This study explored effective interviewer strategies and lessons-learned based on collection of narrative data by telephone with a sub-sample of women from a population-based survey, which included sexual minority women. Qualitative follow-up, in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey. Questions explored the lives and experiences of women, including use of alcohol and drugs, social relationships, identity, and past traumatic experiences. Strategies for success in interviews emerged in three overarching areas: 1) cultivating rapport and maintaining connection, 2) demonstrating responsiveness to interviewee content, concerns, and 3) communicating regard for the interviewee and her contribution. Findings underscore both the viability and value of telephone interviews as a method for collecting rich narrative data on sensitive subjects among women, including women who may be marginalized.
This study examined relationships between past experiences of victimization (sexual abuse and physical abuse in childhood, sexual abuse and physical abuse in adulthood, and lifetime victimization) and hazardous drinking among sexual minority women compared to exclusively heterosexual women. Data were from 11,169 women responding to sexual identity and sexual behavior questions from three National Alcohol Survey waves: 2000 (n=3,880), 2005 (n=3,464) and 2010 (n=3,825). A hazardous drinking index was constructed from five dichotomous variables (5+ drinking in the past year, drinking two or more drinks daily, drinking to intoxication in the past year, two or more lifetime dependence symptoms and two or more lifetime drinking-related negative consequences). Exclusively heterosexual women were compared to three groups of sexual minority women: lesbian, bisexual, and women who identified as heterosexual but reported same-sex partners. Each of the sexual minority groups reported significantly higher rates of lifetime victimization (59.1% lesbians, 76% bisexuals, and 64.4% heterosexual women reporting same-sex partners) than exclusively heterosexual women (42.3 %). Odds for hazardous drinking among sexual minority women were attenuated when measures of victimization were included in the regression models. Sexual minority groups had significantly higher odds of hazardous drinking, even after controlling for demographic and victimization variables: lesbian (ORadj=2.0, CI=1.1–3.9, p<.01; bisexual (ORadj=1.8, CI=1.0–3.3, p<.05; heterosexual with same-sex partners (ORadj=2.7; CI=1.7–4.3, p<.001). Higher rates of victimization likely contribute to, but do not fully explain, higher rates of hazardous drinking among sexual minority women.
This study examined patterns of smoked substances (cigarettes and marijuana) among heterosexuals, gays, lesbians, and bisexuals based on data from the 2000 National Alcohol Survey (NAS), a population-based telephone survey of adults in the United States. We also examined the effect of bar patronage and sensation-seeking/impulsivity (SSImp) on tobacco and marijuana use. Sexual orientation was defined as: lesbian or gay self-identified, bisexual self-identified, heterosexual selfidentified with same-sex partners in the last five years, and exclusively heterosexual (heterosexual self-identified, reporting no same sex partners). Findings indicate that bisexual women and heterosexual women reporting same-sex partners had higher rates of cigarette smoking than exclusively heterosexual women. Bisexual women, lesbians and heterosexual women with same-sex partners also used marijuana at significantly higher rates than exclusively heterosexual women. Marijuana use was significantly greater and tobacco use was elevated among gay men compared to heterosexual men. SSImp was associated with greater use of both of these substances across nearly all groups. Bar patronage and SSImp did not buffer the relationship between sexual identity and smoking either cigarettes or marijuana. These findings suggest that marijuana and tobacco use differ by sexual identity, particularly among women, and underscore the importance of developing prevention and treatment services that are appropriate for sexual minorities.
Until the 1980s, the limited research on alcohol and other drug (AOD) use among sexual minority women (SMW) focused on alcohol and used samples recruited from gay bars, resulting in inflated estimates of hazardous drinking. Over the past several decades the number of AOD studies with SMW has increased dramatically. To characterize this literature, we conducted a scoping review to answer the following questions: What do we know, and what are the gaps in research about AOD use among SMW? We searched multiple electronic databases (Medline [PubMed], CINAHL, PsycInfo, and Web of Science) for peerreviewed research articles about AOD use among adult SMW published between January 1, 2000 and May 31, 2017. After duplicates were removed the search identified 4,204 articles. We reviewed the titles and abstracts and removed articles that did not meet inclusion criteria. We used full-text review of the remaining 229 articles to make a final determination regarding inclusion and we retained 181 articles for review. Although the quantity of AOD research with SMW has grown substantially, the great majority of studies have been conducted in the United States (US) and most focus on hazardous drinking; relatively little research has focused on other drugs. In addition, although there has been marked improvement in theories and methods used in this research, many gaps and limitations remain. Examples are the lack of longitudinal research; reliance on samples that tend to over-represent white, well-educated, and relatively young women; sparse attention to mechanisms underlying the disproportionately high rates of AOD use among SMW; and the absence of intervention research. In general, more high-quality research on SMW's use of AODs is needed, but gaps and limitations are particularly large in non-western countries. Addressing these research gaps and limitations is essential for providing information that can be used to develop more effective prevention and early intervention strategies, as well as for informing policies that can help to reduce risky drinking and drug misuse among SMW.
These results underscore the utility of using both identity and behavior items to measure sexual orientation particularly for women when assessing alcohol use and alcohol-related problems.
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