York, NY, 10032, USA
| | - Tonda L. Hughes
- Columbia University School of Nursing, 560 W. 168th St., New York, NY, 10032, USA
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17
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Gray J, Santos-Lozada AR, Hard G, Apsley H, O’Sullivan D, Jones AA. Serious Psychological Distress, Substance Use Disorders, and Social Issues Among Men and Women in the United States During the COVID-19 Pandemic. Am J Health Promot 2023; 37:933-939. [PMID: 37401052 PMCID: PMC10333561 DOI: 10.1177/08901171231188187] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
PURPOSE This study assesses the association between SUD, economic hardship, gender, and related risk and protective factors on serious psychological distress (SPD) during the COVID-19 pandemic. DESIGN Quantitative cross-sectional design. SETTING National Survey on Drug Use and Health (NSDUH). SAMPLE Data were from the NSDUH (2020) N = 25,746, representing 238,677,123 US adults, who identified as 18 or older and either male or female. MEASURES SPD measured as scoring a 13 or more on the Kessler (K6) distress scale. SUDs were determined using DSM5 criteria. Sociodemographic and socioeconomic variables included in analyses. ANALYSIS Logistic regressions evaluated the association between gender, protective, and risk factors on SPD. RESULTS After controlling for sociodemographic and related factors of SPD, having a SUD was the strongest correlate of SPD. Other significant correlates of SPD included female gender and an income level at or below the federal poverty threshold. Gender stratified regressions illustrated that religiosity, self-identifying as Black, and high levels of education were protective against SPD for women but not men. Poverty level was more associated with SPD for women than men. CONCLUSION In the United States, individuals with SUDs were nearly four times more likely to report SPD than those without SUDs, controlling for economic hardship and markers of social support during 2020. Effective social interventions to reduce SPD among individuals with SUDs are needed.
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Affiliation(s)
- Joy Gray
- Department of Educational Psychology, Counseling, and Special Education College of Education, The Pennsylvania State University, University Park, PA, USA
| | - Alexis R. Santos-Lozada
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Greg Hard
- Simches Division of Child and Adolescent Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Hannah Apsley
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Deirdre O’Sullivan
- Department of Educational Psychology, Counseling, and Special Education College of Education, The Pennsylvania State University, University Park, PA, USA
- Consortium on Substance Use and Addiction, The Pennsylvania State University, University Park, PA, USA
| | - Abenaa A. Jones
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Consortium on Substance Use and Addiction, The Pennsylvania State University, University Park, PA, USA
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18
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Haik AK, Hussong AM. Problematic Substance Use among Sexual Minority and Heterosexual Young Adults during COVID-19. Behav Sci (Basel) 2023; 13:655. [PMID: 37622795 PMCID: PMC10451818 DOI: 10.3390/bs13080655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
Sexual minority young adults (SMYAs), compared to heterosexual young adults (HYAs), are a uniquely high-risk population for problematic substance use, a disparity perhaps exacerbated by the COVID-19 pandemic. This study tested whether SMYAs had more problematic substance use than HYAs during the pandemic due to isolation and loneliness as well as lower family closeness. Participants (N = 141) aged 23-29 completed self-report surveys in 2014-2015 as college students and in the summer of 2021 as young adults (59% White, 26% Black/African American, 9% Asian/Middle Eastern, 6% Hispanic/Latino, and <1% American Indian/Alaska Native). Results of multivariate regression and multiple group path analyses did not support hypothesized effects-SMYAs did not have greater increases in problematic substance use compared to HYAs, isolation and loneliness were not significant mediators, and family closeness was not a significant moderator. However, SMYAs experienced a lack of social safety-increased loneliness and decreased family closeness-compared to HYAs. Further research is needed to investigate both the impact and underlying processes of this decreased social safety on SMYA well-being beyond the pandemic to better inform tailored supports and interventions.
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Affiliation(s)
- Amanda K. Haik
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3270, USA;
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19
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Kelly LM, Shepherd BF, Brochu PM, Zajac K. Co-occurring suicidal ideation and alcohol-related problems: An intersectional analysis of Native American and White adults with minoritized sexual identities. Addict Behav 2023; 142:107674. [PMID: 36905898 PMCID: PMC10262151 DOI: 10.1016/j.addbeh.2023.107674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 02/11/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Disparities in suicidal ideation (SI) and alcohol use disorder (AUD) are evident in both Native American and minoritized sexual identity groups, relative to non-Hispanic White and heterosexual groups. However, Native Americans report lower drinking and binge drinking rates than White adults. Persons with intersecting identities, specifically Native Americans with minoritized sexual identities, may be at greater risk for SI and drinking, binge drinking, and AUD than White and Native American heterosexual adults. METHODS Five years (2015-2019) of National Survey of Drug Use and Health data were combined (N = 130,157). Multinomial logistic regressions tested racial (Native American vs White) and sexual identity (lesbian/gay/bisexual vs heterosexual) differences in odds of SI, drinking, and co-occurring SI + drinking, versus neither SI/drinking. Subsequent analyses examined SI + binge drinking, and SI + AUD. RESULTS Compared to White heterosexual adults, Native American heterosexual adults reported lower co-occurring SI + drinking odds, whereas Native American sexual minoritized adults reported higher odds. Native American sexual minoritized groups showed greater co-occurring SI + binge drinking odds and greater co-occurring SI + AUD odds compared to White heterosexual adults. Native American sexual minoritized adults showed greater SI only compared to White sexual minoritized adults. Sexual minoritized Native Americans showed higher odds of co-occurring SI + drinking, binge drinking, and AUD than White heterosexual adults. CONCLUSIONS Native American sexual minoritized groups showed higher likelihood of co-occurring SI + drinking, binge drinking, and AUD relative to both White and Native American heterosexual adults. Disparities warrant outreach for suicide and AUD prevention for Native American sexual minoritized adults.
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Affiliation(s)
- Lourah M Kelly
- University of Connecticut, School of Medicine, United States
| | - Benjamin F Shepherd
- Nova Southeastern University, Department of Clinical and School Psychology, United States
| | - Paula M Brochu
- Nova Southeastern University, Department of Clinical and School Psychology, United States
| | - Kristyn Zajac
- University of Connecticut, School of Medicine, United States.
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20
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Ware OD, Austin AE, Srivastava A, Dawes HC, Baruah D, Hall WJ. Characteristics of Outpatient and Residential Substance Use Disorder Treatment Facilities with a Tailored LGBT Program. Subst Abuse 2023; 17:11782218231181274. [PMID: 37342586 PMCID: PMC10278416 DOI: 10.1177/11782218231181274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023]
Abstract
Lesbian, gay, bisexual, and transgender (LGBT) individuals have a high prevalence of substance use disorders (SUDs) and experience unique barriers to treatment. Little is known about the characteristics of SUD treatment facilities providing LGBT-tailored programs at the outpatient and residential levels of care. The purpose of this study is to examine the availability of LGBT-tailored programs in outpatient and residential SUD treatment facilities. Using the National Survey of Substance Abuse Treatment Services 2020, we conducted logistic regression to examine facility characteristics, including ownership, pay assistance, region, outreach, and telehealth services, associated with having an LGBT-tailored program among SUD treatment facilities. Outpatient facilities that were for-profit, had pay assistance, had community outreach services, and provided telemedicine/telehealth were more likely to have an LGBT-tailored program. Those that were government-owned, in the Midwest, and that accepted Medicaid were less likely to have an LGBT-tailored program. Residential facilities that were in the West, for-profit, and had community outreach services were more likely to have an LGBT-tailored program. This study offers a national examination of the availability of LGBT-tailored programs in SUD treatment facilities. Differences in availability based on ownership, region, pay assistance, and outreach highlight potential gaps in treatment availability.
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Affiliation(s)
- Orrin D. Ware
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA
| | - Anna E. Austin
- University of North Carolina at Chapel Hill Gillings School of Public Health, Chapel Hill, NC, USA
| | - Ankur Srivastava
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA
| | - Hayden C. Dawes
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA
| | - Dicky Baruah
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA
| | - William J. Hall
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA
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21
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Janulis P. Life course differences in heavy episodic drinking behaviors across age, gender, and sexual identity in the United States. Addict Behav Rep 2023; 17:100495. [PMID: 37249940 PMCID: PMC10209188 DOI: 10.1016/j.abrep.2023.100495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/04/2023] [Accepted: 05/09/2023] [Indexed: 05/31/2023] Open
Abstract
•This study examines heavy episodic drinking across age, gender, and sexual identity.•Gay/lesbian and bisexual females experience persistent disparities across age.•Gay and bisexual males experience age specific disparities.•Sexual minority adults in the US report complex patterns of heavy alcohol use.•Heavy drinking disparities do not mirror patterns of alcohol use disorders.
