Drabble Laurie A, Mericle Amy A, Gómez Walter, Klinger Jamie L, Trocki Karen F, Karriker-Jaffe Katherine J
College of Health and Human Sciences, San Jose State University, San Jose, CA, USA.
Alcohol Research Group, Public Health Institute, Emeryville, CA, USA.
Ann LGBTQ Public Popul Health. 2021;2(1):53-71. doi: 10.1891/lgbtq-2020-0029.
This study explored whether structural stigma, defined by U.S. state policies related to sexual minority rights, moderated the relationship between sexual identity identity and heavy drinking, alcohol problems, and marijuana use among men and women.
Using combined data from the National Alcohol Survey (NAS) series (2000, 2005, 2010, and 2015), the sample included 11,115 men (421 sexual minority and 10,694 heterosexual) and 14,395 women (413 sexual minority and 13,982 heterosexual). State policy environment was assessed using a time-varying dichotomous indicator of comprehensive protections for sexual minorities (4-6 protections vs. limited or no protections). Gender-stratified logistic regression analyses examined the differential effect of the policy environment by sexual identity on three past-year substance use outcomes: high-intensity drinking (8+ drinks/day), any DSM-5 alcohol use disorder, and marijuana use.
Among women, sexual minority status was associated with increased odds of all alcohol and marijuana use outcomes. Among men, sexual minority status was associated with decreased odds of high-intensity drinking but increased use of marijuana. Comprehensive policy protections were associated significantly decreased odds of high-intensity drinking among sexual minority men and marginally significant decreases among women.
Comprehensive policy protections appear to be protective for high-intensity drinking among sexual minority men and women. Findings underscore the importance of supportive policies in reducing risk of alcohol-related problems among sexual minorities.
本研究探讨了由美国与性少数群体权利相关的州政策所定义的结构性耻辱感，是否缓和了男性和女性的性取向与酗酒、酒精问题及大麻使用之间的关系。
利用国家酒精调查（NAS）系列（2000年、2005年、2010年和2015年）的合并数据，样本包括11115名男性（421名性少数群体和10694名异性恋者）和14395名女性（413名性少数群体和13982名异性恋者）。使用一个随时间变化的二分指标来评估州政策环境，该指标用于衡量对性少数群体的全面保护（4 - 6项保护措施与有限或无保护措施）。按性别分层的逻辑回归分析，考察了政策环境因性取向不同对过去一年三种物质使用结果的差异影响：高强度饮酒（每天8杯以上）、任何符合《精神疾病诊断与统计手册》第5版（DSM - 5）的酒精使用障碍以及大麻使用。
在女性中，性少数群体身份与所有酒精和大麻使用结果的几率增加有关。在男性中，性少数群体身份与高强度饮酒的几率降低但大麻使用增加有关。全面的政策保护与性少数群体男性高强度饮酒的几率显著降低以及女性的略微显著降低有关。
全面的政策保护似乎对性少数群体男性和女性的高强度饮酒具有保护作用。研究结果强调了支持性政策在降低性少数群体中与酒精相关问题风险方面的重要性。
