{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:15:36Z","timestamp":1785406536606,"version":"3.56.0"},"reference-count":37,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"unspecified","delay-in-days":40,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Biosoc. Sci."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Sexual-identity disparities in substance use among U.S. veterans, and whether mental-health treatment mitigates risk for those with depression, remain under-examined. Using data on veterans from the 2021\u20132023 National Survey on Drug Use and Health (NSDUH;\n                    <jats:italic>N<\/jats:italic>\n                    = 7,212), disparities were estimated in past-30-day nicotine, marijuana, binge drinking, and polysubstance use, as well as severe psychological distress (K6\u226513) and past-year suicidal ideation. Guided by a biosocial\/minority-stress framework, multiple imputation was applied (\n                    <jats:italic>m<\/jats:italic>\n                    = 20) and survey-weighted logistic regression adjusting for age, year, race\/ethnicity, sex, education, metro status, insurance, marital status, employment, and income; among veterans with a past-year major depressive episode (MDE), interactions were tested between sexual identity and (a) depression-related clinical contact (DRC) and (b) prescription medication for depressive feelings. Bisexual veterans showed the highest prevalence of marijuana (33.5%) and polysubstance use (30.6%), exceeding that of heterosexual (11.8%, 14.9%) and gay\/lesbian veterans (24.0%, 18.8%). Models restricted to veterans with MDE, past-year DRC (DRC defined as any visit or conversation with a health professional about depressive feelings) moderated risk for gay\/lesbian veterans, with DRC associated with lower odds of binge drinking and polysubstance use; prescription medication showed a similar moderating pattern for nicotine and polysubstance outcomes. Findings for severe psychological distress and suicidal ideation were mixed and consistent with confounding by indication. Results should be interpreted cautiously given the cross-sectional data, self-report, small sexual-minority subgroups, and non-aligned recall windows (past-year mental health\/treatment vs past-30-day substance use). Overall, sexual-identity disparities in substance use are evident, with bisexual veterans bearing the greatest burden, and engagement in DRC and medication among veterans with MDE, particularly gay\/lesbian veterans, showing associations consistent with a buffering effect of affirming care. Longitudinal and qualitative studies are needed to test causal pathways and to illuminate lived experiences, and policy\/clinical efforts should expand culturally competent, integrated services and routine SOGI data collection to monitor and reduce inequities.\n                  <\/jats:p>","DOI":"10.1017\/s0021932026100480","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T08:32:08Z","timestamp":1770712328000},"page":"38-50","source":"Crossref","is-referenced-by-count":0,"title":["Biosocial disparities in substance use among sexual-minority veterans with depression: national evidence on the role of depression-related clinical contact and medication use"],"prefix":"10.1017","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9887-395X","authenticated-orcid":false,"given":"Luke","family":"Manietta","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/049kefs16","id-type":"ROR","asserted-by":"publisher"}],"name":"Southern Illinois University Carbondale"},{"id":[{"id":"https:\/\/ror.org\/0232r4451","id-type":"ROR","asserted-by":"publisher"}],"name":"SIU School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin T.","family":"McDaniel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/049kefs16","id-type":"ROR","asserted-by":"publisher"}],"name":"Southern Illinois University Carbondale"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"S0021932026100480_ref18","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000749"},{"key":"S0021932026100480_ref29","unstructured":"R Core Team. (2023) R Foundation for Statistical Computing. Retrieved 3\/11\/2025 from https:\/\/www.R-project.org\/"},{"key":"S0021932026100480_ref5","unstructured":"Center for Behavioral Health Statistics and Quality (2023) 2022 National Survey on Drug Use and Health (NSDUH): Methodological summary and definitions. Substance Abuse and Mental Health Services Administration. Retrieved 3\/11\/2025 from https:\/\/www.samhsa.gov\/data\/report\/2022-methodological-summary-and-definitions"},{"key":"S0021932026100480_ref35","unstructured":"VHA Directive 1340 (2002) Provision of Health Care for Veterans Who Identify as Lesbian, Gay, or Bisexual."