Exposure to intimate partner violence and subsequent substance use among a nationwide sample of LGBTQIA+ people: results of The PRIDE Study.

BACKGROUND

Individuals who are lesbian, gay, bisexual, transgender, queer or questioning, intersex, aromantic, asexual, or another sexual or gender minority (LGBTQIA+) are at greater risk of both intimate partner violence (IPV) and substance use compared to their cisgender, heterosexual counterparts. However, knowledge regarding the complex relationship between IPV and substance use in LGBTQIA+ communities is limited.

METHODS

This study used data from 2 years of The PRIDE (Population Research in Identity and Disparities for Equality) Study, a nationwide, community-based sample of LGBTQIA+ adults in the United States. Past-year IPV in 2021 was measured using the Extended-Hurt, Insulted, Threaten, Scream scale. Substances used in 2022 were measured via the NIDA-Modified Alcohol, Smoking, and Substance Involvement Screening Test (NM ASSIST). Linear and modified Poisson regression models explored temporal relationships between past-year IPV and prospective substance use.

RESULTS

Participants (n = 3745) were relatively young (median= 34 years, interquartile range: 27.6-48.5) and represented diverse LGBTQIA+ subcommunities. Approximately one-quarter (23.7%) were cisgender women and 17% were cisgender men. Half (49.2%) were gender minority people. Overall, one-quarter (24.6%) reported exposure to IPV in 2021. In adjusted models, past-year IPV was associated with prospective substance use (risk ratio [RR]: 1.11; 95% CI, 1.03-1.19). Additionally, more frequent IPV was associated with a higher prospective NM ASSIST score for cannabis (B: 0.22; 95% CI, 0.08-0.36), stimulants (B: 0.20; 95% CI, 0.06-0.35), hallucinogens (B: 0.07; 95% CI, 0.02-0.12), and narcotics (B: 0.12; 95% CI, 0.03-0.20).

CONCLUSIONS

Exposure to IPV in 2021 was linked to greater substance use in 2022. Findings underscore the role of IPV in substance use among LGBTQIA+ people. Furthermore, they point to the need for increased IPV screening and referral among LGBTQIA+ people, as well as the potential efficacy of trauma-informed substance use interventions that address IPV.