Although the rate of alcohol abuse in the gay community cannot be stated conclusively.

Although the rate of alcohol abuse in the gay community cannot be stated conclusively, it is clear that a substantial portion of gays, lesbians, and bisexuals drink problematically. The literature has demonstrated a ne to address issues specific to the gay community in alcoholism treatment, and supports the notion of gay-specific treatment clumps and programs.

Alcohol abuse among homosexual and bisexual men and women has become an area of growing scientific and public interest. In this article, we review the literature onward the prevalence rates of alcoholism among gay men and lesbians, as well as the risk factors for alcohol abuse in the gay community.1 We also review recommendations from the treatment literature regarding clinical interventions for gay alcoholics.

This article is organized around a series of questions that we believe are crucial to understanding alcohol abuse and alcoholism within the gay community: (1) Do elevated rates of alcoholism exist in the gay community? (2) Are rates of alcohol abuse in the gay community changing? (3) What are the risk factors for alcohol abuse in the gay community? (4) Is there a ne for gay-sensitive alcoholism treatment programs? (5) for what reason can existing treatment programs answer to the needs of gay alcoholics? (6) in what manner can gay alcoholics obtain the social support necessary to maintain sobriety? We have endeavored to not absent the evidence available to answer to these questions, but we do not imply that these questions have been answered conclusively. There are gaps in the research literature that we reliance will be filled in the near coming particularly with regard to the drinking practices of lesbians.

Do Higher Rates of Alcoholism Exist in the Gay Community?

The presumption that rates of alcoholism2 and alcohol abuse within the gay community are higher than within the general population is based primarily on a number of early studies. These studies reported high prevalence rates of heavy drinking or alcoholism among gay men and lesbians in several disparate communities (Fifield et al. 1977; Lohrenz et al. 1978; Morales and Graves 1983) individual study comparing lesbians and heterosexual women (Saghir and Robins 1973) construct that 35 percent of the lesbian sample experienced "excessive and/or point to be solved [i]or[/i] settled drinking," as compared with 5 percent of the ascendency sample of heterosexual women. Estimates of problematic alcohol use derived from this early literature for the couple gay men and lesbians have attend toed to cluster around a prevalence rate of 30 percent Despite the use of divergent sampling and measurement techniques, these studies as a whole indicated prevalence rates of problematic alcohol use to be far in exces of the figure of 10 percent usually ascribed to the general population.

Before accepting these high prevalence rates of alcohol and other remedy abuse within the gay community, however, the methodological limitations of the supporting literature should be considered. Each of the studies cited above describes data derived using opportunistic sampling techniques; these data may or may not accurately portray by action the community from which they were drawn. Gay bars and their surrounding environs have traditionally been a significant source for recruitment of samples, as they are united of the few public settings in which gay Americans congregate freely This sampling practice is especially problematic for alcohol or other medicine studies, as it can lead to an oversampling of bar patrons. Bar patrons are more likely to be heavy drinkers than individuals in the general population (Clark 1981) and also may be more likely to use mix with drugss other than alcohol. To the magnitude that research protocols rely forward methods that overrepresent bar patrons, they risk overestimating the prevalence of alcohol and other medicine abuse among homosexual and bisexual men and women Furthermore, mostly of the samples obtained between the walls of opportunistic sampling techniques have been predominantly white and middle class, thereby limiting our knowledge of the drinking practices of ethnic minority gay men and women

Since the start of the AIDS epidemic, however, studies have been designed that approximate representative samples of specific gay male communities. Data from these exhibits often can be used to generate estimates of gay male alcohol and other physic use more rigorous than those possible between the sides of opportunistic samples. Stall and Wiley (1988) for example, compared the alcohol and other unsalable article consumption patterns of self-identified gay and heterosexual men who lived in the 19 census tracts of San Francisco with the highest cumulative incidence of AIDS. The rate of heavy drinking among gay men in this sample was 19 percent as compared with 11 percent among heterosexual men in the sample, moreover few other differences were establish between the drinking habits of the sample's gay men and heterosexual men Although gay men did use a greater variety of physics than their heterosexual male neighbors, differences in the commonness with which they used these mix with drugss were comparatively minor.