目标:性和性别少数(SGM)人群饮酒风险增加,有害饮酒,与异性恋和顺性个体相比,酒精使用障碍。本文:(A)提出了一个整合交叉性的压迫框架,压力,污名,和基于成瘾的理论来检验基于压迫的压力的复杂和细微的方式(例如,少数族裔压力)导致酒精使用中的性取向和性别认同不平等;(b)进行叙述性回顾,总结了基于压迫的压力源对整个结构,人际关系,以及SGM人群中的个人领域;(c)为酒精领域提供了未来的研究和干预方向。
方法:于2023年7月10日使用多个电子数据库对文献进行了部分审查(即,PsycInfo,PubMed,WebofScience),并专注于研究基于压迫的压力源和酒精使用结果之间的关系,人际关系,和内部水平。搜索词专注于酒精消费;SGM人,特别是SGM有色人种;和基于压迫的压力。横断面研究集中在人际或人际水平的基于异性恋和基于反双性恋压迫的压力源以及酒精使用结果被排除在外,因为它们已被包括在先前的文献综述中。
■跨数据库的初始和组合搜索产生了3,205篇文章。其中,叙述性综述包括50篇同行评审的文章,重点关注以下四个领域的文献,这些文献涉及基于压迫的压力源与酒精使用结果之间的关联:(1)实验,纵向,和经验抽样研究异性恋和反双性恋压迫的压力源(22篇文章);(2)任何研究基于顺性的压力源(12篇文章);(3)任何研究SGM有色人种的交叉压迫(7篇文章,一篇文章与第一类重叠,另一篇与第四类重叠);(4)任何结构压迫研究(11篇)。
结论:此叙述性综述的结果表明,越来越多的证据表明,在酒精使用不平等中存在基于压迫的压力,有害饮酒,和SGM人群的酒精使用障碍。这反映了SGM人民在结构上对压迫和不公正的体现,人际关系,和内部水平。鉴于一些不一致和混合的发现模式,未来的研究需要在饮酒纳入标准方面有更大的特异性,稳健且经过充分验证的措施,更多关注整个生命周期中与文化和发展相关的调节和调解机制,复杂方法的应用,以及交叉和成瘾框架的整合。
OBJECTIVE: Sexual and gender minority (SGM) people are at heightened risk for alcohol use, hazardous drinking, and alcohol use disorder compared to heterosexual and cisgender individuals. This paper: (a) presents an oppression framework that integrates intersectionality, stress, stigma, and addiction-based theories to examine the complex and nuanced ways oppression-based stress (e.g., minority stress) leads to sexual orientation and gender identity inequities in alcohol use; (b) conducts a narrative review that summarizes recent and novel advancements in the literature on the impact of oppression-based stressors on alcohol use outcomes across structural, interpersonal, and intrapersonal domains among SGM people; and (c) provides future research and intervention directions for the alcohol field.
METHODS: A select review of the literature was conducted on July 10, 2023, using multiple electronic databases (i.e., PsycInfo, PubMed, Web of Science) and focusing on studies that had examined the associations between oppression-based stressors and alcohol use outcomes across structural, interpersonal, and intrapersonal levels. Search terms focused on alcohol consumption; SGM people, particularly SGM people of color; and oppression-based stress. Cross-sectional studies that focused on heterosexism-based and anti-bisexual oppression-based stressors at the interpersonal or intrapersonal levels and alcohol use outcomes were excluded as they have been included in prior reviews of the literature.
UNASSIGNED: The initial and combined search across the databases resulted in 3,205 articles. Of those, the narrative review included 50 peer-reviewed articles that focused on the following four areas of the literature on the associations between oppression-based stressors and alcohol use outcomes: (1) experimental, longitudinal, and experience sampling studies of heterosexism- and anti-bisexual oppression-based stressors (22 articles); (2) any studies of cissexism-based stressors (12 articles); (3) any studies of intersectional oppression among SGM people of color (seven articles, one article overlapped with the first category and another overlapped with the fourth category); and (4) any studies of structural oppression (11 articles).
CONCLUSIONS: Results of this narrative review indicate that mounting evidence implicates oppression-based stress in inequities in alcohol use, hazardous drinking, and alcohol use disorder in SGM populations. This reflects SGM people\'s embodiment of oppression and injustice at the structural, interpersonal, and intrapersonal levels. Given some inconsistent and mixed patterns of findings, future research needs greater specificity in drinking inclusion criteria, robust and well-validated measures, more attention to culturally and developmentally relevant moderating and mediating mechanisms across the lifespan, application of sophisticated methodologies, and integration of intersectional and addiction frameworks.