Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults
Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults
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DOI：
10.1111/add.14819
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发表时间：
2019-12-26
期刊：
影响因子：
6
通讯作者：
Boyd, Carol J.
中科院分区：
文献类型：
--
作者：
Kahle, Erin M.;Veliz, Phil;Boyd, Carol J.
背景和目的性少数（SM）人群的经验与性取向相关的压力增加的物质使用障碍（SUD）的发病率较高。社会支持可能会缓和压力对SM成年人SUD的影响。本研究评估社会支持和DSM-5 SUD的性别和性少数身份之间的关联。设计横断面研究，使用2012-13年全国酒精和相关疾病流行病学调查（NESARC-III）的数据。设置和参与者在美国的成人（n = 36309）的全国代表性横断面样本。根据DSM-5酒精使用（AUD）、烟草使用（TUD）和药物使用（DUD）障碍标准定义SUD测量值。结构性社会支持以亲属和非亲属接触的类型和频率来衡量，功能性社会支持以社会供给量表来衡量。结果：与异性恋成年人相比，SM成年人发生所有SUD的几率更高[AUD = 1.535，95% CI = 1.782-1.844; TUD = 1.512，95% CI = 1.234-1.854; DUD = 1.520，95% CI = 1.139-2.028]; SM女性在所有SUD中的比例最高（AUD = 27.1%，TUD = 29.1%，DUD = 10.9%）。社会支持的类型与性别和性别认同状态的SUD差异。较高的社会供给与较低的AUD [校正比值比（aOR）= 0.771，95%CI = 0.705-0.844]、TUD（aOR = 0.747，95%CI = 0.694-0.804）和DUD（aOR = 0.558，95%CI = 0.490-0.636）发生率相关。在异性恋男性中，婚姻与较低的SUD相关（AUD，aOR = 0.500，95% CI = 0.432-0.579; TUD，aOR = 0.603，95% CI = 0.521-0.699; DUD，aOR = 0.504，95%CI = 0.369-0.689）和女性（AUD，aOR = 0.637，95%CI = 0.529-0.767; TUD = 0.0.584，95%CI = 0.507-0.671; DUD，aOR = 0.515，95%CI = 0.372-0.712）。与异性恋成年人相比，至少有一个18岁以下子女的SM女性发生TUD的几率更高（aOR = 1.990，95%CI = 1.325-2.988）。在某些SM亚组中，SM相关歧视与SUD无关，但在报告同性吸引或行为的男性异性恋识别个体中的歧视与AUD相关（aOR = 4.608，95%CI = 1.615-13.14）。结论：在美国，功能性支持（支持的质量或提供）和结构性支持（社交网络的类型和频率）与物质使用障碍（SUD）之间存在显著相关性，这些相关性因性别和性别身份状态而异。
Background and Aims Sexual minority (SM) populations experience higher rates of substance use disorder (SUD) associated with increased sexual orientation-related stress. Social support may moderate the impact of stress on SUD among SM adults. This study assessed associations between social support and DSM-5 SUD by sex and sexual minority identity. Design Cross-sectional study using data from the 2012-13 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). Setting and participants A nationally representative cross-sectional sample of adults (n = 36 309) in the United States. Measurements SUD were defined based on the DSM-5 criteria for alcohol use (AUD), tobacco use (TUD) and drug use (DUD) disorders. Structural social support was measured as the type and frequency of kin and non-kin contact, and functional social support was measured by the Social Provision Scale. Findings SM adults had higher odds of all SUD compared to heterosexual adults [AUD = 1.535, 95% confidence interval (CI) = 1.782-1.844; TUD = 1.512, 95% CI = 1.234-1.854; DUD = 1.520, 95% CI = 1.139-2.028]; SM women experienced the highest proportion of all SUD (AUD = 27.1%, TUD = 29.1%, DUD = 10.9%). Type of social support was differentially associated with SUD by sex and sexual identity status. Higher social provision was associated with lower rates of AUD [adjusted odds ratio (aOR) = 0.771, 95% CI = 0.705-0.844], TUD (aOR = 0.747, 95% CI = 0.694-0.804] and DUD (aOR = 0.558, 95% CI = 0.490-0.636). Marriage was associated with lower SUD among heterosexual men (AUD, aOR = 0.500, 95% CI = 0.432-0.579; TUD, aOR = 0.603, 95% CI = 0.521-0.699; DUD, aOR = 0.504, 95% CI = 0.369-0.689) and women (AUD, aOR = 0.637, 95% CI = 0.529-0.767; TUD = 0.0.584, 95% CI = 0.507-0.671; DUD, aOR = 0.515, 95% CI = 0.372-0.712). Compared to heterosexual adults, SM women with at least one child under the age of 18 years had higher odds of TUD (aOR = 1.990, 95% CI = 1.325-2.988). SM-related discrimination was not associated with SUD among some SM subgroups, but discrimination among male heterosexually identifying individuals reporting same-sex attraction or behavior was associated AUD (aOR = 4.608, 95% CI = 1.615-13.14). Conclusions In the United States there are significant associations between functional support (quality or provision of support) and structural support (type and frequency of social networks) and substance use disorder (SUD) which differ by sex and sexual identity status.