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Affiliation(s)
- Patrick Janulis
- Department of Medical Social Sciences, Northwestern University, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, USA
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22
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Nielsen A, Azra KK, Kim C, Dusing GJ, Chum A. Is the association between sexual minority status and suicide-related behaviours modified by rurality? A discrete-time survival analysis using longitudinal health administrative data. Soc Sci Med 2023; 325:115896. [PMID: 37084702 DOI: 10.1016/j.socscimed.2023.115896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/08/2023] [Accepted: 04/06/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND While self-reported data shows that lesbian, gay, and bisexual (LBG) individuals have a greater suicide-related behaviours (SRB) risk, little is known about how rurality may amplify SRB risk associated with sexual minority status. Sexual minority individuals in rural areas may experience unique stressors due to stigma and a lack of LGB-specific social and mental health services. Using a population-representative sample linked to clinical SRB outcomes, we examined whether rurality modifies the association between sexual minority status and SRB risk. METHODS A nationally representative survey linked to administrative health data was used to construct a cohort of individuals (unweighted n = 169,091; weighted n = 8,778,115) in Ontario, Canada, and captured all SRB-related emergency department visits, hospitalizations, and deaths between 2007 and 2017. Sex-stratified discrete-time survival analyses were used to examine interactions between rurality and sexual minority status on SRB risk while controlling for potential confounders. RESULTS Sexual minority men had 2.18 times higher SRB odds compared to their heterosexual counterparts (95%CI 1.21-3.91), while sexual minority women had 2.07 times higher odds (95%CI 1.48-2.89) after adjusting for the confounders. The Rurality Index of Ontario and the Index of Remoteness were associated with the odds of SRB in a dose-response manner. No significant interactions were observed between rural and sexual minority status. CONCLUSIONS Our study provides evidence that rural and sexual minority status both independently contribute to an elevated likelihood of SRB; however, rurality did not appear to modify SRB risk by sexual orientation. Implementation and evaluation of interventions to reduce SRB in both rural and sexual minority populations are required.
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Affiliation(s)
- Andrew Nielsen
- Canadian Institute for Health Information, 4110 Yonge St Suite 300, North York, ON M2P 2B7, Canada
| | - Karanpreet Kaur Azra
- Ontario Shores Centre for Mental Health Sciences, 700 Gordon St, Whitby, Ontario, L1N 5S9, Canada
| | - Chungah Kim
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada
| | - Gabriel John Dusing
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada
| | - Antony Chum
- School of Kinesiology and Health Science, York University, 4700 Keele St, Toronto, Ontario, M3J 1P3, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M7, Canada; Unity Health Toronto, MAP Centre for Urban Health Solutions, 209 Victoria Street, 3rd floor, Toronto, Ontario, M5B 1T8, Canada.
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McCurdy AL, Gower AL, Rider GN, Thomas D, Watson RJ, Eisenberg ME, Russell ST. Adolescent substance use at the intersections of foster care, sexual orientation and gender identity, racial/ethnic identity, and sex assigned at birth. CHILD ABUSE & NEGLECT 2023; 137:106042. [PMID: 36706614 PMCID: PMC10695276 DOI: 10.1016/j.chiabu.2023.106042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 01/04/2023] [Accepted: 01/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) youth are overrepresented in foster care and report greater substance use during adolescence. OBJECTIVE Using an intersectional lens, the current study investigates differences in foster care placement and variation in substance use at the intersections of foster care and sexual orientation, gender identity, racial/ethnic identities, and sex assigned at birth. PARTICIPANTS AND SETTINGS A sample of 121,910 LGBTQ youth (grades 6-12) completed either the Minnesota Student Survey in 2019, the California Healthy Kids Survey from 2017 to 2019, or the 2017 LGBTQ National Teen Study. METHODS Youth reported their substance use in the past 30 days (alcohol, binge drinking, cigarette, marijuana), social positions (sexual orientation, gender identity, racial/ethnic identities, sex assigned at birth), living arrangement (foster care or not), and grade in school. Logistic regression was used to examine the main and interaction effects of foster care and social positions on youth substance use. RESULTS Results indicated significant differences in substance use at the intersection of foster care placement and youth social positions. Significant two-way interactions for foster care placement and social positions emerged predicting alcohol, binge drinking, and marijuana use. CONCLUSIONS Findings show that LGBTQ youth in foster care are at higher risk for substance use than those not in foster care. Particular support is needed for lesbian, gay, and questioning youth, transgender youth, LGBTQ youth assigned male at birth, and Asian or Pacific Islander LGBTQ youth in foster care.
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Affiliation(s)
- Amy L McCurdy
- Department of Human Development and Family Sciences, University of Texas, 108 Dean Keeton St, Austin, TX 78712, USA.
| | - Amy L Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, USA.
| | - G Nic Rider
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, 1300 S 2nd St., Ste. 180, Minneapolis, MN 55454, USA.
| | - De'Shay Thomas
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, USA.
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd U1058, Storrs, CT 06269, USA.
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, USA.
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas, 108 Dean Keeton St, Austin, TX 78712, USA.
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24
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Tsuyuki K, Chan E, Lucea MB, Cimino A, Rudolph AE, Tesfai Y, Campbell JC, Catabay CJ, Stockman JK. Characterising a syndemic among black women at risk for HIV: the role of sociostructural inequity and adverse childhood experiences. Sex Transm Infect 2023; 99:7-13. [PMID: 35595503 PMCID: PMC9887352 DOI: 10.1136/sextrans-2021-055224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/13/2022] [Indexed: 02/03/2023] Open
Abstract
Objectives Black women disproportionately experience STIs (including HIV/AIDS), gender-based violence, substance misuse and mental health conditions. Addressing a gap in syndemic research, we characterised comorbidity overlap within the context of sociostructural inequities and adverse childhood experiences (ACEs) among black women in Baltimore, Maryland. Methods Between 2015 and 2018, black women (n=305) were recruited from STI clinics in Baltimore, Maryland. Among those with complete survey data (n=230), we conducted a latent class analysis to differentiate women based on their profile of the following syndemic comorbidities: STIs, adult sexual victimisation, substance misuse and mental health disorders. We then examined the association between ACEs and syndemic latent class membership. Results Thirty-three percent of women experienced three to nine ACEs before age 18 years, and 44% reported four to six comorbidities. The two-class latent class solution demonstrated the best fit model, and women were categorised in either class 1 (past-year STI; 59%) or class 2 (syndemic comorbidities; 41%). Women in class 2 were more likely to report unstable housing (10% vs 3%) and identify as bisexual/gay (22% vs 10%) than women in class 1. ACEs were significantly associated with an increased likelihood of class 2 membership. Conclusions This study reinforces the importance of screening for ACEs and offering trauma-informed, integrated care for black women with syndemic comorbidities. It also highlights the critical nature of tailoring interventions to improve sociostructural equity, preventing and reducing syndemic development.
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Affiliation(s)
- Kiyomi Tsuyuki
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Erica Chan
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | | | - Andrea Cimino
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Abby E Rudolph
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Yordanos Tesfai
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | | | - Christina J Catabay
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Jamila K Stockman
- Department of Medicine, University of California San Diego, La Jolla, California, USA
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Kler S, Shepherd BF, Renteria R. Community Connectedness as a Moderator of the Association between Intersectional Microaggressions and Alcohol Use among Sexual and Gender Minoritized People of Color. Subst Use Misuse 2023; 58:129-138. [PMID: 36440902 DOI: 10.1080/10826084.2022.2149246] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: Researchers have documented associations between discrete conceptualizations of microaggressions (e.g., sexual identity, gender identity, and racial identity microaggressions) and alcohol use among sexual and gender minoritized people of color (SGM-POC). However, little is known about the association between intersectional microaggressions and alcohol use among SGM-POC. Moreover, protective factors such as community connectedness have been examined via similar discrete conceptualizations instead of examining SGM-POC community connectedness with other SGM-POC individuals. Objectives: The purpose of this study was to explore the association between intersectional microaggressions and alcohol use among SGM-POC and test whether different types of community connectedness moderated this association. Methods: Cross-sectional data were collected from a sample of 267 SGM-POC individuals. Four moderation analyses were done to analyze whether different types of community connectedness (sexual identity, racial identity, gender identity, and SGM-POC identity community connectedness) were moderators of the association of intersectional microaggressions and alcohol use. Results: Intersectional microaggressions were significantly positively correlated with alcohol use. Furthermore, SGM-POC community connectedness moderated this association such that the association was stronger for individuals with higher levels of SGM-POC community connectedness, but not lower levels of SGM-POC community connectedness. Conclusions: These findings showcase the importance of assessing for intersectional microaggressions as a risk factor for alcohol use. Similarly, the findings suggest that SGM-POC community connectedness may be a protective factor against alcohol use for SGM-POC.
