Substance use risk among lesbian, gay and bisexual students: Data from the 2005 New York City Youth Risk Behavior Survey

Background: For 13 states conducting the Youth Risk Behavior Survey (YRBS), developed to monitor health risk behaviors among in-school youth, sexual orientation and sexual behavior are ascertained. Prior research indicates significant differences in drug/alcohol use among youth with differing sexual behavior/identity. In 2005, for the first time, the NYC YRBS included sexual identity questions.

METHODS: 2005 NYC YRBS survey data were analyzed. Based on self-reported sexual behavior and identity, female respondents were categorized into heterosexual (N=3565), lesbian (N=132), and bisexual (N=290) groups and males into heterosexual (N=3538), gay (N=118), and bisexual (N=101) groups. Persons with discordant behavior and identity were classified as gay/lesbian if either identity or behavior were reported as such. Those who were missing behavior and identity were excluded (N=374). Chi-Square analysis and one-way analysis of variance with post hoc test of mean difference were used to determine differences in reported substance use between groups.

RESULTS: Significant differences were found between groups in reported tobacco, alcohol, and other drug use. Overall trends show that lesbian/gay/bisexual (LGB) youth were more likely to report ever using substances and increased alcohol use (days drank, binge drinking, age first used). Lesbian/bisexual girls and bisexual boys reported increased tobacco use (age first used, last 30-days, quantity).

DISCUSSION: These data suggest that NYC LGB youth may face significantly greater risk for substance use than heterosexuals. Prevention and health promotion programs must include messages which target and resonate with LGB youth. Furthermore, the data suggest the importance of including sexual orientation on the YRBS.