{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:37:06Z","timestamp":1787063826527,"version":"build-2736575974"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5-6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The aims of the study are to identify health-related behaviors associated with sexual orientation among active duty military personnel and to compare those behaviors when lesbian, gay, and bisexual (LGB) groups are aggregated and disaggregated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We used public data from the 2015 Health-Related Behavior Survey of Active Duty Military Personnel. Binomial logistic regression analyses were used to examine differences between and within heterosexual, same-sex, and bisexual groups as predicted by the following correlates: demographic characteristics, physical activity, substance use, probable mood disorders, unwanted sexual contact, physical abuse, suicidal behaviors, and sexually transmitted infection (STI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In univariate analyses, rates of lifetime unwanted sexual contact and lifetime suicidal ideation were significantly higher for bisexual females compared to other groups. The results of regression analyses differed depending on whether LGB groups were aggregated or disaggregated. Aggregated LGB versus heterosexual model found significant differences with respect to unwanted sexual contact, lifetime suicide attempt, STI, smoking, and marijuana use. Disaggregated models found different patterns of significant correlates, e.g., correlates comparing gays to heterosexual males were STI, sexual contact, lifetime suicide attempt, and age; correlates comparing lesbians to heterosexual females were heavy drinking, probable post-traumatic stress disorder, ever used marijuana, lifetime suicide attempt, lifetime physical abuse, and smoking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings are consistent with those of previous research showing highest risk for suicidal behaviors and substance abuse among bisexual individuals. We recommend that future studies and clinical care consider LGB sexual identities as heterogeneous groups; otherwise, risks for adverse health behaviors may be overlooked.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaa539","type":"journal-article","created":{"date-parts":[[2020,12,12]],"date-time":"2020-12-12T02:35:17Z","timestamp":1607740517000},"page":"556-564","source":"Crossref","is-referenced-by-count":14,"title":["Health Behavior Differences Between Male and Female U.S. Military Personnel by Sexual Orientation: The Importance of Disaggregating Lesbian, Gay, and Bisexual Groups"],"prefix":"10.1093","volume":"186","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3171-6856","authenticated-orcid":false,"suffix":"PhD","given":"Diana D","family":"Jeffery","sequence":"first","affiliation":[{"name":"Department of Defense, Defense Health Agency, Falls Church, VA 22042, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"PhD","given":"Matthew R","family":"Beymer","sequence":"additional","affiliation":[{"name":"Behavioral and Social Health Outcomes Program, Defense Health Agency, US Army Satellite, Aberdeen Proving Ground, MD 21005, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"MEd","given":"Mark J","family":"Mattiko","sequence":"additional","affiliation":[{"name":"Health, Safety, and Work-Life Directorate, United States Coast Guard, Washington, DC 20032, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"MD, MA","given":"Donald","family":"Shell","sequence":"additional","affiliation":[{"name":"Department of Defense, Office of the Assistant Secretary of Defense (Health Affairs), Falls Church, VA 22042, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"key":"2021050314322308900_R1","article-title":"\u201cDon\u2019t Ask, Don\u2019t Tell\u201d: The Law and Military Policy on Same-Sex Behavior","volume-title":"Congressional Research Service Report for Congress, 7-5700, R40782","author":"Burrelli","year":"2010"},{"key":"2021050314322308900_R2","volume-title":"Sexual Orientation and U.S. Military Personnel Policy: An Update of RAND\u2019s 1993 Study","author":"National Defense Research Institute, RAND Corporation","year":"2010"},{"key":"2021050314322308900_R3","article-title":"Under Secretary of Defense for Personnel and Readiness Memorandum for Secretaries of the Military Departments, Repeal of DADT and Future Impact on Policy","author":"Department of Defense","year":"2011"},{"key":"2021050314322308900_R4","article-title":"2013 State of the Behavioral Health of the United States Coast Guard, Department of Homeland Security","author":"Mattiko"},{"issue":"11-12","key":"2021050314322308900_R5","doi-asserted-by":"crossref","first-page":"e693","DOI":"10.1093\/milmed\/usz070","article-title":"Cross-sectional study of sexual behavior, alcohol use, and mental health conditions associated with sexually transmitted infections among deploying shipboard US military personnel","volume":"184","author":"Harbertson","year":"2019","journal-title":"Mil Med"},{"issue":"8","key":"2021050314322308900_R6","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1136\/sextrans-2015-052163","article-title":"Sexually transmitted infections and sexual behaviour of deploying shipboard US military personnel: a cross-sectional analysis","volume":"91","author":"Harbertson","year":"2015","journal-title":"Sex Transm Infect"},{"issue":"2","key":"2021050314322308900_R7","article-title":"2015 Department of Defense Health Related Behaviors Survey (HRBS)","volume":"8","author":"Meadows","year":"2018","journal-title":"Rand Health Q"},{"issue":"4","key":"2021050314322308900_R8","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.jadohealth.2011.07.009","article-title":"Impact of victimization on risk of suicide among lesbian, gay, and bisexual high school students in San Francisco","volume":"50","author":"Shields","year":"2012","journal-title":"J Adolesc Health"},{"issue":"2","key":"2021050314322308900_R9","doi-asserted-by":"crossref","first-page":"216","DOI":"10.3109\/10826084.2015.1092988","article-title":"Association of alcohol misuse with sexual identity and sexual behavior in women veterans","volume":"51","author":"Lehavot","year":"2016","journal-title":"Subst Use Misuse"},{"issue":"8","key":"2021050314322308900_R10","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1111\/jsm.12581","article-title":"Bisexuality and suicide: a systematic review of the current literature","volume":"11","author":"Pompili","year":"2014","journal-title":"J Sex Med"},{"key":"2021050314322308900_R11","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.drugalcdep.2014.11.012","article-title":"Missing data in substance abuse research? 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