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Affiliation(s)
- Satveer Kler
- Southern Illinois University, Carbondale, IL, USA
| | - Benjamin F Shepherd
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Roberto Renteria
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
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26
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Paschen-Wolff MM, Kidd JD, Paine EA. The State of the Research on Opioid Outcomes Among Lesbian, Gay, Bisexual, Transgender, Queer, and Other Sexuality- and Gender-Diverse Populations: A Scoping Review. LGBT Health 2023; 10:1-17. [PMID: 36318023 PMCID: PMC10081720 DOI: 10.1089/lgbt.2022.0036] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: Research on opioid misuse, opioid use disorder (OUD), and overdose (i.e., opioid outcomes) among lesbian, gay, bisexual, transgender, queer, and other populations within the LGBTQ umbrella (LGBTQ+) remains sparse. The purpose of this scoping review was to characterize the state of the research on opioid outcomes among LGBTQ+ populations, and identify gaps in the extant literature and areas for future research. Methods: We conducted a scoping review of peer-reviewed, English language articles published between 2011 and 2020 that examined opioid outcomes among LGBTQ+ populations in the CINAHL, Embase, PubMed, and PsycINFO databases. We extracted data from articles that focused on opioid outcomes within their specific aims or purpose. We include a general summary for articles that secondarily described opioid outcomes among LGBTQ+ populations. Results: Of 113 published studies that examined opioid outcomes among LGBTQ+ populations, 10% (n = 11) were specifically designed to focus on this topic. Across studies, bisexual populations, particularly women, were at highest risk for opioid misuse and OUD. Few studies examined opioid outcomes by more than one dimension of sexual orientation (n = 3, 27%), race and/or ethnicity (n = 3, 27%), or age (n = 5, 45%). Only two included transgender or gender diverse samples; only one explicitly measured gender identity. Conclusions: Future research is needed to understand the impact of the opioid epidemic on LGBTQ+ people, particularly transgender and other gender diverse individuals, and the intersectional role of race, ethnicity, and age in opioid disparities among LGBTQ+ individuals. Additional research could contribute to the development of much-needed affirming OUD treatment and other services for LGBTQ+ people.
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Affiliation(s)
- Margaret M Paschen-Wolff
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center at New York State Psychiatric Institute, New York, New York, USA
| | - Jeremy D Kidd
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center at New York State Psychiatric Institute, New York, New York, USA
| | - Emily Allen Paine
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York, New York, USA
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27
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Dyar C. A Review of Disparities in Cannabis Use and Cannabis Use Disorder Affecting Sexual and Gender Minority Populations and Evidence for Contributing Factors. CURRENT ADDICTION REPORTS 2022; 9:589-597. [PMID: 37637872 PMCID: PMC10449003 DOI: 10.1007/s40429-022-00452-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2022] [Indexed: 11/08/2022]
Abstract
Purpose of Review Sexual and gender minorities (SGM) appear to be at elevated risk for cannabis use (CU) and cannabis use disorder (CUD) compared to cisgender heterosexuals. However, risk factors remain understudied among SGM. This review aims to summarize evidence for disparities in CU and CUD affecting SGM and factors contributing to these disparities. Recent Findings We found strong evidence that sexual minorities are at elevated risk for CU and CUD is elevated for sexual minority women. Evidence supports a concurrent association between minority stress and CUD symptoms. There is robust support for coping motives as a mechanism linking minority stress to subsequent CU and CUD. Studies also point to CU norms and contexts as potential risk factors. Summary SGM are at high risk for CU and CUD, and minority stress, CU norms, and contextual factors are implicated. Additional research is needed on CU among gender minorities, prospective effects of risk factors, and interventions for SGM.
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Kline NS, Griner SB, Neelamegam M, Webb NJ, Morales JJ, Rhodes SD. Responding to "Don't Say Gay" Laws in the US: Research Priorities and Considerations for Health Equity. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 19:1397-1402. [PMID: 36406660 PMCID: PMC9666954 DOI: 10.1007/s13178-022-00773-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Despite increased legal rights for lesbian, gay, bisexual, transgender, and queer-identifying (LGBTQ +) people in the USA over the past 30 years, there has been an increasing number of anti-LGBTQ + laws proposed and passed at the state level. One of the most notorious laws, Florida's HB 1557, also known as the "Don't Say Gay" law, garnered substantial national attention for prohibiting discussions of sexual orientation or gender identity in public school classrooms. Other states quickly proposed similar laws, but little scholarship exists on the potential impacts of these laws. METHODS We explore the potential health equity ramifications of laws like Florida's HB 1557, focusing on the individual, interpersonal, and broader policy and practice implications. Examining these policies through the lens of political determinants of health, we identify theoretical and methodological approaches needed to address recent "Don't Say Gay" policies. RESULTS Theoretical approaches emphasizing power, intersectionality, and the role of politics in health should guide research examining the impacts of recent anti-LGBTQ + policies. Laws like Florida's HB 1557 emphasize the need for methodological approaches that emphasize collaborative engagement between researchers and community members, and future research may be needed to understand how stressors created by law and policy can have individual and interpersonal consequences. CONCLUSIONS Public health researchers have a role to play in reversing policies that negatively affect LGBTQ + individuals and undermine health equity. Research combating harmful policies may require theoretical approaches attentive to power differences and methodological approaches that squarely focus on disrupting power imbalances.
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Affiliation(s)
- Nolan S. Kline
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107 USA
| | - Stacey B. Griner
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107 USA
| | - Malinee Neelamegam
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107 USA
| | - Nathaniel J. Webb
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107 USA
| | | | - Scott D. Rhodes
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27101 USA
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Mattelin E, Fröberg F, Korhonen L, Khanolkar AR. Health and health-related behaviours in refugees and migrants who self-identify as sexual or gender minority - A National population-based study in Sweden. EClinicalMedicine 2022; 52:101641. [PMID: 36313143 PMCID: PMC9596319 DOI: 10.1016/j.eclinm.2022.101641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND To examine health and health-related behaviors in migrant and refugee individuals who identify as sexual or gender minority, and in comparison to their heterosexual peers. METHODS The study included 168,952 individuals (aged 16-84 years, males: 45·9%, sexual or gender minorities: 3·1%) who answered the Swedish National Public Health Survey in 2018 and 2020. Participants were grouped into Swedish-and Western-born (White) heterosexual, White sexual- or gender minority, migrant heterosexual, migrant sexual- or gender minority, refugee heterosexual, and refugee sexual- or gender minority. Outcomes included mental health (for example suicidal ideation, wellbeing), general health, risky behaviors (risk alcohol use, risk gambling, and substance use), and experiences of violence. Associations between 1) sexual- or gender -ethnic identities and 2) gender-ethnic identities and all outcomes were analyzed using logistic and linear regression adjusting for sex, age, and educational level. FINDINGS Being a sexual- or gender minority, regardless of ethnic minority status, was associated with worse general health and mental ill-health compared to heterosexual peers including suicidal ideation in refugee sexual- or gender minority individuals (OR 2·42, 95 % CI 1·44-4·08). Ethnic minorities (heterosexual and sexual- or gender minority migrants and refugees) had lower odds of drug and risk alcohol use compared to White heterosexual peers but higher odds of risk gambling (1·88, 1·49-2·37 for refugee heterosexuals). Transgender refugees had high odds for risk gambling (8·62, 1·94-38·40) and exposure to physical violence (7·46, 2·97-18·70). INTERPRETATION In this national population-based study, sexual and gender minority individuals have worse mental and general health regardless of ethnic minority status. We did not find evidence for worse health in sexual- or gender minority refugees in comparison to migrant, and White sexual- or gender minorities and their heterosexual peers. Transgender individuals (White and ethnic minority) experienced significantly higher levels of physical violence. Public health policy should emphasize preventive measures to reduce exposure to violence and discrimination in sexual- and gender minority individuals, increase access and use of mental healthcare services and sensitise healthcare professionals about higher rates of health and related issues faced by sexual- and gender minority individuals including those with multiple minority identities. FUNDING We received no external funding for this study and hence the funder had no role in the study design, data collection, data analysis, data interpretation, writing of the manuscript and the decision to submit.
