BACKGROUND Prior studies characterizing sexual minority substance use disparities have primarily compared lesbian/gay and bisexual individuals, respectively or in combination, to heterosexual individuals. In light of emerging evidence that bisexual individuals may have particularly elevated substance use risk, we examine differences in recent substance use between bisexual and lesbian/gay individuals using national survey data. METHODS Data on 126,463 adults (including 8241 LGB adults) were from the 2015-2017 National Survey on Drug Use and Health. Substance use outcomes included binge drinking, cigarette smoking, cigar smoking, marijuana use, illicit drug use, opioid misuse, alcohol use disorder, nicotine dependence, and substance use disorder. Logistic regression was used to estimate sexual identity- and gender-specific odds ratios, controlling for demographic characteristics. Of particular interest were estimates comparing bisexual and lesbian/gay individuals of the same gender. RESULTS Both male and female sexual minority adults had significantly elevated rates of substance use compared to heterosexual adults. Furthermore, relative to lesbian/gay women, bisexual women had significantly elevated odds of binge drinking (aOR = 1.29), marijuana use (aOR = 1.42), illicit drug use (aOR = 1.55), opioid misuse (aOR = 1.53), and alcohol use disorder (aOR = 1.48). Relative to gay men, bisexual men had significantly elevated cigar use (aOR = 1.64). CONCLUSIONS Bisexual women were at significantly greater risk for multiple substance use behaviors relative to lesbian/gay women. We did not observe any substance use behaviors for which bisexual individuals had significantly lower risk than their lesbian/gay peers. These disparities may be explained, in part, by unique risk factors for substance use experienced by bisexual individuals, particularly bisexual women.

中文翻译：

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性少数族裔物质使用方面的差异：与其他性少数族裔群体相比，双性恋女性的风险较高。

背景技术先前表征性少数物质使用差异的研究主要将女同性恋者/同性恋者和双性恋者分别或组合地与异性恋者进行了比较。鉴于新出现的证据表明双性恋者可能具有特别高的物质使用风险，因此，我们使用国家调查数据研究了双性恋者和女同性恋/同性恋者之间最近的物质使用差异。方法126,463名成人（包括8241名LGB成人）的数据来自2015-2017年全国药物使用和健康调查。物质使用的结果包括暴饮暴食，吸烟，抽雪茄，使用大麻，非法药物使用，阿片类药物滥用，酒精使用障碍，尼古丁依赖和物质使用障碍。使用Logistic回归来估计特定性别和性别的比值比，控制人口特征。特别令人感兴趣的是比较相同性别的双性恋者和女同性恋者/同性恋者的估计。结果与异性恋成年人相比，男性和女性少数族裔成年人的物质使用率均显着提高。此外，相对于女同性恋/同志女性，双性恋女性的暴饮暴食（aOR = 1.29），大麻使用（aOR = 1.42），非法药物使用（aOR = 1.55），阿片类药物滥用（aOR = 1.53）和饮酒障碍（aOR = 1.48）。相对于男同性恋者，双性恋男人的雪茄使用量显着增加（aOR = 1.64）。结论双性恋女性相对于女同性恋者/同志女性而言，发生多种物质使用行为的风险明显更高。我们没有观察到双性恋者的危险性明显低于其同性恋者/同龄人的任何药物滥用行为。这些差异可以部分地由双性恋者，特别是双性恋女性经历的物质使用的独特危险因素来解释。