Department of Psychology, Lagomarcino Hall, 901 Stange Road, Ames, IA 50011-1041, USA.
Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA; University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
Addict Behav. 2019 Sep;96:76-81. doi: 10.1016/j.addbeh.2019.04.021. Epub 2019 Apr 22.
Minority sexual orientation (i.e., Lesbian, Gay, Bisexual; LGB) is a risk indicator for mental health and substance use problems. Findings are inconsistent across studies investigating LGB substance use and risk factors, possibly due to heterogeneity in LGB subgroups. To inform models of substance use risk, we identified empirical patterns of substance use and related risk behaviors among LGB individuals.
LGB participants (N = 343; M = 35.5, SD = 11.8; 71.4% = Female; 80.5% = White) were screened in an Emergency Department as part of a randomized controlled trial of an alcohol brief intervention. We conducted latent class analyses using the AUDIT-C (12 month; frequency, quantity, & binge) and ASSIST (12 month; illicit or misused prescription substance). Multinomial regression was performed to test predictors of class membership including depression symptoms, driving after alcohol or marijuana, and sexually transmitted infection (STI) history.
A 3-class model fit best and included "low use alcohol, marijuana, and tobacco users," (Low use; n = 244) "hazardous alcohol, tobacco and marijuana users," (Hazardous; n = 74) and "high-risk polysubstance users" (HPU; n = 25). The Low use class comprised the largest proportion of the sample across age, race/ethnicity, and sexual orientation. Compared to the Low use class, higher likelihood of depression symptoms, driving after alcohol or marijuana use, and STI was found for both Hazardous and HPU classes.
Researchers and clinicians should consider substance use patterns within the LGB population to inform interventions that address a variety of complex needs such as allocating more support for LGB individuals endorsing high-risk polysubstance use.
少数性取向（即同性恋、双性恋和异性恋者；LGB）是心理健康和物质使用问题的风险指标。研究 LGB 物质使用和风险因素的发现结果不一致，这可能是由于 LGB 亚组的异质性造成的。为了为物质使用风险模型提供信息，我们确定了 LGB 个体物质使用和相关风险行为的经验模式。
LGB 参与者（N=343；M=35.5，SD=11.8；71.4%=女性；80.5%=白人）作为一项酒精简短干预随机对照试验的一部分在急诊室进行了筛选。我们使用 AUDIT-C（12 个月；频率、数量和狂饮）和 ASSIST（12 个月；非法或滥用处方药物）进行潜在类别分析。使用多项逻辑回归检验抑郁症状、酒后或大麻后驾车以及性传播感染（STI）史等类别的预测因素。
3 类模型拟合最好，包括“低酒精、大麻和烟草使用的低使用类”（低使用；n=244）、“危险酒精、烟草和大麻使用的危险类”（危险；n=74）和“高风险多物质使用的高风险类”（HPU；n=25）。在年龄、种族/民族和性取向方面，低使用类构成了样本中最大的比例。与低使用类相比，危险类和 HPU 类的抑郁症状、酒后或大麻后驾车以及 STI 的可能性更高。
研究人员和临床医生应考虑 LGB 人群中的物质使用模式，以告知干预措施，这些干预措施可以解决多种复杂需求，例如为高风险多物质使用的 LGB 个人提供更多支持。
