Sexual Orientation Disparities in Longitudinal Alcohol Use Patterns Among Adolescents

Abstract

Objective: To compare sexual orientation group dif- ferences in the longitudinal development of alcohol use behaviors during adolescence. Design: Community-based prospective cohort study. Setting: Self-reported questionnaires. Participants:Atotal of 13 450 GrowingUpToday Study participants (79.7% of the original cohort) aged 9 to 14 years at baseline in 1996 were followed up for more than 7 years. Results: Compared with heterosexual participants, youth reporting any minority sexual orientation reported hav- ing initiated alcohol use at younger ages. Greater risk of alcohol use was consistently observed for mostly hetero- sexual malesandfemalesandfor bisexual females, whereas gay and bisexual males and lesbians reported elevated lev- els of alcohol use on only some indicators. Gender was an important modifier of alcohol use risk; mostly het- erosexual and bisexual females exhibited the highest rela- tive risk. Younger age at alcohol use initiation among par- ticipants with minority sexual orientations significantly contributed to their elevated risk of binge drinking. Main Exposure: Self-reported sexual orientation clas- sified as heterosexual, mostly heterosexual, bisexual, or gay/lesbian. Main Outcome Measures: Age at alcohol use initia- tion, any past-month drinking,numberof alcoholic drinks usually consumed, and number of binge drinking epi- sodes in the past year. Conclusions: Our findings suggest that disparities in al- cohol use among youth with a minority sexual orienta- tion emerge in early adolescence and persist into young adulthood. Health care providers should be aware that adolescents with a minority sexual orientation are at greater risk of alcohol use.