Sexual-orientation differences in drinking patterns and use of drinking contexts among college students

Background: Evidence suggests there are important sexual-orientation differences in alcohol consumption, particularly among women. Little is known about where gay/lesbian and bisexual college students drink or differences in drinking patterns derived from graduated frequency measures between heterosexual, gay/lesbian, and bisexual students. The goal of this analysis was to examine patterns of alcohol consumption-including drinking prevalence, quantity, frequency, and contexts of use-by sexual orientation. Methods: Data on sexual identity, gender, drinking behaviors, and drinking contexts were examined from repeated cross-sectional samples of undergraduate students attending 14 public California universities from 2003-2011 (n = 58,903). Multivariable statistical techniques were employed to examine sexual-orientation differences stratified by gender. Results: Gay males, lesbians, and bisexual females were significantly more likely to report drinking alcohol in the current semester than their same-gender heterosexual peers (relative risks ranged from 1.07 to 1.10, p-values <0.01). Among current drinkers, bisexual females consumed 7 or more drinks and lesbians consumed 10 or more drinks on significantly more days than heterosexual females. On the other hand, gay male drinkers consumed 8 or more drinks on significantly fewer days than heterosexual male drinkers. Compared to their same-gender heterosexual peers: lesbian/gay and bisexual students drank less frequently at Greek parties (incidence rate ratios [IRRs] ranged from 0.52 to 0.73, p-values <0.01); lesbians (IRR = 0.84, p = 0.043) and bisexual males (IRR = 0.82, p = 0.009) drank less frequently at off-campus parties; and gay males drank more frequently outdoors (IRR = 1.63, p < 0.001) and at bars/restaurants (IRR = 1.21, p = 0.013). Conclusions: Alcohol prevention programs and future research should consider sexual-orientation differences in drinking patterns and use of drinking contexts.