School of Social Welfare, University of Kansas, United States of America.
Alcohol Research Group, Emeryville, CA, United States of America.
J Subst Use Addict Treat. 2024 Dec;167:209519. doi: 10.1016/j.josat.2024.209519. Epub 2024 Sep 10.
Sexual minority (e.g., bisexual, gay, lesbian, queer) and gender minority (e.g., transgender, non-binary, gender expansive) individuals (SGMI) experience higher rates of alcohol and other substance use disorders than their heterosexual and cisgender (i.e., non-transgender) counterparts. 12-Step programs are currently the most common source of support for alcohol and other substance use-related problems in the United States. Little is known about rates and levels of participation and outcomes of SGMI in 12-Step programs. Examining SGMI with a lifetime alcohol or other substance use disorder, this study aims to: 1) describe lifetime attendance rates (any vs. none) and levels of participation (number of program activities) in 12-Step groups among SGMI overall and compare rates of attendance and levels of participation across sexual and gender minority identities and 2) determine how lifetime level of participation in 12-Step programs relates to past-year alcohol and other substance use outcomes.
We used data collected through The PRIDE Study, a national, large-scale, longitudinal health study of adult SGMI, administering supplemental questions to assess alcohol and other substance use disorders and 12-step participation. Zero-Inflated Negative Binomial models (N = 1353) run with sexual and gender identities as predictors of lifetime 12-step attendance (yes/no) and level of 12-Step participation determine if greater levels of 12-Step participation were associated with lower levels of past-year Alcohol and Substance Use Disorder (AUD & SUD) symptoms. The study ran models for those with lifetime AUD (n = 1074) and SUD (n = 659) separately.
Participants who engaged in greater levels of 12-Step participation had lower levels of past-year AUD and SUD symptoms. Gay and queer respondents with AUD were more likely and lesbian respondents with SUD were less likely than other participants to have ever participated in 12-Step programs. All other associations between sexual/gender identities and 12-Step participation disappeared when age was added to the model.
This study provides preliminary evidence that 12-Step participation may be an effective resource for reducing AUD and SUD symptoms among SGMI. Younger SGMI and SGMI holding sexual/gender identities other than gay and queer may require additional support to initiate participation in 12-Step programs.
性少数群体（例如双性恋、同性恋、女同性恋、酷儿）和性别少数群体（例如跨性别、非二元性别、性别扩展）个体（SGMI）比异性恋和顺性别（即非跨性别）个体经历更高的酒精和其他物质使用障碍的发生率。12 步程序目前是美国治疗酒精和其他物质使用相关问题最常用的支持来源。关于 SGMI 在 12 步程序中的参与率和参与水平以及结果知之甚少。本研究旨在通过对有终身酒精或其他物质使用障碍的 SGMI 进行检查：1）描述 SGMI 总体上参加 12 步团体的终身出席率（任何 vs. 无）和参与水平（计划活动次数），并比较性和性别少数群体身份的出席率和参与水平，以及 2）确定 12 步程序参与度的终身水平与过去一年的酒精和其他物质使用结果之间的关系。
我们使用通过“骄傲研究”（The PRIDE Study）收集的数据，这是一项针对成年 SGMI 的全国性、大规模、纵向健康研究，通过补充问题评估酒精和其他物质使用障碍以及 12 步程序的参与情况。使用零膨胀负二项式模型（N=1353），以性和性别身份为预测因子，确定终身参加 12 步程序（是/否）和 12 步参与程度，以确定更高程度的 12 步参与是否与过去一年的酒精和物质使用障碍（AUD 和 SUD）症状的严重程度呈负相关。该研究分别对有终身 AUD（n=1074）和 SUD（n=659）的参与者运行了模型。
参与度更高的 12 步程序的参与者过去一年的 AUD 和 SUD 症状较轻。有 AUD 的男同性恋和酷儿参与者比其他参与者更有可能参加过 12 步程序，而有 SUD 的女同性恋参与者则比其他参与者更不可能参加过 12 步程序。当在模型中加入年龄因素后，所有其他与性/性别身份和 12 步程序参与度的关联都消失了。
本研究初步表明，12 步程序可能是减少 SGMI 中 AUD 和 SUD 症状的有效资源。年龄较小的 SGMI 和持有同性恋和酷儿以外的性/性别身份的 SGMI 可能需要额外的支持才能开始参与 12 步程序。
