close

Вход

Забыли?

вход по аккаунту

код для вставкиСкачать
Sexual orientation and drug of choice
D. Zullino, S. Achab, G. Thorens, R. Khan, R. Manghi and Y. Khazaal
http://addictologie.hug-ge.ch
WHO collaborating center
Introduction

Substance use problems usually found to be more prevalent in
lesbian, gay, and bisexual (LGB) populations
http://addictologie.hug-ge.ch
Green & Feinstein, 2012; Meyer, 1995, 2003
Hypotheses

Affiliation with gay culture

LGB communities centered on activities involving consumption (e.g. bars, circuit
parties).

Can lead to social networks of LGB individuals with heavier consumption

Can make it more difficult to avoid triggers for substance use (e.g. bars, peers who
drink)

Demographic factors (female, older age) less robust protective factors

Stress related to being a sexual minority (Minority stress model)

Bisexual identity : particularly related to increased risk for substance
abuse
http://addictologie.hug-ge.ch
Bux, 1996
Methodological flaws in the existing research

Recruitment of participants from bars

Lack of appropriate comparison groups

Poor assessment of multiple dimensions of sexual
orientation
http://addictologie.hug-ge.ch
Green & Feinstein, 2012; McCabe et al., 2009
Sexual orientation: multidimensional construct

at least 3 components

sexual attraction


sexual behavior


refers to the desire to have sexual relations with one or both sexes
refers to any mutually voluntary activity with another person that involves genital
contact and sexual arousal, even if intercourse or orgasm did not occur
sexual identity

refers to personally selected labels attached to the perceptions and meanings
individuals have about their sexuality

The 3 components are not perfectly correlated with one another

May be differentially associated with psychological outcomes
http://addictologie.hug-ge.ch
Rationale

Longitudinal studies on substance consumption rare and costly

Mostly realized in North America, where youth culture is
multiple

Studies are rare in Europe

Switzerland stands in the head of European countries with
regard to substance consumption rates by teenagers
http://addictologie.hug-ge.ch
C-SURF

Cohort study

Coordinated by

Centre hospitalier universitaire vaudois (CHUV), Lausanne

Social and Preventive Medicine Institute at Zürich University

Financial support of the Swiss National Research Foundation

Seeks to follow substance consumption by 19-year-old-young adults
during at least 10 years

concerns young Swiss adults who have to go through the mandatory recruitment
process at the Swiss army

covers 98% of the Swiss male 18-year-old
http://addictologie.hug-ge.ch
Collaborating centers

Division of Addictology, Department of mental health and psychiatry, Geneva

CHUV, University Hospital Center of the Canton of Vaud, Lausanne

IUMSP Institute of Social and Preventive Medicine, Lausanne

DUMSC, Department of Medicine and Community Health, Lausanne

AS Addiction Switzerland, Lausanne

ISPM, Institute for Social and Preventive Medicine, Zürich

Institute for Social and Preventive Medicine, Geneva

ISGF, Institute for Research in Addiction and Health, Zürich

University Hospital of Erlangen, Germany

Center for Alcohol and Addiction Studies, USA
http://addictologie.hug-ge.ch
Subjects

All young men at the army recruitment centers in Lausanne,
Windisch and Mels invited to participate
http://addictologie.hug-ge.ch

n = 5,387

Data collected between August 2010
and November 2011
Questionnaire

Online questionnaire (a hard copy sent by post if wished)

45 - 60 minutes

socioprofessional and family background

lifestyle and personality

consumption of tobacco, alcohol, cannabis and other drugs

gambling and gaming activities and use of internet

sexuality

physical and mental health

knowledge about other health-related aspects
http://addictologie.hug-ge.ch
Analyses

Proportions, mean values and standard deviations to describe
general characteristics

Between-group differences by one-way ANOVAs and chisquare

Significance set at p<0.05

Multinomial logistic regression for association between sexual
preference and a set of independent variables
http://addictologie.hug-ge.ch
Sexual preferences

89.7% considered themselves exclusively
heterosexuals and 1% exclusively homosexuals