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Affiliation(s)
- Erica Mattelin
- Barnafrid, Swedish National Center on Violence Against Children, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Corresponding author.
| | - Frida Fröberg
- Barnafrid, Swedish National Center on Violence Against Children, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Laura Korhonen
- Barnafrid, Swedish National Center on Violence Against Children, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Amal R. Khanolkar
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Population Health Sciences, School of Life Course & Population Sciences, King's College London, London, United Kingdom
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Mauro PM, Philbin MM, Greene ER, Diaz JE, Askari MS, Martins SS. Daily cannabis use, cannabis use disorder, and any medical cannabis use among US adults: Associations within racial, ethnic, and sexual minoritized identities in a changing policy context. Prev Med Rep 2022; 28:101822. [PMID: 35620050 PMCID: PMC9127402 DOI: 10.1016/j.pmedr.2022.101822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 11/05/2022] Open
Abstract
Daily cannabis use, disorder, and medical use were higher among sexual minoritized adults. Magnitudes of association were comparable across racial and ethnic subgroups. Associations with cross-sectional MCL status differed by racial, ethnic, and sexual minoritized subgroup. Cannabis outcome prevalences were generally higher in states with MCLs.
Differences in cannabis use patterns among racial, ethnic and sexual minoritized identity subgroups have been attributed to marginalized identity stressors. However, associations at the intersection of these minoritized identities remain underexplored in a changing medical cannabis law (MCL) context. We estimated medical cannabis and daily cannabis use, and cannabis use disorder (CUD) by intersecting racial, ethnic and sexual minoritized identity subgroups. We included 189,800 adults in the 2015–2019 National Survey on Drug Use and Health identifying as non-Hispanic white, non-Hispanic Black, or Hispanic and self-reported heterosexual, gay/lesbian, or bisexual sexual identity. We estimated the adjusted odds of past-year: (a) any medical cannabis, (b) daily cannabis use (i.e., 300 + days/year), and (c) DSM-5-proxy CUD by sexual identity, stratified by race and ethnicity. Cannabis measures were higher among sexual minoritized groups than heterosexual adults across racial and ethnic subgroups. Bisexual adults had higher odds of any medical cannabis use than their heterosexual counterparts: non-Hispanic white (6.4% vs. 1.8%; aOR = 2.6, 95% CI = [2.5–3.5]), non-Hispanic Black (4.1% vs. 1.7%; aOR = 2.7, 95% CI = [1.6–4.5]), and Hispanic adults (5.3% vs. 1.8 %; aOR = 2.6, 95% CI = [1.9–3.3]). We found heterogeneous associations with state MCL status across subgroups stratified by race and ethnicity. Bisexual adults in MCL states had higher odds of any medical cannabis use among non-Hispanic white (aOR = 2.0, 95% CI = [1.4–2.9]) and Hispanic (aOR = 3.6, 95% CI = [1.2–10.2]) adults compared to their non-MCL counterparts, but this was marginal among non-Hispanic Black bisexual adults (aOR = 1.6, 95% CI = [1.0–2.6]). Studies should assess intended and unintended cannabis policy effects among racial, ethnic, and sexual identity subgroups.
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Harper LA, Beck KC, Drazdowski TK, Li C. Sex and Sexual Identity Differences in Poly-tobacco Use and Psychological Distress in U.S. Adults: Results From the National Health Interview Survey. Nicotine Tob Res 2022; 25:19-27. [PMID: 35894290 PMCID: PMC9717376 DOI: 10.1093/ntr/ntac180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 05/31/2022] [Accepted: 07/21/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Poly-tobacco use (PTU), or the concomitant use of two or more nicotine and tobacco products, are a growing public health concern. Adults reporting increased psychological distress (PD) experience profound nicotine and tobacco health-related disparities. Sexual minority (SM) adults report more PTU and higher levels of PD than heterosexuals, yet little is known about patterns of nicotine and tobacco use and its relationship to PD in SM populations. AIMS AND METHODS The purpose of this study was to investigate sexual identity differences in PD and PTU. Data were drawn from the 2016-2018 National Health Interview Survey (N = 83 017), an annual cross-sectional survey of a nationally representative sample of U.S. adults. PD was assessed using the Kessler Psychological Distress Scale (K6). We fit sex-stratified, weighted, adjusted logistic models to compare PTU and PD by sexual identity. RESULTS PTU was more prevalent in adults with higher K6 scores. Female adults and SM adults had significantly higher K6 scores and were significantly more likely to experience serious PD when compared to their male and heterosexual counterparts. CONCLUSIONS The current study provides a snapshot of trends in PTU in relation to PD, gender, and sexual identity. Findings suggest higher rates of both PD and PTU in SM adults. Further research examining the mechanisms underlying this disparity is critical to the development of effective intervention and prevention strategies. IMPLICATIONS Little is known about sex and sexual identity differences in the relations between patterns of tobacco product use and PD. This study is the first to examine the effect of gender and sexual identity on both PD and PTU. SMs reported higher rates of PD and were more likely to be poly-tobacco users. As new ways of engaging nicotine/tobacco continue to proliferate, health risks will endure especially for marginalized populations. An increased understanding of the psychological and social correlates of PTU in SMs is warranted.
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Affiliation(s)
- Leia A Harper
- Corresponding Author: Leia A. Harper, PhD, Department of Psychology, Reed College, 3203 SE Woodstock Blvd., Portland, OR 97202, USA. E-mail:
| | - Kira C Beck
- Department of Psychology, Reed College, Portland, OR, USA
| | | | - Christina Li
- Department of Psychology, Reed College, Portland, OR, USA
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Drabble LA, Munroe C, Mericle AA, Zollweg S, Trocki KF, Karriker-Jaffe KJ. Impact of the policy environment on substance use among sexual minority women. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 3. [PMID: 35813352 PMCID: PMC9262325 DOI: 10.1016/j.dadr.2022.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Sexual minority women (SMW) are at greater risk for heavy episodic drinking, frequent marijuana use, and tobacco use than heterosexual women. Because past research has suggested the political and social environment may influence disparities in substance use by sexual orientation, this study examined associations of the U.S. state-level policy environment on substance use by SMW. Methods: A total of 732 SMW participants were recruited from two national online panels: a general population panel (n = 333) and a sexual minority-specific panel (n = 399). Past year substance use was defined by number of days of heavy episodic drinking (HED; 4+ drinks in a day), weekly tobacco use (once a week or more vs. less or none), and weekly marijuana use (once a week or more vs. less or none). Comprehensive state policy protection was defined by enactment of five policies protecting rights of sexual minorities. Regression models compared substance use outcomes for SMW living in states with comprehensive policy protections to SMW living in states with fewer or no protections. Models also assessed the impact of state policies related to alcohol (state monopoly on alcohol wholesale or retail sales), tobacco (state enactment of comprehensive smoke-free workplace laws) and marijuana (legalization of purchase, possession, or consumption of marijuana for recreational use). Results: Comprehensive policy protections were associated with fewer HED days. Recreational marijuana legalization was associated with higher odds of weekly use. Conclusions: Findings underscore the importance of policy protections for sexual minorities in reducing substance use, particularly HED, among SMW.
