Norris Alyssa, Rich Carla, Kaplan Clair, Krieger Naomi, Carey Kate B, Carey Michael P
Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Providence RI 02903.
Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI 02903.
Psychol Sex. 2021;12(1-2):141-161. doi: 10.1080/19419899.2020.1729848. Epub 2020 Mar 10.
Little is known about whether there are differences in rates of sexual violence and its association with substance use based on women's identities, specifically the intersection of their race/ethnicity and sexual orientation.
Women ( = 546; 18 to 29 years of age) recruited from a reproductive healthcare clinic reported their race, ethnicity, sexual orientation, sexual violence history and substance use. Five logistic regressions examined (a) rates of sexual violence, and (b) the strength of the associations between sexual violence and four substance use outcomes (heavy alcohol use, marijuana use, cigarette use, number of cigarettes used) based on sexual orientation. Subsequent logistic regressions examined race/ethnicity as a moderator of the associations between sexual orientation and (a) rates of sexual violence and (b) substance use.
Most women surveyed were heterosexual (64%), and 35% of all women reported unwanted sex. Sexual minority women (SMW) reported higher rates of sexual violence and substance use than heterosexual women. Sexual violence was more strongly associated with heavy alcohol use, but not with marijuana or cigarette use, for SMW than heterosexual women. Rates of sexual violence varied based on the intersection of sexual orientation and race/ethnicity. Although SMW were more likely to report sexual violence than heterosexual women, this association was weaker for Black/Latinx women than for non-Hispanic White women ( = 0.39, 95%CI [0.18, 0.82]). Race/ethnicity did not moderate the strength of associations between sexual violence and substance use.
SMW exhibit increased risk for sexual violence and substance use, and victimization was associated with heavy alcohol use. Few racial/ethnic differences emerged as a function of sexual orientation, so SMW are a group with unique needs around sexual violence experiences and substance use, regardless of race/ethnicity. Healthcare providers should be aware of the link between substance use and prior victimization when treating SMW.
关于基于女性身份，特别是其种族/族裔与性取向的交叉情况，性暴力发生率及其与物质使用之间的关联是否存在差异，目前所知甚少。
从一家生殖健康诊所招募的年龄在18至29岁之间的女性（n = 546）报告了她们的种族、族裔、性取向、性暴力史和物质使用情况。五项逻辑回归分析考察了：（a）性暴力发生率，以及（b）基于性取向的性暴力与四种物质使用结果（大量饮酒、使用大麻、吸烟、吸烟数量）之间关联的强度。随后的逻辑回归分析将种族/族裔作为性取向与（a）性暴力发生率和（b）物质使用之间关联的调节因素进行考察。
接受调查的大多数女性为异性恋（64%），所有女性中有35%报告曾遭遇过非自愿性行为。性少数群体女性（SMW）报告的性暴力和物质使用发生率高于异性恋女性。与异性恋女性相比，性少数群体女性中，性暴力与大量饮酒的关联更强，但与使用大麻或吸烟无关。性暴力发生率因性取向和种族/族裔的交叉情况而异。尽管性少数群体女性比异性恋女性更有可能报告性暴力，但这种关联在黑人/拉丁裔女性中比在非西班牙裔白人女性中更弱（OR = 0.39，95%CI [0.18, 0.82]）。种族/族裔并未调节性暴力与物质使用之间关联的强度。
性少数群体女性遭受性暴力和物质使用的风险增加，且受害情况与大量饮酒有关。作为性取向的一个函数，几乎没有出现种族/族裔差异，因此无论种族/族裔如何，性少数群体女性在性暴力经历和物质使用方面都是有独特需求的群体。医疗保健提供者在治疗性少数群体女性时应意识到物质使用与既往受害情况之间的联系。
