“We deserve to be seen, heard, and included in recovery spaces:” A content analysis informing the improvement of treatment for alcohol use for sexually diverse individuals
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Authors
Aguilar-Bonnette, Aaron
Issue Date
2025
Type
Dissertation
Language
en_US
Keywords
Addiction , Alcohol use treatment , Harm reduction , LGBTQ+
Alternative Title
Abstract
Objectives: Excessive alcohol use is a public health concern that results in hundreds of billions of dollars in economic costs each year and leads to increased risk for disease, premature death, and other physical and mental health concerns. Sexually diverse individuals (SD; e.g., lesbian, gay, bisexual, queer) represent a community disproportionately impacted by alcohol use disorder (AUD) and alcohol-related problems. Though SD individuals utilize alcohol-related treatment services at a higher rate than the general population, the number of SD individuals with AUDs who seek treatment is low compared to the number of SD individuals with AUDs who do not seek treatment. Thus, current alcohol use treatment programs may not adequately engage or meet the needs of SD individuals. This study seeks to better understand treatment barriers SD individuals face in alcohol-related treatment that may be contributing to low treatment utilization, highlight ways of improving treatment for SD individuals experiencing AUD, and disseminating the findings to provide additional resources and increased knowledge for service providers who work with this community. Methods: A sample of 11 adults 18 years or older who identify as SD (e.g., lesbian, gay, bisexual, queer) and who are currently receiving, or have received (within a one-year timeframe) alcohol use treatment for AUD were recruited for this study. Semi-structured interviews were conducted, transcribed, and a conventional content analysis approach was used to interpret data.
Results: Findings from conventional content analysis indicated participants felt their sexuality played a major role in their alcohol use (e.g., identity suppression and exploration, community drinking norms). Additionally, participants emphasized the importance of creating and maintaining an inclusive and affirming environment, including mind/body/spirit components to treatment (e.g., body work, spirit-based programming), having competent and friendly staff (e.g., trauma-informed staff, increased training on working with community), and including a diverse selection of treatment and recovery models. Finally, all participants shared positive perceptions of incorporating aspects of harm reduction into treatment.
Conclusions: These recommendations should be taken into consideration when discussing treatment improvements, program policies, and program structure. It should be a priority to ensure that SD individuals feel safe, understood, validated, and are receiving the most effective treatment possible when entering programs.