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Affiliation(s)
- Laurie A. Drabble
- San Jose State University College of Health and Human Sciences, San Jose, CA, USA
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
- Corresponding author.
| | - Cat Munroe
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Amy A. Mericle
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | | | - Karen F. Trocki
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
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Bhugra D, Killaspy H, Kar A, Levin S, Chumakov E, Rogoza D, Harvey C, Bagga H, Owino-Wamari Y, Everall I, Bishop A, Javate KR, Westmore I, Ahuja A, Torales J, Rubin H, Castaldelli-Maia J, Ng R, Nakajima GA, Levounis P, Ventriglio A. IRP commission: sexual minorities and mental health: global perspectives. Int Rev Psychiatry 2022; 34:171-199. [PMID: 36151836 DOI: 10.1080/09540261.2022.2045912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Sexual orientation is a key determinant of the identity of human beings. It has also been seen as a social determinant of health. People whose sexual orientation is non-heterosexual or sexual minorities or sexually diverse are included in the broad umbrella term LGBT (Lesbian, Gay, Bisexual, and Transgender) which is a commonly used acronym in activism, social policy, and subsequently cultural literature. For this reason, this Commission focuses primarily on sexual orientation i.e. lesbian, gay and bisexual (LGB) groups. We have used terms non-heterosexual, sexual minorities or sexual variation interchangeably. We have not considered asexual individuals as research in the field is too limited. We are cognisant of the fact that topics relating to mental health and sexual orientation discussed in this Commission will intersect with other issues of personal, cultural and social identity, and will thus be relevant to individuals including many transgender individuals. The inclusion of mental health issues relevant to gender-diverse individuals as well as gender identity is important and deserves its own separate detailed discussion. The exact number of sexually diverse individuals in a population is often difficult to estimate but is likely to be somewhere around 5% of the population. Rates of various psychiatry disorders and suicidal ideation and acts of suicide in LGB populations are higher than general population and these have been attributed to minority stress hypothesis. Elimination of inequality in law can lead to reduction in psychiatric morbidity in these groups. However, these are all diverse groups but even within each group there is diversity and each individual has a distinct and unique experiences, upbringing, responses to their own sexual orientation, and generating varying responses from families, peers and friends as well as communities (including healthcare professionals). The mental healthcare needs of sexual minority individuals vary and these variations must be taken into account in design, development and delivery of healthcare and policies. Improving access to services will help engagement and outcomes and also reduce stigma. The commission recommends that there is no role for so-called conversion therapies and other recommendations are made for clinicians, researchers and policymakers.
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Affiliation(s)
- Dinesh Bhugra
- Emeritus Mental Health & Cultural Diversity, PO72, Centre for Affective Disorders, Institute of Psychiatry, Kings College, London, UK
| | - Helen Killaspy
- Rehabilitation Psychiatry, University College, London, UK
| | - Anindya Kar
- Advanced Neuropsychiatry Institute, Kolkata, India
| | - Saul Levin
- Chief Executive and Medical Director, American Psychiatric Association, Washington, DC, USA
| | - Egor Chumakov
- Department of Psychiatry, St Petersburg State University, St Petersburg, Russia
| | - Daniel Rogoza
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Carol Harvey
- Department of Psychiatry, University of Melbourne and North Western Mental Health, Melbourne, Australia
| | | | | | - Ian Everall
- Institute of Psychiatry, Kings College, London, UK
| | - Amie Bishop
- OutRight Action International, Seattle, WA, USA
| | | | - Ian Westmore
- South African Society of Psychiatrists, Bloemfonten, South Africa
| | - Amir Ahuja
- Los Angeles LGBT Center, AGLP: The Association of LGBTQ Psychiatrists, Los Angeles, CA, USA
| | - Julio Torales
- Department of Psychiatry, National University of Asunción, San Lorenzo, Paraguay
| | - Howard Rubin
- Department of Psychiatry, UCSF School of Medicine, San Francisco, CA, USA
| | - Joao Castaldelli-Maia
- Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil.,Columbia University, New York, NY, USA
| | - Roger Ng
- Alpha Clinic, Central, Hong Kong, China
| | | | - Petros Levounis
- Department of Psychiatry, Rutgers New Jersey Medical School, Newark, NJ, USA
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Impulsivity, Binegativity, Drinking to Cope, and Alcohol-related Behaviors: A Moderated Mediation Model Among Bisexual Women. SEX ROLES 2022. [DOI: 10.1007/s11199-022-01283-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dunbar MS, Siconolfi D, Rodriguez A, Seelam R, Davis JP, Tucker JS, D’Amico EJ. Alcohol and Cannabis Use Trajectories and Outcomes in a Sample of Hispanic, White, and Asian Sexual and Gender Minority Emerging Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042059. [PMID: 35206249 PMCID: PMC8871829 DOI: 10.3390/ijerph19042059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 02/05/2023]
Abstract
Substance use disproportionately affects health and psychosocial outcomes for some racial/ethnic groups, but few longitudinal studies examine the extent to which sexual and gender minority (SGM) emerging adults of different racial/ethnic groups may experience disparities in outcomes at similar levels of alcohol or cannabis use. This study used five waves of annual survey data (spanning 2015 (average age 18) to 2020 (average age 23)) from an ongoing longitudinal cohort study of emerging adults. In the subset of 359 SGM emerging adults, separate sequelae of change models assessed differences in trajectories of alcohol or cannabis use (past 30-day frequency) and multiple health and psychosocial outcomes across Hispanic, Asian, and White individuals. White SGM emerging adults showed higher baseline levels of alcohol and cannabis frequency compared to Hispanic and Asian peers, but all groups showed similar rates of change (slope) over time. We observed few racial/ethnic differences in SGM emerging adult outcomes at the same levels of alcohol or cannabis use; that is, racial/ethnic groups showed similar patterns on most health and psychosocial outcomes; however, some differences emerged. For example, Asian respondents reported less engagement in sex with casual partners after using alcohol, marijuana, or other drugs compared to their White peers, at the same levels of alcohol use (β = −0.579, p = 0.03) or cannabis use (β = −0.737, p = 0.007). Findings underscore a need to consider multiple outcome domains and factors beyond additive stress in examining the effects of substance use across different groups of SGM individuals. More longitudinal studies with large, contemporary, and diverse samples of SGM emerging adults are needed to better characterize similarities and differences in patterns of substance use and use-related consequences in relation to intersecting SGM, racial/ethnic, and other identities.
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Affiliation(s)
- Michael S. Dunbar
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA;
- Correspondence:
| | - Daniel Siconolfi
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA;
| | | | - Rachana Seelam
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA; (R.S.); (J.S.T.); (E.J.D.)
| | - Jordan P. Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34th Street, Los Angeles, CA 90089, USA;
| | - Joan S. Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA; (R.S.); (J.S.T.); (E.J.D.)
| | - Elizabeth J. D’Amico
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA; (R.S.); (J.S.T.); (E.J.D.)
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Kidd JD, Paschen-Wolff MM, Mericle AA, Caceres BA, Drabble LA, Hughes TL. A scoping review of alcohol, tobacco, and other drug use treatment interventions for sexual and gender minority populations. J Subst Abuse Treat 2022; 133:108539. [PMID: 34175174 PMCID: PMC8674383 DOI: 10.1016/j.jsat.2021.108539] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/28/2021] [Accepted: 06/02/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Alcohol, tobacco, and other drug use are among the most prevalent and important health disparities affecting sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, transgender) populations. Although numerous government agencies and health experts have called for substance use intervention studies to address these disparities, such studies continue to be relatively rare. METHOD We conducted a scoping review of prevention and drug treatment intervention studies for alcohol, tobacco, and other drug use that were conducted with SGM adults. We searched three databases to identify pertinent English-language, peer-reviewed articles published between 1985 and 2019. RESULTS Our search yielded 71 articles. The majority focused on sexual minority men and studied individual or group psychotherapies for alcohol, tobacco, or methamphetamine use. CONCLUSION Our findings highlight the need for intervention research focused on sexual minority women and gender minority individuals and on cannabis and opioid use. There is also a need for more research that evaluates dyadic, population-level, and medication interventions.
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Affiliation(s)
- Jeremy D Kidd
- Columbia University Irving Medical Center, 622 W. 168th Street, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Margaret M Paschen-Wolff
- Columbia University Irving Medical Center, 622 W. 168th Street, New York, NY 10032, USA; New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Amy A Mericle
- Alcohol Research Group at the Public Health Institute, 6001 Shellmound Street, Suite 450, Emeryville, CA 94608, USA.
| | - Billy A Caceres
- Columbia University School of Nursing, 560 W. 168th Street, New York, NY 10032, USA.
| | - Laurie A Drabble
- San Jose State University, College of Health and Human Sciences, One Washington Square, San Jose, CA 95191, USA.
| | - Tonda L Hughes
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA; Columbia University School of Nursing, 560 W. 168th Street, New York, NY 10032, USA.
