Sexual orientation disparities in illicit substance use: Interactions with age, race/ethnicity, and gender across multiple substances

Background: Compared to their heterosexual counterparts, lesbian, gay, and bisexual (LGB) youth report earlier initiation and steeper illicit substance use trajectories into young adulthood than heterosexual youth. Little is known about demographic differences (i.e., age, race/ethnicity, and gender) in drug use and how these differences influence sexual orientation disparities in illicit substance use. Additionally, to our knowledge no previous studies have examined whether these patterns of group differences in drug use are consistent across multiple substance types. Methods: Using Youth Risk Behavior Survey data pooled from 14 locations and 2 years (weighted N>34,000), we examined how age, race/ethnicity, and gender modified relationships between sexual orientation and illicit substance use (i.e., marijuana, cocaine, ecstasy/MDMA, inhalants, heroin). Results: Sexual minorities endorsed significantly more substance use than sexual majority youth, t(3248) = -20.30, p<.001. In terms of gender by sexual orientation interactions, male sexual minorities endorsed the highest rates of drug use for all substances except marijuana use for which female sexual minorities endorsed the most use. In the sexual majority population, there were significant racial differences in drug use, F(7,36110) = 66.05, p<.001, but there were fewer racial differences among sexual minority adolescents. Finally, use of all substances except inhalants increased with development, with older sexual minorities reporting the highest rates of drug use. Differences by sexual identity and sexual behavior will also be examined. Conclusions: Analyses reveal several novel findings for racial, gender, and developmental differences in drug use that help to explain sexual orientation disparities in use of a variety of substances.