Illicit Substance Use Disparities Among Lesbian, Gay, and Bisexual High School Students in the U.S. in 2017

PURPOSE: Studies have demonstrated a disparity in sexual minority adolescents and substance use, possibly due to factors contributing to minority stress. The objective of this study is to investigate the association between self-identifying as lesbian, gay, or bisexual and illicit substance use compared to those who identify as heterosexual among high school students in the U.S. METHODS: A secondary data analysis of a cross-sectional study was performed using data from the Youth Risk Behavior Surveillance System in 2017. The study included adolescents attending public, Catholic, or private U.S. high schools. Participants with missing data on substance use and sexual orientation were excluded. The final sample size was 12,370. The main outcome variable was illicit substance use, which included marijuana and cocaine, among others. The main exposure variable was students who identified as heterosexual, gay or lesbian, bisexual, and unsure. Binary logistic regression analysis was used to calculate unadjusted and adjusted odds ratios and 95% confidence intervals (CIs). RESULTS: Participants who identified as bisexual had 1.65-fold increased odds (95% CI 1.32-2.05) of ever using illicit substance(s) compared to heterosexuals. Those who identified as not sure of their sexual identity had 1.37-fold increased odds of ever using illicit substance(s) compared to heterosexuals (95% CI 1.03-1.83). CONCLUSIONS: The results will provide health professionals with more information about illicit substance use among lesbian, gay, or bisexual identified adolescents. An increase in the understanding of health disparities associated with sexual identity may assist in the development of interventions