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Ledingham E, Adams RS, Heaphy D, Duarte A, Reif S. Perspectives of adults with disabilities and opioid misuse: Qualitative findings illuminating experiences with stigma and substance use treatment. Disabil Health J 2022; 15:101292. [DOI: 10.1016/j.dhjo.2022.101292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 01/16/2023]
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Daily Marijuana Use Predicts HIV Seroconversion Among Black Men Who Have Sex with Men and Transgender Women in Atlanta, GA. AIDS Behav 2022; 26:2503-2515. [PMID: 35094179 DOI: 10.1007/s10461-022-03598-5] [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: 01/20/2022] [Indexed: 11/01/2022]
Abstract
We evaluated whether different types of substance use predicted HIV seroconversion among a cohort of 449 Black men who have sex with men (MSM) and transgender women (TGW). A community-based sample was recruited in Atlanta, GA between December 2012 and November 2014. Participants completed a survey and were tested for STIs (Chlamydia and gonorrhoeae using urine samples and rectal swabs) at baseline. HIV testing was conducted at 12-months post enrollment. Multivariable binary logistic regression was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CI) for associations between substance use and HIV seroconversion. By 12-month follow-up, 5.3% (n = 24) of participants seroconverted. In multivariable analyses, daily marijuana use was positively associated with HIV seroconversion (aOR 3.07, 95% CI 1.11-8.48, P = 0.030). HIV incidence was high and daily marijuana use was associated with a more than threefold increased odds of HIV seroconversion among a community-based cohort of Black MSM and TGW.
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Sönmez İ, Palamar JJ. Sexual Orientation and Age of First Drug Use Among Adults in the United States. Subst Use Misuse 2022; 57:1313-1321. [PMID: 35614545 PMCID: PMC9202448 DOI: 10.1080/10826084.2022.2079138] [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: 10/18/2022]
Abstract
BACKGROUND Early onset of drug use could lead to long-term impairments, and research suggests that substance use and substance use disorders are more common among lesbian, gay, and bisexual (LGB) individuals. We sought to determine whether adults of different sexual identities were at differential risk for an earlier onset of drug use. METHODS We examined data from adults participating in the five waves (2015-2019) of the National Survey on Drug Use and Health, a nationally representative sample of noninstitutionalized adults in the United States. We determined whether current sexual identity was associated with retrospectively reported age of the first use of marijuana, cocaine, inhalants, ecstasy, and methamphetamine. RESULTS Compared to heterosexual individuals of the same sex, gay men had a later age of onset of use of all five drugs examined (marijuana, cocaine, inhalants, ecstasy, and methamphetamine) and bisexual men had a later onset of marijuana and inhalant use. Bisexual women had earlier age of onset for marijuana, cocaine, and ecstasy use. When examining early initiation (prior to age 15), both lesbian and bisexual women had greater odds of early initiation for marijuana, cocaine, and ecstasy; bisexual men had greater odds of early initiation for cocaine. Gay men had lower odds of initiation prior to age 15 for marijuana, inhalants, and methamphetamine. CONCLUSIONS Current sexual identity is a correlate of earlier onset drug use. Longitudinal research is needed to further examine such associations as sexual identity can shift over time. Results are discussed in relation to prevention efforts aiming younger LGB persons.
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Affiliation(s)
- İbrahim Sönmez
- Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Hinds Z, Herbitter C, Bryant WT, Newberger NG, Livingston NA. Hazardous Substance Use Among Sexual and Gender Minority Adults: A Deeper Look into Distal Minority Stressors. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2022; 10:10.1037/sgd0000583. [PMID: 37885566 PMCID: PMC10601395 DOI: 10.1037/sgd0000583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Discrimination and victimization drive health disparities among sexual and gender minority (SGM) individuals, yet little is known about the relative impacts of specific experience types on hazardous substance use. Using data from 704 SGM adults, we examined SGM-related discrimination vs. victimization and specific experiences as predictors of hazardous substance use. SGM-related victimization, not discrimination, predicted hazardous substance use, and SGM-related sexual assault and harassment predicted hazardous alcohol use, although only sexual assault predicted hazardous drug use. These findings implicate lifetime SGM-related victimization, and SGM-related sexual assault and harassment specifically, as key correlates of recent hazardous substance use among SGM adults.
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Affiliation(s)
- Zig Hinds
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
| | - Cara Herbitter
- VA Boston Healthcare System, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | - William T. Bryant
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
- Medical University of South Carolina, Charleston, SC, USA
| | - Noam G. Newberger
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
| | - Nicholas A. Livingston
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
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Schuler MS, Collins RL, Ramchand R. Disparities in Use/Misuse of Specific Illicit and Prescription Drugs among Sexual Minority Adults in a National Sample. Subst Use Misuse 2022; 57:461-471. [PMID: 35067155 DOI: 10.1080/10826084.2021.2019776] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background: Compared to heterosexual adults, lesbian, gay, and bisexual (LGB) adults have higher rates of any illicit drug use and any prescription drug misuse, yet disparities regarding specific drugs remain poorly characterized. Methods: We examined disparities by sexual identity and sex for 8 illicit and prescription drugs using 2015-2019 National Survey on Drug Use and Health data. Outcomes included past-year use/misuse of cocaine/crack, hallucinogens, inhalants, methamphetamine, heroin, prescription opioids, prescription stimulants, prescription tranquilizers/sedatives, and level of polydrug use/misuse (2 substances; 3+ substances). For each outcome, odds ratios relative to heterosexual adults of same sex were estimated using logistic regression controlling for demographics; significant estimates were interpreted as a disparity. Results: Among gay men, significant disparities were present for all drugs except prescription stimulants and heroin; inhalant use was particularly elevated. Bisexual women exhibited significant disparities for every drug examined, as did bisexual men (except heroin). Among lesbian/gay women, disparities were only present for prescription opioids and stimulants. Relative to heterosexual peers, use of 3+ substances was 3 times higher among gay men and bisexual women and 2 times higher among bisexual men. Conclusions: Consistent with minority stress theory, prevalences of illicit and prescription drug use/misuse were 2-3 times higher among LGB adults than heterosexual adults. Illicit drug use should not be perceived as only impacting gay/bisexual men - bisexual women had similar - or higher - prevalences of hallucinogen, cocaine, methamphetamine, and heroin use. Yet, in contrast to bisexual women, lesbian/gay women did not exhibit disparities for any illicit drugs.
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Akré ER, Anderson A, Stojanovski K, Chung KW, VanKim NA, Chae DH. Depression, Anxiety, and Alcohol Use Among LGBTQ+ People During the COVID-19 Pandemic. Am J Public Health 2021; 111:1610-1619. [PMID: 34410817 PMCID: PMC8589058 DOI: 10.2105/ajph.2021.306394] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 11/04/2022]
Abstract
Objectives. To describe disparities in depression, anxiety, and problem drinking by sexual orientation, sexual behavior, and gender identity during the COVID-19 pandemic. Methods. Data were collected May 21 to July 15, 2020, from 3245 adults living in 5 major US metropolitan areas (Atlanta, Georgia; Chicago, Illinois; New Orleans, Louisiana; New York, New York; and Los Angeles, California). Participants were characterized as cisgender straight or LGBTQ+ (i.e., lesbian, gay, bisexual, and transgender people, and men who have sex with men, and women who have sex with women not identifying as lesbian, gay, bisexual, or transgender). Results. Cisgender straight participants had the lowest levels of depression, anxiety, and problem drinking compared with all other sexual orientation, sexual behavior, and gender identity groups, and, in general, LGBTQ+ participants were more likely to report that these health problems were "more than usual" during the COVID-19 pandemic. Conclusions. LGBTQ+ communities experienced worse mental health and problem drinking than their cisgender straight counterparts during the COVID-19 pandemic. Future research should assess the impact of the pandemic on health inequities. Policymakers should consider resources to support LGBTQ+ mental health and substance use prevention in COVID-19 recovery efforts.
