1. H
azardous Drinking, Drinking Expectancies And Risky Sexual Behaviors In A Community Sample Of Adult Sexual Minority Women
33rd Annual Research Society Meeting
June 29, 2010, San Antonio, Texas
Tonda Hughes, PhD, RN, FAAN
University of Illinois at Chicago

2. Acknowledgements Co-Authors Alicia Matthews, PhD Laura Szalacha, PhD
Sharon Wilsnack, PhD
Frances Aranda, PhD, MPH
Kelly Martin, MPH
Research supported by National Institute on Alcohol Abuse and Alcoholism (NIAAA) # AA00266 and AA13328 (T. Hughes, PI)

3. Background SMW have disproportionately high rates of alcohol use
Alcohol use is a known risk factor for sexual risk-taking
SMW, especially lesbians, are perceived to be at low risk for sexually transmitted infections.
The majority of research on sexual risk behaviors has focused on young SMW

4. Research Questions Do sexual risk behaviors differ by sexual identity?
What are the relationships among sexual risk behaviors and demographic characteristics, sexual identity, hazardous drinking and sexuality/intimacy enhancement drinking expectancies?

5. Chicago Health & Life Experiences of Women Study (CHLEW)
10-year longitudinal study of sexual minority women’s drinking ( )
Chicago community-based sample of adult SMW

6. Targeted Groups (baseline sample)
Women of color
Younger (< 25 yrs) & older (> 50 yrs)
Lower income ($10,000/year or less)
Lower education (high school or less)

7. Baseline Sample Characteristics (N=447)
52% women of color
18-83 years (average = 39 yrs)
56% bachelor’s degree or higher
25% household income <$20,000
68% in committed relationship
31% at least one child

8. Wave 2 Retention (n=384) Wave 2 retention rate = 86%
Women with < HS education more likely to drop out; no other significant predictors of attrition

9. Outcome Variable: Risky Sex Index
Risky sexual behaviors (baseline & wave 1)
Number of sex partners
Use of condoms/barrier protection against STIs
Becoming sexually forward when drinking
Responses summed: 0=none to 9=all risky behaviors

10. Main Predictor: Sexual Identity
Recognizing that sexuality is only part of your
identity, how do you define your sexual identity?
Exclusively lesbian/gay
Mostly lesbian/ gay
Bisexual
Mostly heterosexual
Exclusively heterosexual

11. Control Variables: Demographic Characteristics
Age
Race/ethnicity
Education level
Income (annual household)
Employment status (full, part, unemployed)
Relationship status
(in a committed relationship vs. not)

12. Covariate: Hazardous Drinking Index
Previous 12 months
Heavy drinking (yes/no)
Heavy episodic drinking (yes/no)
Intoxication (yes/no)
Adverse drinking consequences (any of 8)
Alcohol dependence symptoms (any of 5)
Dichotomous responses summed. Scale: 0=none to 5=all five indicators

13. Covariate: Drinking Expectancies
“When you drink, how true is it that...”
you feel less shy or more self-confident?
you feel less inhibited about sex?
sexual activity is more pleasurable for you?
you feel more sexually attractive?
you feel closer to the person you share drinks with?
Responses options: never (0) to usually (3); scale = 0 to 15

14. Data Analysis
Bivariate analyses examined distributions of study variables and compared across sexual identities
Series of nested regression models predicting adult risky sexual behaviors
Model 1: demographic control variables
Model 2: sexual identity added
Model 3: hazardous drinking, sexuality/intimacy related drinking expectancies added

15. Results

16. Sexual Identity (n=368)
Sexual Identity

17. Sexual Identity Differences
Bisexual women tended to be younger (34.7 yrs) than exclusively lesbian (43.4 yrs) and mostly lesbian (37.8 yrs) women
None of the other demographic characteristics differed based on sexual identity

18. Hazardous Drinking by Sexual Identity
***P<.001

19. Alcohol Expectancies by Sexual Identity

20. Risky Sexual Behavior by Sexual Identity
***P<.001

21. Sexual Risk Scores
Negatively associated with age (r = -.33, p<.001).
Negatively associated with committed relationship status. Women in committed relationships reported significantly lower level of risky sexual behavior (M = 2.56 vs. M = 2.88, p<.001).
Positively associated with hazardous drinking (r = .33, p<. 001) and with sexuality/intimacy-related drinking expectancies (r = .23, p<. 001).

22. R2 .18 .20 .36 Regression Models Predicting Risky Sexual Behavior
β (Std Error)
-.05 (.007)***
.25 (.198)
-.03 (.208)
.16 (.090)
-.15 (086)
.08 (.087)
-.39 (.176)*
Model 2
β (Std Error)
-.05 (.007)***
.25 (.196)
-.03 (.206)
.14 (.090)
-.16 (.085)
.02 (.086)
-.36 (.175)*
.37 (.177)*
1.22 (.447)***
Model 3
β (Std Error)
-.03 (.005)***
.22 (.176)
-.05 (.186)
.10 (.081)
-.07 (.077)
.05 (.077)
-.25 (.158)
.22 (.160)
1.00 (.402)*
.32 (.052)***
.73 (.134)**
Demographic Characteristics
Age
Black (White = Referent Group)
Latina
Education
Income
Employment
Committed Relationship
Sexual Orientation
Mostly Lesbian (Lesbian = Referent Group)
Bisexual
Alcohol Use
Hazardous Drinking
Alcohol Expectancies R
*p<.05 **p<.01 ***p<.001

23. Limitations Nonprobability sample Small number of bisexual women
Limited measures of risky sex
Limited measures of negative health outcomes

24. Conclusions & Recommendations
SMW do engage in risky sexual behaviors, but risk differs across sexual identity groups
Associations between alcohol expectancies and risky sexual behaviors are consistent with previous research

25. Conclusions & Recommendations (cont.)
Bisexual women & younger women were at highest risk for both hazardous drinking and risky sexual behaviors
Strategies to reduce sexual risk should address the influence of alcohol and take into consideration the differing level of risk within sexual minority populations.

26. Thank You!!!