Record Details

The Relationship Between Sexual Orientation Identity and Specific Health Behaviors

ScholarsArchive at Oregon State University

Field Value
Title The Relationship Between Sexual Orientation Identity and Specific Health Behaviors
Names Muzacz, Arien K. (creator)
Dykeman, Cass (advisor)
Date Issued 2015-06-05 (iso8601)
Note Graduation date: 2015
Abstract The American Counseling Association's Code of Ethics states that counselors and
counselor trainees must be competent providers of multicultural counseling, able to practice
effectively with clients whose identities differ from their own. Counseling students and trainees
receive very little training around sexual orientation and how to work with clients who identify
as members of a sexual minority group (i.e., LGB; lesbian, gay or bisexual). Counselors,
counselor educators and pre-service counselors are also asked to seek out current, relevant
research to provide a basis for the interventions and treatment offered to clients.
Recent literature in public health has identified health disparities among individuals who
identify as, or are identified as, sexual minorities. Higher rates of psychiatric disorders, substance
use, heart disease, tobacco use, and obesity have been found in LGB samples as compared to
heterosexual samples. However, existing articles are limited by: (a) sampling issues, including
small sample sizes, (b) an overall lack of racial and ethnic diversity, and (c) the conflation of
sexual behavior with identity. Additionally, counselors and counselor educators have not
researched these differences in health behaviors and conditions.
In the current study, the prevalence of harmful or potentially hazardous alcohol use and
drug use among patients who self-identified as gay, lesbian, bisexual and heterosexual was
compared in a diverse sample of patients visiting New York City STD clinics. Levels of alcohol
and drug use were compared by sexual orientation identity using nonparametric analyses. Results
showed that patients who identified as LGB reported higher rates of potentially harmful drug and
alcohol use than patients who identified as heterosexual.
Next, data collected from patients visiting New York City STD clinics for a physician
visit were examined using binary logistic regression analyses. The aim of this study was to
determine whether a relationship exists between sexual orientation identity and likelihood of
diagnosis with a sexually transmitted infection (STI). In addition, known demographic and
behavioral predictor variables were included in this regression analysis as covariates (i.e., race,
ethnicity, age, gender identity, alcohol use, drug use, same-sex sexual behavior). Results showed
that a relationship does exist between sexual orientation identity and likelihood of STI diagnosis,
such that identifying as LGB increases an individual's odds of receiving a STI diagnosis. This
predictor variable was found to increase the likelihood of diagnosis along with covariates
including Black/African American racial identity, Hispanic ethnicity, same-sex sexual behavior,
and drug use. Covariates that decreased the odds of STI diagnosis included female gender
identity, transgender identity, and older age.
The primary implication that emerged from the aforementioned research was that
individuals who identify as sexual minorities (i.e., as LGB) have different relationships to health
behaviors than individuals who identify as heterosexual. Therefore, LGB individuals should be
given an opportunity to self-identify their sexual orientation upon intake and screened for
quantity and frequency of substance use so that counselors can be aware of the individual’s risk
of developing a substance use disorder. Individuals should also be asked discrete questions
about sexual orientation identity as well as attraction and behavior, so that individuals who
identify as LGB can be engaged in open discussion about sexual behaviors and safer sex
practices as necessary, and not assumed to be engaging in behavior that places them at risk for
STIs. More qualitative research is needed to determine why some LGB individuals engage in
hazardous levels of alcohol and drug use while others do not, and to explore the relationship
between LGB identity and engagement in sexual risk behaviors.
Genre Thesis/Dissertation
Topic regression analysis
Identifier http://hdl.handle.net/1957/56262

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