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Affiliation(s)
- Ellesse-Roselee Akré
- At the time of the study, E. R. Akré was a postdoctoral researcher at Vanderbilt University, Nashville, TN, and she completed the work while with Geisel School of Medicine at Dartmouth, the Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH. Andrew Anderson is with Tulane University, School of Public Health and Tropical Medicine, Department of Health Policy and Management, New Orleans, LA. Kristefer Stojanovski is with University of Michigan, School of Public Health, Department of Health Behavior and Health Education, Ann Arbor. Kara W. Chung and David H. Chae are with Tulane University, School of Public Health and Tropical Medicine, Department of Global Community Health and Behavioral Sciences. Nicole A. VanKim is with University of Massachusetts: Amherst, School of Public Health and Health Sciences, Department of Epidemiology
| | - Andrew Anderson
- At the time of the study, E. R. Akré was a postdoctoral researcher at Vanderbilt University, Nashville, TN, and she completed the work while with Geisel School of Medicine at Dartmouth, the Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH. Andrew Anderson is with Tulane University, School of Public Health and Tropical Medicine, Department of Health Policy and Management, New Orleans, LA. Kristefer Stojanovski is with University of Michigan, School of Public Health, Department of Health Behavior and Health Education, Ann Arbor. Kara W. Chung and David H. Chae are with Tulane University, School of Public Health and Tropical Medicine, Department of Global Community Health and Behavioral Sciences. Nicole A. VanKim is with University of Massachusetts: Amherst, School of Public Health and Health Sciences, Department of Epidemiology
| | - Kristefer Stojanovski
- At the time of the study, E. R. Akré was a postdoctoral researcher at Vanderbilt University, Nashville, TN, and she completed the work while with Geisel School of Medicine at Dartmouth, the Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH. Andrew Anderson is with Tulane University, School of Public Health and Tropical Medicine, Department of Health Policy and Management, New Orleans, LA. Kristefer Stojanovski is with University of Michigan, School of Public Health, Department of Health Behavior and Health Education, Ann Arbor. Kara W. Chung and David H. Chae are with Tulane University, School of Public Health and Tropical Medicine, Department of Global Community Health and Behavioral Sciences. Nicole A. VanKim is with University of Massachusetts: Amherst, School of Public Health and Health Sciences, Department of Epidemiology
| | - Kara W Chung
- At the time of the study, E. R. Akré was a postdoctoral researcher at Vanderbilt University, Nashville, TN, and she completed the work while with Geisel School of Medicine at Dartmouth, the Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH. Andrew Anderson is with Tulane University, School of Public Health and Tropical Medicine, Department of Health Policy and Management, New Orleans, LA. Kristefer Stojanovski is with University of Michigan, School of Public Health, Department of Health Behavior and Health Education, Ann Arbor. Kara W. Chung and David H. Chae are with Tulane University, School of Public Health and Tropical Medicine, Department of Global Community Health and Behavioral Sciences. Nicole A. VanKim is with University of Massachusetts: Amherst, School of Public Health and Health Sciences, Department of Epidemiology
| | - Nicole A VanKim
- At the time of the study, E. R. Akré was a postdoctoral researcher at Vanderbilt University, Nashville, TN, and she completed the work while with Geisel School of Medicine at Dartmouth, the Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH. Andrew Anderson is with Tulane University, School of Public Health and Tropical Medicine, Department of Health Policy and Management, New Orleans, LA. Kristefer Stojanovski is with University of Michigan, School of Public Health, Department of Health Behavior and Health Education, Ann Arbor. Kara W. Chung and David H. Chae are with Tulane University, School of Public Health and Tropical Medicine, Department of Global Community Health and Behavioral Sciences. Nicole A. VanKim is with University of Massachusetts: Amherst, School of Public Health and Health Sciences, Department of Epidemiology
| | - David H Chae
- At the time of the study, E. R. Akré was a postdoctoral researcher at Vanderbilt University, Nashville, TN, and she completed the work while with Geisel School of Medicine at Dartmouth, the Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH. Andrew Anderson is with Tulane University, School of Public Health and Tropical Medicine, Department of Health Policy and Management, New Orleans, LA. Kristefer Stojanovski is with University of Michigan, School of Public Health, Department of Health Behavior and Health Education, Ann Arbor. Kara W. Chung and David H. Chae are with Tulane University, School of Public Health and Tropical Medicine, Department of Global Community Health and Behavioral Sciences. Nicole A. VanKim is with University of Massachusetts: Amherst, School of Public Health and Health Sciences, Department of Epidemiology
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Kelly LM, Shepherd BF, Becker SJ. Elevated risk of substance use disorder and suicidal ideation among Black and Hispanic lesbian, gay, and bisexual adults. Drug Alcohol Depend 2021; 226:108848. [PMID: 34214885 PMCID: PMC8431829 DOI: 10.1016/j.drugalcdep.2021.108848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/04/2021] [Accepted: 05/13/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Black and Hispanic persons who identify as lesbian, gay, or bisexual (LGB) experience health disparities relative to non-Hispanic White and heterosexual groups respectively, including higher rates of suicidal ideation (SI) and substance use disorder (SUD). To elucidate intersectional risk, we used a large national sample to examine rates of SI, SUD, and their co-occurrence (SI + SUD) at the intersection of sexual identity and race/ethnicity. METHOD Data were from five years (2015-2019) of the National Survey of Drug Use and Heath (unweighted N = 189,127). Multinomial logistic regressions with persons without SI and SUD as references were stratified by gender and controlled for survey year, age, education, marital status, and income. RESULTS Compared to same-race and same-gender heterosexual adults, White, Black, and Hispanic LGB men and women showed higher odds of SI (AOR = 2.86-4.45), SUD (AOR = 1.23-3.01), and SI + SUD (AOR = 2.72-6.85). Compared to same-gender White heterosexual adults, Black and Latinx heterosexual men and women showed lower odds of SI (AORs = .54-.65), SUD (AORs = .52-.78) and SI + SUD (AORs = .41-.57). Compared to same-gender White LGB adults, Black and Hispanic women, but not men, showed lower SI odds (AORs = .58-.72). Compared to same-gender White heterosexual adults, Black and Hispanic LGB men and women showed higher odds of SI (AORs = 1.71-2.51) and SI + SUD (AORs = 1.91-2.97). CONCLUSIONS Consistent with research showing effects of multiple minority stress on behavioral health, adults with intersecting racial/ethnic and sexual minority identities showed increased odds of SI, SUD, and SI + SUD relative to Non-Hispanic White heterosexual peers. Black, Hispanic, and White LGB adults may benefit from screening and intervention for SI and SUD.
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Affiliation(s)
- Lourah M Kelly
- University of Connecticut School of Medicine, United States.
| | | | - Sara J Becker
- Brown University School of Public Health, United States; Warren Alpert Medical School of Brown University, United States
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Adams J, Asiasiga L, Neville S. Justifications for heavy alcohol use among gender and sexually diverse people. Glob Public Health 2021; 17:2018-2033. [PMID: 34369856 DOI: 10.1080/17441692.2021.1957492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A range of research reports that many gender and sexually diverse people drink alcohol at heavy levels. This study used 24 focus groups to explore shared understandings of alcohol use among gender and sexually diverse people living in New Zealand. An inductive, data-driven thematic analysis was employed to identify explanations for heavy drinking among gender and sexually diverse people. Three key explanations were articulated: alcohol is needed for socialising; drinking helps coping with stress; alcohol and drug treatment services are inadequate. These results demonstrate justifications for heavy drinking in certain contexts. This behaviour runs counter to public health approaches and messages that highlight low-risk levels of drinking or not drinking as desirable. Public health interventions should continue to address alcohol use at a whole population level but should be supplemented by policy and interventions that take into account the sociocultural contexts and structural conditions that encourage drinking among gender and sexually diverse people.
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Affiliation(s)
- Jeffery Adams
- SHORE & Whāriki Research Centre, Massey University, Auckland, New Zealand
| | - Lanuola Asiasiga
- SHORE & Whāriki Research Centre, Massey University, Auckland, New Zealand
| | - Stephen Neville
- Department of Nursing, Auckland University of Technology, Auckland, New Zealand
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Ganz O, Delnevo CD. Cigarette Smoking and the Role of Menthol in Tobacco Use Inequalities for Sexual Minorities. Nicotine Tob Res 2021; 23:1942-1946. [PMID: 34255831 DOI: 10.1093/ntr/ntab101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 05/10/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Cigarette smoking is disproportionately common among sexual minorities. While menthol market share has increased in the past decade, research on menthol cigarette smoking among sexual minorities is scant. For this study, we examined menthol cigarette smoking in the United States, by sex and sexual identity using a nationally representative sample of adults. AIMS AND METHODS We pooled data from the 2015-2019 National Survey on Drug Use and Health. We used chi-square tests and multivariable logistic regression models to examine (1) past 30-day cigarette use, (2) past 30-day menthol use, and (3) menthol preference among adults who have smoked cigarettes in the past 30 days for the following groups: heterosexual/straight males, heterosexual/straight females, gay males, gay/lesbian females, bisexual males, and bisexual females. Data were analyzed in September 2020. RESULTS Bivariate analyses revealed that prevalence of cigarette smoking and menthol cigarette smoking were higher among sexual minorities compared with heterosexual respondents, and that preference for menthol was highest among lesbian/gay and bisexual females who smoke. Multivariable models showed that compared with heterosexual females who smoke, odds of menthol preference were lower among heterosexual/straight and bisexual males who smoke, and higher among bisexual females. CONCLUSIONS Our study found that menthol preference was disproportionately high among sexual minorities who smoke-bisexual and gay/lesbian females who smoke in particular. Research is needed to understand why menthol use is common among sexual minorities who smoke. IMPLICATIONS Using data from a nationally representative study, this study makes a unique contribution to literature by identifying differences in menthol smoking between sexual minority subgroups. Specifically, we found that menthol smoking was highest among sexual minority females (ie, lesbian/gay and bisexual females) compared with other sexual minorities. These findings highlight the need for targeted interventions to prevent menthol cigarette initiation among sexual minorities, as well as to promote smoking cessation among sexual minorities who smoke menthol cigarettes, with an emphasis on sexual minority females. Future research should examine the impact of a potential menthol ban on these inequalities.
