Rates and Predictors of Alcoholics Anonymous Involvement Among Sexual Minorities and Heterosexuals

BACKGROUND/PURPOSE:

Sexual minorities (e.g., gay, lesbian, bisexual individuals) are more likely than heterosexuals to experience symptoms of alcohol use disorder. Among the general population, Alcoholics Anonymous (AA) is the most common source of support for alcohol-related problems in the United States. Among general samples, religiosity and family support have been found to increase the likelihood of AA involvement. Small, qualitative studies of sexual minority samples suggest that religiosity and family support may predict AA involvement in the opposite direction for sexual minorities; these studies have found that sexual minorities who are more religious feel less comfortable participating in AA due to tensions between their religious beliefs and their sexual orientations, and sexual minorities with less family support participate in AA partially to compensate for their lack of family support. Despite higher rates of alcohol use disorders among sexual minorities, no known research has examined rates or predictors of AA involvement among sexual minorities. To fill this gap, this presentation answers the following questions: (a) Are sexual minorities involved in AA at different rates than heterosexuals? (b) Do religiosity and family support predict AA involvement differently across sexual orientations?

METHODS:

A nationally representative sample of 24,636 adults (n=576 sexual minorities) were surveyed between 1995 and 2010 through four waves of the National Alcohol Survey. Sexual orientation, gender, lifetime alcohol use symptom severity, religiosity, and family support were self-reported. Logistic regression was utilized to determine odds of AA involvement across sexual orientation and odds of AA involvement for individuals with varying levels of religiosity and family support, compared across sexual orientations, controlling for gender and lifetime alcohol use symptom severity.

RESULTS:

Overall, 8.5% (n=49) of sexual minorities vs. 2.7% (n=548) of heterosexuals endorsed AA involvement. Sexual minorities were three times as likely as heterosexuals to be involved with AA (AOR: 3.01, p<.0001). Respondents with more family support had lower adjusted odds of AA involvement (AOR: 0.84, p<.0001) regardless of sexual orientation. Religiosity was unassociated with AA involvement regardless of sexual orientation.

CONCLUSIONS/IMPLICATIONS:

This study fills an important gap by being the first national, quantitative study to compare rates and predictors of AA involvement across sexual orientation. The finding that sexual minorities have higher rates of AA involvement may suggest that AA is an important source of support and a promising referral option for members of this community who are struggling with alcohol use. Future research should assess satisfaction and outcomes of AA involvement among sexual minorities to test these hypotheses. Limitations of this study include its use of cross-sectional data and the small number of sexual minority respondents endorsing AA involvement, which limited potential for causal inference and statistical power for moderation analyses. These limitations may help to explain several unexpected null results, including the absence of differences in predictors of AA involvement across sexual orientations. Future research should replicate this analysis using longitudinal data and a larger sample of sexual minorities endorsing AA involvement to bolster confidence in these null results.