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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Bostwick, Wendy B; Hughes, Tonda L; Everett, Bethany (2015) Health Behavior, Status, and Outcomes Among a Community-Based Sample of Lesbian and Bisexual Women. LGBT Health 2:121-6
Hughes, Tonda L (2015) Developing a Research Career Focusing on a Stigmatized and Marginalized Population: Sexual Minority Women's Drinking. Subst Abus 36:144-8
Talley, Amelia E; Aranda, Frances; Hughes, Tonda L et al. (2015) Longitudinal Associations among Discordant Sexual Orientation Dimensions and Hazardous Drinking in a Cohort of Sexual Minority Women. J Health Soc Behav 56:225-45
Martin, Kelly; Johnson, Timothy P; Hughes, Tonda L (2015) USING RESPONDENT DRIVEN SAMPLING TO RECRUIT SEXUAL MINORITY WOMEN. Surv Pract 8:
Aranda, Frances; Matthews, Alicia K; Hughes, Tonda L et al. (2015) Coming out in color: racial/ethnic differences in the relationship between level of sexual identity disclosure and depression among lesbians. Cultur Divers Ethnic Minor Psychol 21:247-57
Hughes, Tonda L; Wilsnack, Sharon C; Kristjanson, Arlinda F (2015) Substance use and related problems among U.S. women who identify as mostly heterosexual. BMC Public Health 15:803
Matthews, Alicia K; Riley, Barth B; Everett, Bethany et al. (2014) A longitudinal study of the correlates of persistent smoking among sexual minority women. Nicotine Tob Res 16:1199-206
Talley, Amelia E; Hughes, Tonda L; Aranda, Frances et al. (2014) Exploring alcohol-use behaviors among heterosexual and sexual minority adolescents: intersections with sex, age, and race/ethnicity. Am J Public Health 104:295-303
Hughes, Tonda L; Johnson, Timothy P; Steffen, Alana D et al. (2014) Lifetime Victimization, Hazardous Drinking, and Depression Among Heterosexual and Sexual Minority Women. LGBT Health 1:192-203
Andersen, Judith P; Hughes, Tonda L; Zou, Christopher et al. (2014) Lifetime victimization and physical health outcomes among lesbian and heterosexual women. PLoS One 9:e101939

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