Alcohol misuse and associations with childhood maltreatment and out-of-home placement among urban two-spirit American Indian and Alaska native people

This study examined associations between alcohol misuse and childhood maltreatment and out-of-home placement among urban lesbian, gay, and bisexual (referred to as two-spirit) American Indian and Alaska Native adults. In a multi-site study, data were obtained from 294 individuals who consumed alcohol during the past year. The results indicated that 72.3% of men and 62.4% of women engaged in hazardous and harmful alcohol use and 50.8% of men and 48.7% of women met criteria for past-year alcohol dependence. The most common types of childhood maltreatment were physical abuse among male drinkers (62.7%) and emotional abuse (71.8%) among female drinkers. Men and women reported high percentages of out-of-home placement (39% and 47%, OPEN ACCESS Int. J. Environ. Res. Public Health 2014, 11 10462 respectively). Logistic multiple regressions found that for male drinkers boarding school attendance and foster care placement were significant predictors of past-year alcohol dependence. For female drinkers, being adopted was significantly associated with a decreased risk of past-year drinking binge or spree. Dose-response relationships, using number of childhood exposures as a predictor, were not significant. The results highlight the need for alcohol and violence prevention and intervention strategies among urban two-spirit individuals.