Do Substance Use Norms and Perceived Drug Availability Mediate Sexual Orientation Differences in Patterns of Substance Use? Results from the California Quality of Life Survey II

Abstract

ABSTRACT. Objective: Illicit drug and heavy alcohol use is more common among sexual minorities compared with heterosexuals. This difference has sometimes been attributed to more tolerant substance use norms within the gay community, although evidence is sparse. The current study investigated the role of perceived drug availability and tolerant injunctive norms in mediating the linkage between minority sexual orientation status and higher rates of prior-year substance use. Method: We used data from the second California Quality of Life Survey (Cal-QOL II), a followback telephone survey in 2008-2009 of individuals fi rst interviewed in the population-based 2007 California Health Interview Survey. The sample comprised 2,671 individuals, oversampled for minority sexual orientation. Respondents were administered a structured interview assessing past-year alcohol and illicit drug use, perceptions of perceived illicit drug availability, and injunctive norms concerning illicit drug and heavier alcohol use. We used structural equation modeling methods to test a mediational model linking sexual orientation and substance use behaviors via perceptions of drug availability and social norms pertaining to substance use. Results: Compared with heterosexual individuals, sexual minorities reported higher levels of substance use, perceived drug availability, and tolerant social norms. A successfully fi tting model suggests that much of the association between minority sexual orientation and substance use is mediated by these sexual orientation-related differences in drug availability perceptions and tolerant norms for substance use. Conclusions: Social environmental context, including subcultural norms and perceived drug availability, is an important factor infl uencing substance use among sexual minorities and should be addressed in community interventions. (J. Stud. Alcohol Drugs, 73, 675-685, 2012) A CCUMULATING EVIDENCE SHOWS THAT individuals with minority sexual orientation, regardless of their gender, tend to have higher rates of illicit drug and heavy alcohol use than do their same-gender heterosexual counterparts (Burgard et al., 2005;Cochran et al., , 2004Drabble et al., 2005;Gruskin et al., 2001;Hughes et al., 2010;McCabe et al., 2009;McLaughlin et al., 2010;Talley et al., 2011). Several population-based studies have reported higher rates of illicit drug and alcohol use and problem drinking among homosexually active women compared with exclusively heterosexual women, even after controlling for differences in sociodemographic characteristics (Burgard et al., 2005;Cochran et al., , 2004Drabble et al., 2005;Gruskin et al., 2001;Hughes et al., 2010;McCabe et al., 2009;McLaughlin et al., 2010;Talley et al., 2011). Further, a population-based survey of women ages 18-29 in low-income neighborhoods in northern California found that women who reported having both male and female sexual partners had signifi cantly higher rates of injection drug use compared with others (Scheer et al., 2002). Similarly, studies conducted with m...

Association of exposure to neighborhood drug activity, neurobehavioral traits, and marijuana use among at-risk African American females

“…However, neighborhood drug activity has not been linked, consistently, to increased drug use among African American young persons (Crum et al, 1996;Furr-Holden et al, 2014;Lambert, Brown, Phillips, & Ialongo, 2004;Ridenour et al, 2009). Thus, while drugs may be more readily available in neighborhoods with drug activity, the simple assumption that exposure to drug activity increases drug use may not be correct (Cochran et al, 2012;Crum et al, 1996;Wagner & Anthony, 2002;Wertz & Sayette, 2001). This relationship is likely complex and requires consideration of the synergistic effects of exposure, intra-person factors (e.g., neurobehavioral traits), and other social and cultural factors (Mennis & Mason, 2012;Ridenour et al, 2009Ridenour et al, , 2013.…”

“…One unique characteristic of economically disadvantaged African American neighborhoods that is conceptualized as a risk factor for substance use is visible drug market activity (Crum, Lillie-Blanton, & Anthony, 1996;Saxe et al, 2001;Wallace & Muroff, 2002;Wertz & Sayette, 2001). In lower socioeconomic (SES) neighborhoods with visible drug activity there are more opportunities to use drugs and drug sub-cultures likely reduce inhibitions about drug use, thereby increasing the likelihood of use (Wagner & Anthony, 2002;Linton, Jennings, Latkin, Gomez, & Mehta, 2014;Wertz & Sayette, 2001;Cochran, Grella, & Mays, 2012).…”

A Comparison of Substance Use Behaviors of Hispanic Men by Sexual Orientation

“…Previous research conducted with the general population of MSM has reported that incongruence often exists between orientation, self-identification, and behaviors. This incongruence may be one of the factors that contributes to the high rates of mental health issues (including substance use) that exists among MSM (Cochran et al 2012; Marshall et al, 2008; McCabe et al, 2010). A more complete comparison of substance abuse behaviors between heterosexual Hispanic men and Hispanic MSM is necessary that includes sexual identification, sexual attraction, and sexual behaviors.…”

Application of Space-Time Scan Statistics to Describe Geographic and Temporal Clustering of Visible Drug Activity

“…1 Drug-related law enforcement has been associated with negative health outcomes 23,4 and has been scrutinized for being disproportionately targeted in low-income minority communities. 1 Inequities in the targeting of drug-related law enforcement have partly been attributed to the extent to which drug market activity is visible.…”

“…10 Perceived opportunities to use illicit drugs have been associated with urges to use illicit drugs 22 and social norms supportive of use. 23 Through such pathways, visible drug activity may encourage illicit drug use. Additionally, the purveyance of social disorder, physical disorder, economic deprivation, and increased likelihood of incarceration in areas with high visible drug activity may further lead to poor drug-related sequelae.…”