},{"key":"S0021932026100480_ref33","doi-asserted-by":"publisher","DOI":"10.1037\/a0035840"},{"key":"S0021932026100480_ref1","unstructured":"AHCJ Staff (2025 ) Download time: What journalists should know about disappearing federal health data. https:\/\/healthjournalism.org\/blog\/2025\/01\/download-time-what-journalists-should-know-about-disappearing-federal-health-data\/"},{"key":"S0021932026100480_ref13","doi-asserted-by":"publisher","DOI":"10.1037\/a0035909"},{"key":"S0021932026100480_ref30","doi-asserted-by":"publisher","DOI":"10.1111\/sipr.12001"},{"key":"S0021932026100480_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s11930-017-0096-3"},{"key":"S0021932026100480_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usx082"},{"key":"S0021932026100480_ref21","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000464"},{"key":"S0021932026100480_ref28","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000683"},{"key":"S0021932026100480_ref27","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-75"},{"key":"S0021932026100480_ref12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0282376"},{"key":"S0021932026100480_ref34","doi-asserted-by":"publisher","DOI":"10.2147\/SAR.S116720"},{"key":"S0021932026100480_ref16","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.39986"},{"key":"S0021932026100480_ref17","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2023.0224"},{"key":"S0021932026100480_ref32","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0267810"},{"key":"S0021932026100480_ref4","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"S0021932026100480_ref2","doi-asserted-by":"publisher","DOI":"10.1037\/a0024659"},{"key":"S0021932026100480_ref19","unstructured":"Lawrence, Q (2025) Pentagon agrees to settle historic lawsuit with LGBTQ+ veterans over discharge status. NPR. https:\/\/www.npr.org\/2025\/01\/06\/nx-s1-5250269\/pentagon-lawsuit-lgbtq-veterans-benefits"},{"key":"S0021932026100480_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2022.107587"},{"key":"S0021932026100480_ref3","unstructured":"APA Task Force on Psychological Practice with Sexual Minority Persons (2021) Guidelines for Psychological Practice with Sexual Minority Persons. American Psychological Association. www.apa.org\/about\/policy\/psychological-practice-sexual-minority-persons.pdf"},{"key":"S0021932026100480_ref31","volume-title":"The State of Health and Health Care for LGBTQ+ Veterans : Differences among Sexual and Gender Minority Veterans, by Identity and State Policy Climate, 2015-2021","author":"Schuler","year":"2024"},{"key":"S0021932026100480_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.alcohol.2022.07.005"},{"key":"S0021932026100480_ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-024-01408-8"},{"key":"S0021932026100480_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.09.020"},{"key":"S0021932026100480_ref10","first-page":"2","article-title":"The biosocial approach to human development, behavior, and health across the life course","volume":"4","author":"Harris","year":"2018","journal-title":"The Russell Sage Foundation Journal of the Social Sciences"},{"key":"S0021932026100480_ref11","doi-asserted-by":"publisher","DOI":"10.1037\/a0016441"},{"key":"S0021932026100480_ref24","unstructured":"Lumley, T (2019) mitools: Tools for Multiple Imputation of Missing Data. https:\/\/tslumley.r-universe.dev\/mitools\/citation"},{"key":"S0021932026100480_ref15","doi-asserted-by":"publisher","DOI":"10.1037\/pst0000453"},{"key":"S0021932026100480_ref9","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-12-00131"},{"key":"S0021932026100480_ref37","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.19651"},{"key":"S0021932026100480_ref20","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2024.4318"},{"key":"S0021932026100480_ref26","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.129.5.674"},{"key":"S0021932026100480_ref14","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000799"},{"key":"S0021932026100480_ref23","unstructured":"Lumley (2024) Survey: Analysis of Complex Survey Samples."}],"container-title":["Journal of Biosocial Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0021932026100480","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T08:35:38Z","timestamp":1774859738000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0021932026100480\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["S0021932026100480"],"URL":"https:\/\/doi.org\/10.1017\/s0021932026100480","relation":{},"ISSN":["0021-9320","1469-7599"],"issn-type":[{"value":"0021-9320","type":"print"},{"value":"1469-7599","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}