SURVEY TITLE: National Household Survey on Drug Abuse (now known as the National Survey on Drug Use and Health)

ACRONYMN: NHSDA

SPONSOR: Substance Abuse and Mental Health Services Administration, United States
Department of Health and Human Services.

SURVEY PURPOSE: Survey monitoring trends in alcohol, tobacco, and illicit drug use; measuring demographic correlates of drug use; and providing information on related topics, including drug treatment. Addition of “personal behaviors” module in 1996 done at the request and support of CDC, but has not been repeated.

LOCATION SAMPLED: United States.

YEARS SEXUAL ORIENTATION DATA COLLECTED: 1996.

SAMPLE SIZE: unknown/unavailable.

METHOD OF SEXUAL ORIENTATION DATA COLLECTION: Self-Completed Questionnaire

SEXUAL ORIENTATION QUESTIONS: “During the past 12 months, have you had sex with only males, only females, or with both males and females? Remember: by sex we mean only vaginal oral or anal. Please only mark one box for the best answer”

RESULTS:

• Cochran SD, Ackerman D, Mays VM, Ross MW. Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population. Addiction. 2004 Aug;99(8):989-98. AIMS: The aim of this study was to compare patterns of drug use and dependence between homosexually experienced and exclusively heterosexually experienced individuals. DESIGN: We used a cross-sectional national household interview survey conducted in the United States. SETTING: Secondary data analysis of the 1996 National Household Survey on Drug Abuse was employed. PARTICIPANTS: Participants were sexually active individuals, aged 18 years and older, who reported the genders of their sexual partners in the past 12 months; included 174 homosexually experienced (98 men, 96 women) and 9714 exclusively heterosexually experienced (3922 men, 5792 women) respondents. MEASUREMENTS: Life-time, past 30 days and daily use of nine classes of drugs. Symptoms of dysfunctional use and dependence. FINDINGS: There were consistent patterns of elevated drug use in homosexually experienced individuals for life-time drug use, but these were greatly attenuated for recent use. Homosexually experienced men were more likely to report use of marijuana, cocaine and heroin, and homosexually experienced women more likely to report use of marijuana and analgesics than individuals reporting only opposite-sex partners. Both homosexually active men and women were more likely than exclusively heterosexually active respondents to report at least one symptom indicating dysfunctional drug use across all drug classes, and to meet criteria for marijuana dependence syndrome. The only difference between homosexually experienced men and women was that men were more likely to report any daily drug use. CONCLUSIONS: These data are consistent with surveys suggesting that there is a moderate elevation of drug, particularly marijuana, use and dependence in gay and bisexual men and women when compared to heterosexual men and women.
• Anderson JE, Wilson RW, Barker P, Doll, L, Jones TS, Holtgrave D. Prevalence of Sexual and Drug-Related HIV Risk Behaviors in the U.S. Adult Population: Results of the 1996 National Household Survey on Drug Abuse. Journal of Acquired Immune Deficiency Syndromes. 1999;21: 148-156.CONTEXT: Data on the prevalence of HIV risk behavior that are representative of the general population are needed to help evaluate the effectiveness of prevention programs. OBJECTIVE: To use data from a large national interview survey to make estimates of the prevalence of sexual and drug-related HIV risk behaviors in the adult population of the United States. DESIGN: Nationally representative cross-sectional survey with in-person interviews collecting information on drug use and sexual behavior. SETTING AND PARTICIPANTS: 12,381 U.S. adults aged between 18 and 59 who were respondents to the 1996 National Household Survey on Drug Abuse, as part of sample of the noninstitutionalized population. Interviews took place in respondents homes using face-to-face interviewer-administered and self-administered questionnaires. RESULTS: In total, 2.8% of respondents were classified as having increased risk for HIV through sexual behavior; this represents 3.9 million persons. 1.7% reported some degree of risk through drug-related behaviors, representing 1.2 million persons. 3.5% of adults (5 million persons) were found to have some degree of HIV risk from sexual or drug-related behavior. Persons who were at risk through drug behavior were much more likely than others to be at risk through sexual behavior. Condom use was not related to HIV risk, although having a recent HIV test was found to be. Among those who reported some behaviors that placed them at increased risk for HIV infection, only 22% used a condom the last time they had sex with a regular partner. CONCLUSIONS: The high rate of sexual risk behavior on the part of drug users suggests increasing condom use for this group should be a priority goal for programs, especially condom use with main partners. Survey work needs to be continued and improved to make it possible to assess the impact of successful local prevention efforts on national rates of HIV risk behavior.
• Cochran SD, Mays VM. Relationship between Psychiatric Syndromes and Behaviorally Defined Sexual Orientation in a Sample of the US Population. American Journal of Epidemiology. 2000;151(5):516-523. Most surveys of the prevalence of psychiatric disorders among lesbians and gay men find no increased risk in comparison with heterosexuals. However, the majority of this work has relied on convenience samples drawn from the visible lesbian and gay community. The authors examined differences in 1-year prevalence of six psychiatric syndromes among sexually active individuals in the 1996 National Household Survey of Drug Abuse who reported either exclusive heterosexuality (n = 9,714) or having any same-gender sex partners (n = 194) in the prior year. Although nearly three quarters of homosexually active individuals did not meet criteria for any of the six syndromes assessed, in multivariate logistic regression analyses, homosexually active men were more likely than other men to evidence major depression and panic attack syndromes. In contrast, homosexually active women were more likely than other women to be classified with alcohol or drug dependency syndromes. Both men and women reporting any same-gender sex partners were more likely than others to have used mental health services in the year prior to interview. These findings suggest a small increased risk among homosexually active populations in 1-year psychiatric morbidity and use of mental health care services.
  
• Cochran SD; Keenan C; Schober C; Mays VM. Estimates of alcohol use and clinical treatment needs among homosexually active men and women in the US population.
  Journal of Consulting and Clinical Psychology 68(6): 1062-1071, 2000. (60 refs.) Concerns about dysfunctional alcohol use among lesbians and gay men are longstanding. The authors examined alcohol use patterns and treatment utilization among adults interviewed in the 1996 National Household Survey on Drug Abuse. Sexually active respondents were classified into 2 groups: these with at least 1 same-gender sexual partner (n = 194) in the year prior to interview and those with only opposite-gender sexual partners (n = 9,714). The authors compared these 2 groups separately by gender. For men, normative alcohol use patterns or morbidity did not differ significantly between the 2 groups. However, homosexually active women reported using alcohol more frequently and in greater amounts and experienced greater alcohol-related morbidity than exclusively heterosexually active women. Findings suggest higher risk for alcohol-related problems among lesbians as compared with other women, perhaps because of a more common pattern of moderate alcohol consumption.
  

DATA ACCESS: oas.samhsa.gov/nsduh.htm