Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI, USA.
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
Am J Drug Alcohol Abuse. 2024 Jul 3;50(4):481-491. doi: 10.1080/00952990.2024.2378837. Epub 2024 Aug 19.
Many national studies fail to account for discordance between sexual orientation dimensions (e.g. a mismatch between sexual identity and sexual attraction) or sexual identity fluidity (e.g. changes in sexual identity over time). To examine the longitudinal relationships among sexual identity fluidity/stability, sexual orientation discordance/concordance, and alcohol and other drug use disorder symptoms. The study used nationally representative longitudinal data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health (PATH) study of US adolescents and adults ( = 24,591). Substance use disorder symptoms were most prevalent (45.8%) among bisexual-stable females relative to all other sexual identity subgroups. The adjusted odds ratios (AORs) of substance use disorder symptoms were significantly higher among bisexual-stable females vs. heterosexual-stable females in all models (AOR range: 1.94-2.32), while no such associations were found for males. Sexual identity-attraction discordant females had significantly greater AORs (17/20 instances) of substance use disorder symptoms compared to concordant females; this finding was not as consistent for males (6/20 instances). Sexual orientation discordance was significantly associated with substance use disorder symptoms, especially among females discordant in their sexual identity and attraction. Bisexual-stable and discordant females are at highest risk of developing symptomatic substance use; it is vital that they receive screening, no matter where they are in their coming out process. This study highlights pitfalls of relying solely on cross-sectional data using a single sexual orientation dimension to understand the relationship between sexual orientation and substance use disorder.
许多国家的研究未能考虑到性取向维度之间的不一致（例如，性认同和性吸引之间不匹配）或性认同流动性（例如，性认同随时间的变化）。研究目的是探讨性认同流动性/稳定性、性取向一致性/不一致性以及酒精和其他药物使用障碍症状之间的纵向关系。本研究使用了来自美国青少年和成年人（=24591 人）的全国代表性纵向数据，这些数据来自烟草和健康人群评估（PATH）研究的第 1-5 波（2013-2019 年）。与所有其他性认同亚组相比，双性恋稳定女性的物质使用障碍症状最为普遍（45.8%）。在所有模型中，与异性恋稳定女性相比，双性恋稳定女性物质使用障碍症状的调整后比值比（AOR）显著更高（AOR 范围：1.94-2.32），而男性则没有这种关联。与性认同吸引一致的女性相比，性认同吸引不一致的女性物质使用障碍症状的 AOR 显著更高（17/20 例）；而对于男性，这一发现并不一致（6/20 例）。性取向不一致与物质使用障碍症状显著相关，尤其是在性认同和性吸引不一致的女性中。双性恋稳定和不一致的女性是出现症状性物质使用的高风险人群；无论她们处于出柜过程的哪个阶段，对她们进行筛查都是至关重要的。本研究强调了仅依赖横断面数据使用单一性取向维度来理解性取向和物质使用障碍之间关系的陷阱。
