Abstract
This study examined relationships between past experiences of victimization (sexual abuse and physical abuse in childhood, sexual abuse and physical abuse in adulthood, and lifetime victimization) and hazardous drinking among sexual minority women compared to exclusively heterosexual women. Data were from 11,169 women responding to sexual identity and sexual behavior questions from three National Alcohol Survey waves: 2000 (n = 3,880), 2005 (n = 3,464), and 2010 (n = 3,825). A hazardous drinking index was constructed from five dichotomous variables (5+ drinking in the past year, drinking two or more drinks daily, drinking to intoxication in the past year, two or more lifetime dependence symptoms, and two or more lifetime drinking-related negative consequences). Exclusively heterosexual women were compared with three groups of sexual minority women: lesbian, bisexual, and women who identified as heterosexual but reported same-sex partners. Each of the sexual minority groups reported significantly higher rates of lifetime victimization (59.1% lesbians, 76% bisexuals, and 64.4% heterosexual women reporting same-sex partners) than exclusively heterosexual women (42.3%). Odds for hazardous drinking among sexual minority women were attenuated when measures of victimization were included in the regression models. Sexual minority groups had significantly higher odds of hazardous drinking, even after controlling for demographic and victimization variables: lesbian (ORadj = 2.0, CI = 1.1-3.9, p < .01; bisexual (ORadj = 1.8, CI = 1.0-3.3, p < .05; heterosexual with same-sex partners (ORadj = 2.7; CI = 1.7-4.3, p < .001). Higher rates of victimization likely contribute to, but do not fully explain, higher rates of hazardous drinking among sexual minority women.
Highlights
The need for greater research attention to alcohol use and alcohol-related problems among sexual minority women was identified more than 10 years ago in an Institute of Medicine report on lesbian health (Solarz, 1999)
Sexual minority women are generally less likely to abstain from drinking alcohol and are more likely to report heavy episodic drinking, negative consequences associated with drinking, symptoms of alcohol dependence, and help-seeking for alcohol related problems (Cochran, Keenan, Schober, & Mays, 2000; Cochran & Mays, 2000; Drabble, Trocki, & Midanik, 2005; McCabe, Hughes, Bostwick, West, & Boyd, 2009; Wilsnack et al, 2008)
We found strong relationships between hazardous drinking and reports of childhood, adult, and lifetime victimization
Summary
Several studies have found higher risk of alcohol-related problems among bisexual women (McCabe, Hughes, & Boyd, 2004; McCabe, Hughes, & Bostwick, 2005; Wilsnack et al, 2008) and women who self-identify as ‘mostly heterosexual’ (Austin, Roberts, Corliss, & Molnar, 2008; Hughes, Szalacha, & McNair, 2010; Wilsnack et al, 2008; Ziyadeh et al, 2007) Multiple factors, both individual and contextual, are posited to contribute to sexualorientation related disparities in hazardous drinking. There is growing evidence to support the hypothesis that minority stress is associated with elevated risk of alcohol and drug problems among sexual minorities
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