Bisexual attraction reported by 7.4%

1.9% avoided the question regarding their sexual
preference
http://addictologie.hug-ge.ch
Lifetime consumption
Ever drunk > 12 alcoholic
beverages?
Ever smoke > 50 cigarettes
Ever smoked cannabis
Magic mushrooms
Other hallucinogens (LSD,
PCP/Angeldust, etc.)
Salvia divinarum
Speed
Amphetamines
Chrystal Meth (Ice)
Poppers
Glue sniffing
Ecstasy, MDMA
Cocaine, crack, freebase
Heroin
Ketamines
GHB/GBL/1-4 butandiol (BDB)
http://addictologie.hug-ge.ch
Exclusively
heterosexual
Exclusively
homosexual
Bisexually
attracted
(n=5’371)
86.7
(n=62)
77.4
(n=442)
88.7
38.6
46.5
5.4
4
5.1
4.5
3.1
1.1
4.7
4.4
5.3
3
0.4
0.5
0.4
41.9
45.4
11.3
11.3
6.5
11.3
14.5
1.6
25.8
11.3
14.5
9.7
1.6
4.8
3.2
49.2
58.5
9.4
7
5.9
6.3
5.2
1.6
7.7
7.7
9.9
5.4
0.7
0.9
1.1
ns
<0.001
<0.001
<0.001
<0.001
ns
<0.05
<0.001
<0.001
<0.001
<0.001
<0.001
<0.001
<0.001
<0.001
<0.001
Last year consumption
Exclusively
heterosexual
(n=5’371)
92
Exclusively
homosexual
(n=62)
90.3
Bisexually
attracted
(n=442)
91.6
> 50 cigarettes
46.4
51.6
56.9
Cannabis
29.7
30.6
40.8
Magic mushrooms
2.6
6.5
3.8
- Other hallucinogens (LSD,
PCP/Angeldust, etc.)
- Salvia divinarum
2.1
9.7
3.9
2.1
3.2
2.5
- Speed
2.5
3.1
4.1
- Amphetamines
1.7
9.7
4.7
- Chrystal Meth (Ice)
0.4
1.6
0.5
- Poppers
2
19.4
4.5
- Glue sniffing
2
6.5
3.9
3.4
11.3
6.6
3
9.7
5.4
- Heroin
0.4
1.6
0.7
- Ketamines
0.5
4.8
0.9
- GHB/GBL/1-4 butandiol (BDB)
0.4
3.2
1.1
The last 12 months
> 12 alcoholic beverages?
- Ecstasy, MDMA
- Cocaine, crack, freebase
http://addictologie.hug-ge.ch
ns
ns
ns
ns
ns
ns
ns
<0.05
ns
<0.01
ns
ns
ns
ns
ns
ns
Multinomial logistic regression:
Independent variables

Number of alcoholic beverages consumed during a typical day

Frequency of alcohol consumption during a typical week

Number of cigarettes smoked during a typical day

Smoking frequency in the past year

Number of illicit substances used in the past year (composite
variable)
http://addictologie.hug-ge.ch
Multinomial logistic regression
S ex ual
bis ex ually attrac ted
ex c lus iv ely hom os ex ual
preferenc e
V ariable
S ig.
E x p (B )
95% C .I. for ex p (B )
Low er
U pper
Interc ept
0.00005
-
-
-
N um ber of alc oholic beverages
0.06
0.88
0.78
1
N um ber of c igarettes s m ok ed
0.08
1.05
0.99
1.11
N um ber of illic it s ubs tanc es us ed
0.002
1.23
1.08
1.41
- 4-7 day s a w eek
0.3
0.58
0.19
1.75
- 3 day s a w eek or les s
0
-
-
-
- 5-7 day s a w eek
0.6
0.78
0.29
2.08
- 4 day s a w eek or les s
0
-
-
-
Interc ept
0.00005
-
-
-
N um ber of alc oholic beverages
0.009
0.95
0.91
0.99
N um ber of c igarettes s m ok ed
0.2
0.98
0.96
1.01
N um ber of illic it s ubs tanc es us ed
0.003
1.12
1.04
1.2
- 4-7 day s a w eek
0.4
1.15
0.8
1.66
- 3 day s a w eek or les s
0
-
-
-
- 5-7 day s a w eek
0.8
1.04
0.73
1.48
- 4 day s a w eek or les s
0
-
-
-
a
F requenc y of alc ohol c ons um ption
S m ok ing frequenc y
F requenc y of alc ohol c ons um ption
S m ok ing frequenc y
http://addictologie.hug-ge.ch
Jasinski & Ford, 2008; McCabe et al, 2005
College studies

Gay men significantly less likely to binge drink than
heterosexual men

Gay men significantly less likely to endorse norms that are
permissive of binge drinking

Elevated rates of binge drinking in college samples canceling out the
typical LGB/heterosexual differences during this period ?
http://addictologie.hug-ge.ch
Conclusions


Homosexual men

Higher proportion of lifetime drug use (excepted alcohol and cannabis)

Maintain popper and amphetamine consumption until age 20

Hypothesis: gay culture effect?
Bisexual men

Higher proportion of lifetime cigarette and cannabis use

Higher tendency to maintain cigarette and cannabis use until age 20

Less drinks/day

Maintain popper and amphetamine use, but at lesser proportion than
homosexual men

Hypothesis: less affiliated to gay culture, more tendency to consume for
(minority)stress-reduction?
http://addictologie.hug-ge.ch
Service d’addictologie
Centre collaborateur OMS
pour l’enseignement et la recherche sur les addictions
http://addictologie.hug-ge.ch
1/--страниц
Пожаловаться на содержимое документа