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Try out PMC Labs and tell us what you think. Learn More. The present research examines the associations between three distinct dimensions of sexual orientation and substance use in a random sample of undergraduate students. A Web-based survey was administered to students attending a large, midwestern research university in the spring of Using multivariate logistic regression analyses, several measures of alcohol and other drug use were compared across three dimensions of sexual orientation: sexual identity, sexual attraction and sexual behavior.

All three dimensions of sexual orientation were associated with substance use, including heavy episodic drinking, cigarette smoking and illicit drug use. Study findings suggest substantial variability in substance use across the three dimensions of sexual orientation and reinforce the importance of stratifying by gender and using multiple measures to assess sexual orientation. Study have implications for future research and for interventions aimed at reducing substance use among college students.

In the past two decades, health research has increasingly focused on the relationship between sexual orientation and health. In the past 5 years alone, a of major publications have aled the movement of lesbian, gay and bisexual LGB health issues from the margins Woman want real sex Bostwick Georgia the mainstream. As with any nascent field of inquiry, researchers conducting studies on LGB health must grapple with a of methodological issues. Of particular importance is the definition and measurement of sexual orientation.

Despite a growing consensus that sexual orientation includes behavioral, affective attraction or desire and cognitive identity dimensions Diamond, ; Hughes, ; Hughes and Eliason, ; Laumann et al. The lack of standard definitions and measures makes comparisons across studies difficult. For instance, a strictly behavioral measure of sexual orientation may be associated with different health risks than a measure of sexual identity or sexual attraction.

The manner in which sexual orientation is defined and measured has important implications for health research and practice. Alcohol and other drug AOD use represents the greatest cause of preventable death and injury among U. Abbey, ; Dowdall and Wechsler, ; Perkins, studies suggest that LGB college students are at higher risk than their heterosexual counterparts for substance use e.

To date, most college-based research has used a single measure of sexual orientation sexual identity, sexual attraction or sexual behavior or has not assessed sexual orientation at all. Although prior research shows a correlation between same-sex attraction, behavior and identity Laumann et al. Such findings emphasize the importance of better understanding the measurement of this construct.

A few studies have examined the relationship between sexual behavior and substance use among college students e. For example, Eisenberg and Wechsler compared substance use in a nationally representative sample of college students based on self-reports of sexual behavior with same-gender, both-gender and other-gender partners. Undergraduate women who reported both male and female sexual partners were ificantly more likely than women with only male partners to report heavy episodic drinking, cigarette smoking and marijuana use.

Substance use did not differ between female students who reported exclusively same-gender partners and exclusively male partners. Neither male students who reported same-gender partners only nor those who reported both-gender partners were at higher risk for substance use than those with female partners only.

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In fact, men with only female partners were ificantly more likely than those with both female and male partners to report heavy episodic drinking. The relationship between sexual identity and substance use has also been examined in several college-based studies e. For example, DeBord and colleagues surveyed a random sample of college students over 4 years and found LGB students had higher levels of alcohol involvement than a matched comparison group of heterosexual students. Measures in Debord et al.

Although alcohol use differed between LGB and heterosexual students, no differences were found between the two groups in illicit drug use. In a later study that analyzed findings by gender, McCabe and colleagues found no differences in alcohol use and heavy episodic drinking rates between college women who identified as lesbian and bisexual, and those who identified as heterosexual.

Lesbian and bisexual women were, however, ificantly more likely than heterosexual women to smoke cigarettes in the past month and to use marijuana before college, in the past month and in the past yearecstasy past year and other illicit drugs past month and past year. Gay and bisexual men were ificantly less likely than heterosexual men to report heavy episodic drinking in the past 2 weeks but more likely to report marijuana use in the past year and ecstasy use before college. Compared with research examining either identity-related or behavioral dimensions of sexual orientation, substantially less college-based substance use research has examined the role of sexual attraction among college students.

However, Russell et al. In this nationally representative sample, substance use was compared in to year-old adolescents, based on reported lifetime romantic attraction Russell et al. Adolescent males and females who were attracted to both genders were more likely than those with only other-gender attractions to report cigarette smoking, heavy drinking, alcohol-related problems, and marijuana and other illicit drug use.

