Prevalence of alcohol use amongst sexual and gender minority (LGBTQ plus ) communities in the UK: a systematic scoping review

This systematic scoping review indicates that the prevalence of harmful alcohol use is higher in LGBTQ+ people in the UK, compared with their heterosexual counterparts. This finding is novel but in line with the evidence from several other countries. Background: globally, alcohol use rates vary by sexual orientation and gender identity (SOGI), but UK government statistics on alcohol use in the LGBTQ+ population are missing. Aim: this systematic scoping review determined the prevalence of alcohol use amongst gender and sexual minority people in the UK. Methods: empirical UK studies from 2010 onwards reporting the prevalence of alcohol use in SOGI compared with heterosexual/cisgender people were included. Searches in MEDLINE, Embase, Web of Science, PsycINFO, CINAHL, Cochrane Library, Google Scholar, Google, charity websites and systematic reviews were conducted in October 2021, using SOGI, alcohol and prevalence terms. Citation checking was done by two authors, with disagreements resolved through discussion. Data extraction was done by one author (CM) and checked by another (LZ). Quality assessment was performed by study design, sample type and statistical analysis of results. A narrative synthesis was qualitatively combined with a tabular presentation of results. Results: database and website searches found 6607 potentially relevant citations, and 505 full texts were reviewed with 20 studies included, found in 21 publications and grey literature reports. Most were on sexual orientation, including 12 from large cohort studies. Harmful alcohol use is higher in LGBTQ+ people than heterosexual people in the UK, a result similar to that found in other countries. Qualitative data reflected alcohol's role as emotional support. Fewer asexual people drank alcohol compared with allosexual people, and there were no data available regarding intersex people. Conclusion: funded cohort studies and service providers should routinely collect SOGI data. Standardized reporting of SOGI and alcohol use would improve comparability across studies.