Department of Family and Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Ste A, Salt Lake City, UT 84108, United States.
Prev Med. 2021 Apr;145:106401. doi: 10.1016/j.ypmed.2020.106401. Epub 2020 Dec 31.
Prior research has shown that sexual minorities are disproportionately affected by substance use disorders and prescription opioid misuse. While most studies explore how single dimensions of sexual orientation (i.e., identity, attraction, and behavior) are associated with substance use disorders, we aimed to explore how multiple dimensions of sexual orientation interact with substance use behaviors. Specifically, we examined sexual identity-attraction discordance, the situation when one's sexual identity does not match their socially-expected sexual attractions, with prescription opioid misuse. This study assessed the association between sexual identity-attraction discordance with prescription opioid misuse utilizing data from the National Survey on Drug Use and Health from 2015 to 2017 among adults while employing propensity score weighting with multivariable logistic regression. The study included 127,430 adult participants, of whom 1.3%, 4.4%, and 10.6% self-reported prescription opioid misuse in the past month, past year, and lifetime, respectively. Those with discordant sexual identity-attractions had higher odds of prescription opioid misuse in their lifetime (aOR= 1.22, 95% CI 1.07-1.40) when compared to those with concordant sexual identity-attractions. When stratified by sex, we found sexual identity-attraction discordant females had higher odds of prescription opioid misuse in their lifetime (aOR= 1.29, 95% CI 1.13-1.49); there was no association among males. These findings further emphasize the need to consider the dynamic nature of sexual orientation in substance use research.
先前的研究表明，性少数群体（同性恋、双性恋和跨性别者）在物质使用障碍和处方类阿片类药物滥用方面受到不成比例的影响。虽然大多数研究都探讨了性取向的单一维度（即身份、吸引和行为）与物质使用障碍之间的关联，但我们旨在探讨性取向的多个维度如何与物质使用行为相互作用。具体来说，我们研究了性认同-吸引不一致，即一个人的性认同与他们社会期望的性吸引不匹配的情况，与处方类阿片类药物滥用的关系。本研究利用 2015 年至 2017 年全国药物使用和健康调查的数据，评估了性认同-吸引不一致与处方类阿片类药物滥用之间的关联，同时采用倾向评分加权和多变量逻辑回归。研究纳入了 127430 名成年参与者，其中分别有 1.3%、4.4%和 10.6%的人在过去一个月、过去一年和一生中报告有处方类阿片类药物滥用。与性认同-吸引一致的人相比，性认同-吸引不一致的人一生中发生处方类阿片类药物滥用的可能性更高（优势比[aOR]=1.22，95%置信区间[CI]1.07-1.40）。按性别分层后，我们发现性认同-吸引不一致的女性一生中发生处方类阿片类药物滥用的可能性更高（aOR=1.29，95% CI 1.13-1.49）；而男性则没有关联。这些发现进一步强调了在物质使用研究中需要考虑性取向的动态性质。