Adolescent females with same-gender attraction were more likely than females with only other-gender attractions to report getting drunk and using marijuana or other illicit drugs. In contrast, adolescent males with same-gender attraction were not at increased risk for substance use relative to males with only other-gender attractions. A few studies of young women and men not in college have assessed more than one dimension of sexual orientation e. Scheer and colleagues found that the AOD use behaviors among heterosexual women with both male and female partners were more similar to those of self-identified bisexuals than to heterosexual women with male partners only.

Recent work suggests that all three dimensions of sexual orientation should be assessed whenever possible Saewyc et al. To date, no college-based studies have compared substance use behaviors across all three measures of sexual orientation.

Although data regarding sexual orientation and substance use in noncollege student populations is helpful, research suggests that substance use differs between college students and their same-age peers not attending college Johnston et al. To understand better how sexual orientation relates to substance use among college students, various measures of substance use were compared across three dimensions of sexual orientation: sexual identity, sexual attraction and sexual behavior.

A large random sample of undergraduate students attending a midwestern public university was randomly selected and surveyed about their sexual orientation and substance use behaviors using a Web-based instrument. The Institutional Review Board approved the protocol for the present study, and all respondents gave informed consent prior to participation.

The study was conducted during a 1-month period in March and April ofdrawing on a total population of 21, full-time undergraduate college students 10, women and 10, men. The entire sample was sent an message describing the study and inviting them to self-administer the Student Life Survey SLS by clicking on a link to access the Web survey using a unique password. All participants were informed that a research firm unaffiliated with the University was contracted to set up the Web survey and to store and maintain data.

University officials, faculty or staff were unable to access any contact information connected with the data of any respondent. Finally, all respondents were sent information to clarify that participation was voluntary and to explain the relevance of the study and that responses would be kept confidential. Nonrespondents were sent up to three reminder s. The final response rate was To ensure that a Web-based mode of administration would not compromise either participation or the quality of the data, a randomized experiment was conducted in The experiment examined possible survey mode effects for self-reporting sexual orientation and substance use by comparing prevalence estimates between a Web-based survey and a U.

In addition, a telephone follow-up survey of randomly selected nonrespondents from both survey modes was conducted to examine the reasons for nonresponse. Additional information regarding the study de and procedures for the Web-based survey is available elsewhere McCabe,; McCabe et al. The SLS was developed and pilot tested in and contained substance use measures adapted from the Monitoring the Future study Johnston et al. The SLS also included several sociodemographic questions, including three sexual orientation items adapted from the Chicago Health and Life Experiences of Women Study e.

The response scale included the following: 1 none, 2 once, 3 twice, 4 3—5 occasions, 5 6—9 occasions and 6 10 or more occasions Wechsler et al. The same question format and response scale were used to assess illicit use of prescription stimulant medication e. Other illicit drug use was assessed by summing the total of illicit drugs, other than marijuana, used in the past year. Illicit drugs included cocaine, LSD, other psychedelics, amphetamines, crystal methamphetamine, heroin, inhalants, ecstasy, GHB and Rohypnol. The relationship between each sexual orientation measure i.

For Woman want real sex Bostwick Georgia multivariate logistic regression analyses, we adjusted for race and class year, with the largest category for each measure of sexual orientation serving as the reference group i. We used logistic regression to test for gender interactions to determine whether the effects of sexual orientation differed. Because differences were identified, all models were stratified by gender.

Thus, we present separate logistic regression models for men and women. Alcohol and other drug use by sexual identity, sexual attraction and sexual behavior among women, percentage distributions. Notes: Sample sizes based on past month cigarette smoking. Sample sizes vary because of missing responses to individual substance use questions. Alcohol and other drug Woman want real sex Bostwick Georgia by sexual identity, sexual attraction and sexual behavior among women, adjusted odds ratio adj.

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Alcohol and other drug use by sexual identity, sexual attraction and sexual behavior among men, percentage distributions. Notes : Sample sizes based on past month cigarette smoking. Sample sizes vary due to missing responses to individual substance use questions.

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Alcohol and other drug use by sexual identity, sexual attraction and sexual behavior among men. The final sample consisted of 9, undergraduate students, with demographic characteristics that closely resembled the characteristics of the overall student population with respect to race and class Woman want real sex Bostwick Georgia.

