Disparities in alcohol use and heavy episodic drinking among bisexual people: A systematic review, meta-analysis, and meta-regression

Mostafa Shokoohi; David J Kinitz; Dixon Pinto; Zafiro Andrade-Romo; Zhiheng Zeng; Alex Abramovich; Travis Salway; Lori E Ross

doi:10.1016/j.drugalcdep.2022.109433

Disparities in alcohol use and heavy episodic drinking among bisexual people: A systematic review, meta-analysis, and meta-regression

Drug Alcohol Depend. 2022 Jun 1:235:109433. doi: 10.1016/j.drugalcdep.2022.109433. Epub 2022 Mar 28.

Authors

Mostafa Shokoohi¹, David J Kinitz², Dixon Pinto³, Zafiro Andrade-Romo², Zhiheng Zeng⁴, Alex Abramovich⁵, Travis Salway⁶, Lori E Ross²

Affiliations

¹ Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. Electronic address: mostafa.shokoohi@utoronto.ca.
² Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
³ Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.
⁴ Faculty of Medicine, University of British Columbia, Vancouver, Canada.
⁵ Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
⁶ Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada; British Columbia Centre for Disease Control, Vancouver, Canada; Centre for Gender and Sexual Health Equity, Vancouver Canada.

PMID: 35395502
DOI: 10.1016/j.drugalcdep.2022.109433

Abstract

Background: Alcohol consumption is more prevalent among sexual minorities than among heterosexuals; however, differences between minority sexual orientation groups are understudied. This systematic review and meta-analysis aimed to summarize existing evidence on the prevalence of alcohol use among bisexual people compared to their lesbian/gay and heterosexual counterparts.

Methods: A systematic review of literature from 1995 to May 2020 was performed using Medline, PsycInfo, and Embase (OVID), Scopus, CINHAL and LGBT Life (EBSCO), combining keywords for bisexuality and alcohol use. Peer-reviewed publications that reported quantitative data on alcohol use among bisexual people were included. A random-effects model was used to pool the prevalence of two outcomes: any alcohol use and heavy episodic drinking (HED). Subgroup analysis and random-effects meta-regression were used to explore heterogeneity.

Results: Of 105 studies eligible for data extraction, the overall prevalence of alcohol use was higher among bisexuals compared to lesbian/gay and heterosexual people. For example, the prevalence of past-month HED was 30.0% (28.2, 31.8) among bisexual people versus 25.5% (23.8, 27.2) among lesbian/gay and 21.3% (19.6, 23.0) among heterosexual individuals. Pooled odds ratio estimates showed that bisexual people were more likely to report alcohol use and HED compared to their counterparts. Gender was a significant effect modifier in meta-regression analysis, with greater disparities among women than among men.

Conclusions: These results highlight the need for additional research to understand factors underlying bisexual people's greater risk, and particularly bisexual women, as well as alcohol use interventions that are targeted towards the specific needs of bisexual people.

Keywords: Alcohol; Bisexuals; Disparities; Sexual minorities; Systematic review.

Publication types

Meta-Analysis
Review
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Alcohol Drinking / epidemiology
Bisexuality
Female
Heterosexuality
Homosexuality, Female*
Humans
Male
Sexual Behavior
Sexual and Gender Minorities*

Grants and funding

CIHR/Canada