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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2009.03.028 Byline: Luis Ortiz-Hernandez (a), Blanca Lilia Gomez Tello (a), Jesus Valdes (b) Abstract: Evidence of health inequities associated with sexual orientation has been gathered for industrialized countries. The situation for lesbians, gay males, and bisexuals (LGB) from middle- or low-income countries may be worse than those in industrialized nations. Here, we analyze the relationship of sexual orientation with self-rated health and cigarette and alcohol use among a representative sample of Mexican adolescents and youths between the ages of 12 and 29 years, in order to explore whether this association is mediated by discrimination and violence. Three dimensions of sexual orientation (affective attraction, sexual behavior, and identity) were assessed. The outcomes were self-rated health and cigarette and alcohol use. Compared to heterosexuals, LGB youths more frequently smoked [greater than or equal to]6 cigarettes per day, reported having experienced family violence, having crimes perpetrated against them, and having experienced violations of their rights. Among males, gays and bisexuals exhibited a higher risk of poor health than heterosexuals. Compared to heterosexual women, lesbians and bisexual women were more likely to consume alcohol. Many differences in self-rated health and substance use according to sexual orientation were explained by having experienced discrimination and violence. We concluded that lesbian and bisexual females have a higher prevalence of cigarette and alcohol use. It is necessary to develop policies and programs aimed at the reduction of substance abuse among LGB youths (focusing on females who engage in sexual contact with persons of the same gender) and to work against discrimination and violence experienced by LGB people, particularly against non-heterosexual males. Author Affiliation: (a) Departamento de Atencion a la Salud, Universidad Autonoma Metropolitana Xochimilco, Calz. del Hueso 1100, Col. Villa Quietud, Del. Coyoacan, Distrito Federal 04960, Mexico (b) Departamento de Bioquimica, Centro de Investigacion y de Estudios Avanzados, Av. IPN 2508, Colonia San Pedro Zacatenco, Mexico 07360 D.F., Mexico

Research indicates that lesbians who frequent bars are more likely to drink and that lesbians drink more than their heterosexual counterparts. We explored in detail the consequences of lesbians' bar attendance. We conducted 35 in-person, semi-structured interviews and analyzed the data using qualitative methods. The findings are organized into the following categories: safety and support over the life course: lesbian identity development: reduction of stress: and social networks and intimate relationships. In each category, participants' stories are presented to highlight the health tradeoffs associated with bar patronage, the psychosocial importance of the bar, and the relationship between minority stress and alcohol use. Public health implications are discussed. doi: 10.1300/J013v44n02_06 KEYWORDS. Alcohol, bars, lesbians, alcohol problems, substance abuse

A review of the literature on the prevalence of alcohol use and problems among lesbians reveals that the few studies yielding information on this population are beset by design and methodological problems. Those factors possibly associated with higher risk status of lesbians are identified, as are gaps in the literature, and implications for clinical practice and research are discussed.