Table 1 summarizes the prevalence rates of AOD use for women based on sexual identity, sexual attraction and sexual behavior. Prevalence rates of AOD use were compared using chi-square tests. In the bivariate analyses focusing on women, statistically ificant differences were found among groups on all three sexual orientation measures.

Table 2 summarizes multivariate substance use for women based on the three sexual orientation measures. As shown in Table 2adjusted Woman want real sex Bostwick Georgia ratios adj. ORs for the mostly heterosexual group ranged from 1. In contrast, with the exception of monthly cigarette smoking, there were no differences between the only lesbian and only heterosexual groups on any of the measures. No differences were found between bisexual and only heterosexual women in heavy episodic drinking; however, the odds of cigarette smoking and illicit drug use were ificantly higher for bisexual women adj.

Women who were sexually attracted to mostly men had ificantly higher odds than those attracted to only men on all of the measures assessed in the study adj. In contrast, showed no statistically ificant differences between women sexually attracted to only women and those attracted to only men. With a few exceptions, women who were attracted to men and women equally were more likely than those attracted to only men to report use of illicit drugs. For example, these women were eight times more likely to report using illicit drugs other than marijuana adj.

Women attracted to mostly women were more likely to report smoking cigarettes and using marijuana, opioid analgesics and other illicit drugs. Women who had not been sexually active in their lifetime were ificantly less likely to report AOD use than women who had sex with only men. In contrast, women who reported sex with both men and women the behaviorally bisexual group reported ificantly higher rates of AOD use than behaviorally heterosexual women Table 2.

For example, the behaviorally bisexual group was more likely to report heavy episodic drinking adj. Women whose sex partners were only women the behaviorally lesbian group did not differ from women who had sex with only men. Table 3 summarizes the prevalence rates of AOD use for men based on sexual identity, sexual attraction and sexual behavior. of chi-square tests revealed that, although differences were found in most of the bivariate comparisons of male participants in each of the three sexual orientation groups, differences tended to be smaller and less consistent than in comparisons of female students.

Table 4 summarizes multivariate substance use for men based on the three sexual orientation measures. Overall, associations between sexual identity and AOD use were less variable for men than women. For example, very few differences were found between bisexual and only heterosexual men; bisexual men were ificantly less likely than only heterosexual men to report heavy episodic drinking in the past 2 weeks adj. Men who identified as mostly heterosexual were more likely than the only heterosexual reference group to report three of the four illicit drugs assessed in the study; the only nonificant difference was past year illicit use of prescription opioids.

In addition, the mostly homosexual men had higher odds than the only heterosexual men on each of the four illicit drug-use measures. Finally, neither the bisexual nor the only homosexual men differed ificantly from the reference group only heterosexual men with respect to any of the illicit drug use measures. Men attracted to mostly men were less likely than those attracted to only women to report heavy episodic drinking adj.

With respect to cigarette smoking, men attracted to only men were more than two times as likely as those attracted to only women to report monthly smoking adj. No consistent patterns were found in illicit drug use based on sexual attraction. However, men attracted to only women were generally less likely to report use of these drugs. For example, men attracted to only men were approximately two times as likely as those attracted to only women to report past month marijuana use adj.

Men attracted to both men and women were nearly three times as likely to report use of other illicit drugs in the past year adj. Similar to comparisons on sexual behavior within the female sample, men who had not been sexually active had lower odds of AOD use than college men who had sex with only women.

In contrast, with the exception of heavy episodic drinking and monthly cigarette smoking, no differences in substance use were found for men with only female sex partners and those with only male partners. Men who had only male sex partners were more likely to report monthly cigarette smoking adj.

Men whose sex partners were both women and men behaviorally bisexual men were also ificantly less likely than behaviorally heterosexual men to report heavy episodic drinking adj. The AOD use measures were regressed on the collapsed sexual identity variable.

Findings from this study emphasize the importance of using multiple measures of sexual orientation and of using care when collapsing data across of sexual orientation dimensions. In addition, study findings emphasize the importance of analyzing data by gender. In general, we found that nonheterosexual identity, attraction and behavior were associated with a more pronounced and consistent risk of substance use in women than in men.

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