Studies using both probability and nonprobability samples provide ample evidence of lesbians'vulnerability to hazardous drinking. However, very little is known about the factors that increase lesbians'risk for hazardous drinking. We propose to build on and extend our study of sexual identity and drinking, using both cross-sectional and longitudinal data to model effects of cumulative stress on hazardous drinking among lesbians. Lesbians report high rates of traumatic events. Added to these acute stressors are chronic stressors unique to sexual minorities, creating cumulative stress that may be compounded in lesbians of color. Data will be collected from a large, diverse sample of 384 adult lesbians (50% racial/ethnic minority) interviewed previously in 2000 and 2004 and from a new panel (n=250) recruited by respondent-driven sampling, with oversampling of young (age 18-25), Black, and Latina lesbians. Data will be collected in computer-assisted personal interviews conducted by highly trained female interviewers.
The specific aims of the proposed study are (1) to test models of the relationships between cumulative stress and hazardous drinking in lesbians using cross-sectional data;(2) to test models of the relationships between early and later risk factors and hazardous drinking using longitudinal data from the new survey and our previous surveys (3 time points for the original sample);and (3) to compare longitudinal models of associations among early and later risk factors and hazardous drinking in our lesbian sample and in a subsample of heterosexual women from the National Study of Health and Life Experiences of Women (NSHLEW). Cross-sectional analyses will permit fuller assessment of racial/ethnic minority, age and cohort effects on hazardous drinking. We will use structural equation modeling to determine whether the accumulation of early risk factors (e.g., childhood sexual abuse) and adult risk factors (e.g., adult sexual assault, sexual- minority stressors, and racial/ethnic-minority stressors) predict hazardous drinking in lesbians, and to identify characteristics of lesbians at highest risk for hazardous drinking. Longitudinal analyses will allow us to examine changes in drinking patterns and problems over time, and to compare patterns and predictors of drinking changes in lesbians with those among heterosexual women in the NSHLEW. The proposed study, combined with the 2000 and 2004 surveys, will provide the most comprehensive data yet available on the characteristics and determinants of hazardous drinking among lesbians. Such information is critical for explicating similarities and differences across subgroups of women and for planning prevention and treatment strategies to effectively target the needs of these groups. Findings will have important scientific and public health implications for identifying groups at greatest risk for hazardous drinking and for developing culturally sensitive prevention and intervention strategies.

Public Health Relevance

This study will examine how the accumulation of life stressors such as childhood sexual abuse, adult sexual assault, and discrimination based on race/ethnicity or sexual orientation are related to psychological distress and hazardous drinking in adult women. Understanding how different groups of women respond to and cope with multiple life stressors will aid the development of more effective alcohol abuse prevention and intervention strategies for understudied groups of women.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Research Project (R01)
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Risk, Prevention and Intervention for Addictions Study Section (RPIA)
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Arroyo, Judith A
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University of Illinois at Chicago
Schools of Nursing
United States
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Matthews, Alicia K; Steffen, Alana; Hughes, Tonda et al. (2017) Demographic, Healthcare, and Contextual Factors Associated with Smoking Status Among Sexual Minority Women. LGBT Health 4:17-23
Fish, Jessica N; Hughes, Tonda L; Russell, Stephen T (2017) Sexual identity differences in high-intensity binge drinking: findings from a US national sample. Addiction :
Barrantes, Renzo J; Eaton, Asia A; Veldhuis, Cindy B et al. (2017) The Role of Minority Stressors in Lesbian Relationship Commitment and Persistence over Time. Psychol Sex Orientat Gend Divers 4:205-217
Riley, Barth B; Hughes, Tonda L; Wilsnack, Sharon C et al. (2017) Validating a Hazardous Drinking Index in a Sample of Sexual Minority Women: Reliability, Validity, and Predictive Accuracy. Subst Use Misuse 52:43-51
Drabble, Laurie; Veldhuis, Cindy B; Riley, Barth B et al. (2017) Relationship of Religiosity and Spirituality to Hazardous Drinking, Drug Use, and Depression Among Sexual Minority Women. J Homosex :1-24
Dirkes, Jessica; Hughes, Tonda; Ramirez-Valles, Jesus et al. (2016) Sexual identity development: relationship with lifetime suicidal ideation in sexual minority women. J Clin Nurs 25:3545-3556
Everett, Bethany G; Talley, Amelia E; Hughes, Tonda L et al. (2016) Sexual Identity Mobility and Depressive Symptoms: A Longitudinal Analysis of Moderating Factors Among Sexual Minority Women. Arch Sex Behav 45:1731-44
Jeong, Yoo Mi; Veldhuis, Cindy B; Aranda, Frances et al. (2016) Racial/ethnic differences in unmet needs for mental health and substance use treatment in a community-based sample of sexual minority women. J Clin Nurs 25:3557-3569
Steele, Sarah M; Everett, Bethany G; Hughes, Tonda L (2016) Influence of Perceived Femininity, Masculinity, Race/Ethnicity, and Socioeconomic Status on Intimate Partner Violence Among Sexual-Minority Women. J Interpers Violence :886260516683176
Everett, Bethany G; Hatzenbuehler, Mark L; Hughes, Tonda L (2016) The impact of civil union legislation on minority stress, depression, and hazardous drinking in a diverse sample of sexual-minority women: A quasi-natural experiment. Soc Sci Med 169:180-190

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