Similar findings are available from comparisons of alcohol consumption among women who identified their sexual orientation as heterosexual, lesbian, or bisexual in a prospective cohort from the NHSII (Case et al., 2004). The authors found that lesbians and bisexual women were significantly more likely than heterosexual women to report having engaged in heavy drinking, defined as consuming 60 or more alcohol-containing drinks a month.

Drabble and colleagues (2005) examined the prevalence of drinking and alcohol-related problems among homosexual, bisexual, and heterosexual respondents in the 2000 National Alcohol Survey (n = 7,248). Sexual orientation was based on both self-identity and behavior, which yielded four categories of participants: homosexual, bisexual, heterosexual with same-sex partners, and exclusively heterosexual. Few significant differences were found among men by sexual orientation, with the only significant finding being that the gay men had lower abstention rates than the exclusively heterosexual men. By contrast, both the heterosexual women with same-sex partners and the bisexual women had significantly lower abstention rates than the exclusively heterosexual women. The lesbians and bisexual women also had significantly greater odds of reporting alcohol-related social consequences and alcohol dependence (according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth revision [DSM-IV]) than the exclusively heterosexual women.

In the previously mentioned study by Drabble and Trocki (2005), other differences in alcohol use were found among the four groups of female participants. Compared with the exclusively heterosexual women, the mean number of drinks per year was elevated among the lesbians, bisexual women, and women who self-identified as heterosexual but reported same-sex partners. When demographic variables were controlled, however, the only significant difference was between the exclusively heterosexual women and the heterosexual self-identified women with same-sex partners. When looking at alcohol consumption in different contexts, the authors found that the heterosexual self-identified women who reported same-sex partners were more likely both to frequent bars and to drink heavily in bars relative to the exclusively heterosexual women. The bisexual self-identified women were less likely to frequent bars, but were more likely to drink heavily in both bars and party contexts compared with the exclusively heterosexual women (Drabble and Trocki, 2005).

In a study using survey data from 1996–1998, Scheer and colleagues (2002) examined sexual and drug use behaviors among women who have sex with women who resided in low-income neighborhoods in Northern California. Based on sexual behavior, the respondents, aged 18–29, included women who had sex exclusively with men (n = 2,229), women who had sex with both men and women (n = 189), and women who had sex



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