The Association between Hazardous Drinking Indicators and Drinking Problem Concerns among Sexual Minority Women

Sexual minority women (SMW) report high rates of hazardous drinking (HD), treatment utilization that is not commensurate with need, and low perceived alcohol use severity. This study examined SMW's drinking problem concerns by sexual identity and other demographic characteristics, and the strength of associations between endorsement of unique HD indicators and drinking problem concerns. Data were from a supplemental sample of SMW added in Wave 3 of the longitudinal, community-based Chicago Health and Life Experiences of Women (CHLEW) study. HD was measured using a validated 13-item HD Index (HDI). Multivariable logistic regression models examined independent associations between past-five-year drinking problem concerns and each HD indicator. Twelve HD indicators were significantly associated with past-five-year drinking problem concerns, adjusting for age and sexual identity. Adjusted odds ratios varied from 2.44 for driving drunk to 15.52 for drinking first thing in the morning. After adjusting for number of HD indicators endorsed, associations were no longer significant, indicating that number of endorsed indicators was a more important predictor of drinking problem concerns than were individual HD indicators. Early intervention and harm reduction strategies could support SMW in addressing salient aspects of HD before progression to alcohol use disorder.

Mothers’ Sexual Identity and Children’s Health

Sexual minority women face a plethora of structural, socioeconomic, and interpersonal disadvantages and stressors. Research has established negative associations between women’s sexual minority identities and both their own health and their infants’ birth outcomes. Yet a separate body of scholarship has documented similarities in the development and well-being of children living with same-sex couples relative to those living with similarly situated different-sex couples. This study sought to reconcile these literatures by examining the association between maternal sexual identity and child health at ages 5–18 using a US sample from the full population of children of sexual minority women, including those who identify as mostly heterosexual, bisexual, or lesbian, regardless of partner sex or gender. Analyses using data from the National Longitudinal Study of Adolescent to Adult Health (N = 8978) followed women longitudinally and examined several measures of their children’s health, including general health and specific developmental and physical health conditions. Analyses found that children of mostly heterosexual and bisexual women experienced health disadvantages relative to children of heterosexual women, whereas the few children of lesbian women in our sample evidenced a mixture of advantages and disadvantages. These findings underscore that to understand sexual orientation disparities and the intergenerational transmission of health, it is important to incorporate broad measurement of sexual orientation that can capture variation in family forms and in sexual minority identities.

Challenges of Virtual RDS for Recruitment of Sexual Minority Women for a Behavioral Health Study

Respondent-driven sampling (RDS) is an approach commonly used to recruit nonprobability samples of rare and hard-to-find populations. The purpose of this study was to explore the utility of phone- and web-based RDS methodology to sample sexual minority women (SMW) for participation in a telephone survey. Key features included (i) utilizing a national probability survey sample to select seeds; (ii) web-based recruitment with emailed coupons; and (iii) virtual processes for orienting, screening, and scheduling potential participants for computer-assisted telephone interviews. Rather than resulting in a large diverse sample of SMW, only a small group of randomly selected women completed the survey and agreed to recruit their peers, and very few women recruited even one participant. Only seeds from the most recent of two waves of the probability study generated new SMW recruits. Three RDS attempts to recruit SMW over several years and findings from brief qualitative interviews revealed four key challenges to successful phone- and web-based RDS with this population. First, population-based sampling precludes sampling based on participant characteristics that are often used in RDS. Second, methods that distance prospective participants from the research team may impede development of relationships, investment in the study, and motivation to participate. Third, recruitment for telephone surveys may be impeded by multiple burdens on seeds and recruits (e.g., survey length, understanding the study and RDS process). Finally, many seeds from a population-based sample may be needed, which is not generally feasible when working with a limited pool of potential seeds. This method may yield short recruitment chains, which would not meet key RDS assumptions for approximation of a probability sample. In conclusion, potential challenges to using RDS in studies with SMW, particularly those using virtual approaches, should be considered.