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Lesbian, gay and bi adolescents at elevated risk for engaging in polysubstance use

Lesbian, gay and bisexual adolescents were more likely than heterosexual adolescents to be polysubstance users versus non-users across multiple classes of use: experimental users, marijuana-alcohol users, tobacco-alcohol users, medium-frequency three-substance users, and high-frequency three-substance users.

Photo by Đoàn Ngọc Thành from Unsplash.com

Lesbian, gay and bisexual adolescents were more likely than heterosexual adolescents to be polysubstance users versus non-users across multiple classes of use: experimental users, marijuana-alcohol users, tobacco-alcohol users, medium-frequency three-substance users, and high-frequency three-substance users. In general, sexual orientation identity differences in polysubstance use class membership were larger for females, especially bisexual females, than for males.

These are the findings reported in “Latent Classes of Polysubstance Use Among Adolescents in the United States: Intersections of Sexual Identity with Sex, Age, and Race/Ethnicity”, an article published in LGBT Health, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.

The study by Robert W.S. Coulter, Deanna Ware, Jessica N. Fish, and Michael W. Plankey aimed to estimate latent classes of concurrent polysubstance use and test for sexual orientation differences in latent class memberships with representative data from adolescents (in this case, living in 19 US states). The researchers also tested whether sex, race/ethnicity, and age moderated the sexual identity differences in polysubstance use class memberships.

The researchers analyzed data from 119,437 adolescents who participated in the 2015 Youth Risk Behavior Survey. Latent class analysis characterized polysubstance use patterns based on self-reported frequency of lifetime and past-month use of alcohol (including heavy episodic drinking), tobacco (cigarettes, cigars, and smokeless tobacco), and marijuana. Multinomial logistic regression models tested differences in latent class memberships by sexual identity. Interaction terms tested whether sex, race/ethnicity, and age moderated the sexual identity differences in polysubstance use class memberships.

A six-class model of polysubstance use fit the data best and included nonusers (61.5%), experimental users (12.2%), marijuana-alcohol users (14.8%), tobacco-alcohol users (3.8%), medium-frequency three-substance users (3.6%), and high-frequency three-substance users (4.1%). Gay/lesbian- and bisexual-identified adolescents had significantly higher odds than heterosexual-identified adolescents of being in all of the user classes compared with the nonuser class. These sexual identity differences in latent polysubstance use class memberships were generally larger for females than for males, varied occasionally by race/ethnicity, and were sometimes larger for younger ages.

“Compared with their heterosexual peers, gay/lesbian and bisexual adolescents—especially females—are at heightened risk of engaging in multiple types of polysubstance use,” the researchers concluded, recommending that “designing, implementing, and evaluating interventions will likely reduce these sexual orientation disparities.”

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