Sexual Abuse and Substance Use Among Heterosexual and Lesbian Women: Women Enrolled in the ESTHER Study

Our aim was to investigate the association between substance use (cigarette use, alcohol use and illicit drug use) and sexual abuse history among lesbian and heterosexual women using data from the ESTHER Project (Epidemiologic STudy of HEalth Risk in Women). The ESTHER Project (2003-2006) included 1084 women 34 years and over, about half self-identified as lesbian (n= 504). Three self-reported sexual abuse measures were used. Childhood sexual abuse was assessed by asking respondents whether they were sexually abused by a family member or non-family member prior to age 18. Adult sexual abuse asked about forced activity after age 18. Chi square tests compared the prevalence rates of cigarette smoking, alcohol use, and drug use in relation to self-reported sexual abuse and sexual orientation. No significant differences were found between lesbians and heterosexuals in the amount of cigarettes smoked per day or number of drinks consumed per month. Lesbians had significantly higher rates of all types of sexual abuse and significantly higher rates of lifetime illicit drug use (OR=3.6). Logistic regression analysis adjusting for potential confounders (age, race, sexual orientation, sexual abuse history, education, income, mental health diagnosis) found that a younger age, a lesbian sexual orientation, and history of depression were associated with history of illicit drug use. All sexual abuse variables dropped out of the model and therefore were not significant predictors of lifetime illicit drug use. The data suggest that future drug recovery programs and interventions should examine how sexual orientation influences drug use, specifically for lesbians.