Multivariate Patterns of Substance Use, Minority Stress and Contextual Violence Associated with Sexual Revictimization of Lesbian and Bisexual Emerging Adult Women

Background and Purpose: Risk factors for victimization, including sexual victimization, among LGBT+ persons have been identified. These include clinically significant substance use problems, other forms of trauma and victimization, forms of minority stress, as well as other individual, relationship and structural factors. However, our current understanding about the degree to which these risk factors differ between lesbian and bisexual emerging adult women is rudimentary. This gap in the available research represents a challenge in our ability to tailor trauma-informed health and mental health intervention services for sexual minority women. The aim of this study was to describe group differences between lesbian and bisexual women in an Internet-recruited sample of sexual minority emerging adult women, grouped by their experiences of sexual victimization during childhood and during recent intimate partner violence (IPV) for (a) past-year substance use, (b) minority stressors, and (c) contextual violence exposure.

Methods: Samples of lesbian (N=204, mean age = 23.55, 36.8% non-White, 20.0% Latine) and bisexual women (N=249, mean age = 23.35, 31.8% non-White, 18.1% Latine) were recruited on the Internet via CloudResearch. Participants answered a 20-minute survey measuring substance use, lifetime traumas, romantic relationships, sexual-minority related stressors, and structural influences on violence exposure. Sexual victimization was assessed both as a childhood adverse experience (ACE) and as a component of lifetime intimate partner violence (IPV). Substance use involvement was assessed using validated brief screeners (i.e., the AUDIT, DAST, SIP-R). Contextual violence was assessed using measures of relational aggression and victimization, criminal victimization and neighborhood crime. Five measures of minority stressors were included.

Results: Cross-tabulations of the dichotomous childhood sexual victimization variable and the dichotomous sexual victimization IPV variable yielded four groups of lesbian women based on their sexual victimization experiences: Never Sexually Victimized (n=99, 48.5%), Sexually Victimized in Childhood (n=33, 16.2%), Sexually Victimized in Adulthood Via IPV (n=36, 17.6%), and Sexually Revictimized in Adulthood Via IPV (n=36, 17.6%). In the sample of bisexual women, the comparable groupings included: Never Sexually Victimized (n=116, 46.6%), Sexually Victimized in Childhood (n=48, 19.3%), Sexually Victimized in Adulthood via IPV (n=43, 17.3%), and Sexually Revictimized in Adulthood Via IPV (n=42, 16.9%). This classification provided four sexual victimization groups for subsequent MANOVA models. Lesbian women reporting both childhood sexual victimization and sexual victimization IPV reported significantly higher scores for past-year substance use involvement and negative consequences, daily discrimination experiences, relational victimization and criminal victimization, compared to their counterparts with no history of sexual victimization. Among bisexual women, the combined experiences of childhood sexual victimization and IPV sexual victimization were associated with a similar pattern of between-group differences.

Conclusions and Implications: These findings suggest that sexual revictimization of sexual minority women occurs in the context of multivariate patterns of substance use, minority stressors and violence exposure. This highlights the importance of trauma-informed and integrated intervention services to address co-occurring sexual trauma, harmful substance use, and other forms of violence in the lives of sexual minority women, as well as the need for specialized training for social work professionals who provide these services.