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Affiliation(s)
- Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.,Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Cristine D Delnevo
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.,Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
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Schuler MS, Prince DM, Collins RL. Disparities in Social and Economic Determinants of Health by Sexual Identity, Gender, and Age: Results from the 2015-2018 National Survey on Drug Use and Health. LGBT Health 2021; 8:330-339. [PMID: 34101498 DOI: 10.1089/lgbt.2020.0390] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose: We characterize disparities between lesbian, gay, and bisexual (LGB) adults and heterosexual adults across multiple health determinants in a nationally representative sample. Methods: Data on 153,939 adults (including 11,133 LGB adults) were from the 2015-2018 National Survey on Drug Use and Health. Separate Poisson regression models were used to estimate the relative risk (RR) that gay/lesbian and bisexual adults, respectively, experienced each health determinant, relative to heterosexual adults of the same gender and age group (ages 18-25, 26-34, 35-49, and 50-64). Statistically significant RR estimates were interpreted as a disparity. Results: Bisexual females exhibited disparities on all economic/health care access factors (no college degree, household poverty, means-tested assistance, unemployment, and lacking health insurance) across nearly all age groups; lesbian/gay females exhibited disparities in means-tested assistance and health insurance for some age groups. Notably fewer economic disparities were observed among gay and bisexual males. LGB adults (across identity, gender, and age group) were more likely to live alone, to have never been married, and to report low religious service attendance. Bisexual and lesbian/gay females, across age groups, had 1.7-2.2 times the risk of a lifetime arrest for a criminal offense, relative to same-age heterosexual females. Conclusions: Our results highlight that LGB females, particularly bisexual females, experience significant disparities in economic determinants of health, and all LGB subgroups exhibited disparities in some of the examined social determinants of health. The observed disparities, which spanned across age groups, likely contribute to disparities in physical and mental health observed among LGB adults.
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Affiliation(s)
| | - Dana M Prince
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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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 DOI: 10.1016/j.addbeh.2021.106817] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [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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Bochicchio LA, Drabble LA, Riggle ED, Munroe C, Wootton AR, Hughes TL. Understanding Alcohol and Marijuana Use among Sexual Minority Women during the COVID-19 Pandemic: A Descriptive Phenomenological Study. JOURNAL OF HOMOSEXUALITY 2021; 68:631-646. [PMID: 33439793 PMCID: PMC8015866 DOI: 10.1080/00918369.2020.1868187] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Sexual minority women (SMW; e.g., lesbian, bisexual, queer) are at increased risk for heavy/hazardous drinking and marijuana use, which may be exacerbated by stress associated with the COVID-19 pandemic and efforts to mitigate its spread (e.g., sheltering at home). To explore their experiences and perceptions of alcohol and marijuana use in the context of COVID-19, qualitative in-depth interviews were conducted with a diverse sample of 16 SMW from a longitudinal study who previously reported being at least moderate drinkers to explore their experiences and perceptions of alcohol and marijuana use during the pandemic. We used descriptive phenomenological analysis to explore data from the interviews. Participants described how their alcohol/marijuana use intersected with the complex and changing context of the pandemic, revealing four themes: 1) losing and creating routine; 2) seeking recreation and relief; 3) connecting, reconnecting, and disconnecting; and 4) monitoring alcohol and marijuana use boundaries. Findings highlight the importance of fostering community supports and possible interventions informed by the experiences of SMW.
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Affiliation(s)
| | - Laurie A. Drabble
- College of Health & Human Sciences, San José State University, San José, CA
| | - Ellen D.B. Riggle
- Political Science and Gender and Women’s Studies, University of Kentucky, Lexington, KY
| | | | - Angie R. Wootton
- School of Social Welfare, University of California Berkeley, Berkeley, CA
| | - Tonda L. Hughes
- School of Nursing, Columbia University, New York City, NY
- School of Nursing & Department of Psychiatry, Columbia University, New York City, NY
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Garbarski D. The Survey Measurement of Sexual Orientation: Configurations of Sexual Identity and Attraction and Associations with Mental Health. LGBT Health 2021; 8:307-315. [PMID: 33689404 DOI: 10.1089/lgbt.2020.0270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: This study aimed to examine how configurations of sexual identity and attraction are associated with mental health outcomes. Methods: Data came from the 2015, 2016, and 2017 waves of the National Survey on Drug Use and Health, one of the few nationally representative surveys to ask about sexual attraction. Sexual identity and attraction were combined into groups that are coincident (heterosexual-opposite gender attraction, gay/lesbian-same gender attraction, or bisexual-any multiple gender attraction) or branched (heterosexual-any same gender attraction, gay/lesbian-any opposite gender attraction, bisexual-only same or opposite gender attraction). The association between these configurations and various measures of mental health and well-being-severe psychological distress, major depressive episode, suicidal ideation, and suicide plan or attempt-was examined. Results: Heterosexual coincidence-being heterosexual and only attracted to the opposite gender-was associated with lower mental health risks than all other configurations of sexual identity and attraction. In addition, bisexual with coincident attraction was often associated with worse mental health outcomes than other configurations of identity and attraction, whereas bisexual with branched attraction did not necessarily follow this pattern. Finally, heterosexual with branched attraction was associated with worse mental health outcomes than heterosexual with coincident attraction, but better mental health outcomes than some of the other sexual identity and attraction configurations. Conclusion: Including one question on sexual attraction and its intersection with sexual identity adds nuance to our understanding of disparities in mental health and well-being among previously identified sexual minority and majority groups.
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Affiliation(s)
- Dana Garbarski
- Department of Sociology, Loyola University Chicago, Chicago, Illinois, USA
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Diaz M, Tenney C, Boyd KE, Ford JA. Sexual Identity and Motivations for Prescription Drug Misuse Among U.S. Adults. LGBT Health 2021; 8:107-115. [PMID: 33566728 DOI: 10.1089/lgbt.2020.0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Although we know that sexual minority populations, particularly bisexual individuals, tend to be at increased risk for substance use, less research has focused on prescription drug misuse (PDM). The current study is the first to assess differences in motivations for PDM by sexual identity and sex. This is important as research has established a link between certain motivations and adverse outcomes. Methods: This study used data from multiple years of the National Survey on Drug Use and Health (2015-2018). Respondents who reported past-year PDM were asked follow-up questions to identify motivations for PDM. We ran several weighted cross-tabulations to estimate the prevalence and 95% confidence intervals for motivations for PDM by sexual identity (i.e., heterosexual, lesbian or gay, and bisexual) for males and females separately. When chi-square tests were significant, post hoc comparisons using design-based multivariable regressions were conducted. Results: Prevalence rates for both PDM and substance use disorder associated with prescription drugs were higher among sexual minority adults than heterosexual adults. With regard to motives, bisexual females were more likely to endorse recreational motives (i.e., to get high) for prescription opioids, tranquilizers, and stimulants than heterosexual females. Gay males were more likely to endorse self-treatment motives (e.g., to relax, to lose weight) than both bisexual and heterosexual males. Conclusion: High prevalence rates and endorsement of recreational motives identify bisexual females as an important at-risk population. It is important for clinicians to consider how prevention, treatment, and intervention strategies focused on PDM may be improved to best target this unique population.
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Affiliation(s)
- Madelyn Diaz
- Department of Sociology, University of Central Florida, Orlando, Florida, USA
| | - Caralyn Tenney
- Department of Sociology, University of Central Florida, Orlando, Florida, USA
| | - Kelsey E Boyd
- Department of Sociology, University of Central Florida, Orlando, Florida, USA
| | - Jason A Ford
- Department of Sociology, University of Central Florida, Orlando, Florida, USA
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