REACH Program for Preventing Alcohol Misuse and Sexual Assault in Bisexual Women

Overseen By Lindsay Orchowski, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Lifespan

Disqualifiers: Suicide risk, Alcohol withdrawal

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to develop and evaluate the preliminary efficacy of an intervention to address reducing alcohol use, sexual revictimization, and psychological distress among bisexual+ women (i.e., attraction to more than one gender: bisexual, pansexual, queer). The main questions the study seeks to answer are: 1) what is the feasibility of the recruitment method, research design, interventionist training methods, and delivery of the intervention; 2) does the intervention, relative to control, at the 2- and 4-month follow-up period, produce reductions in the quantity and frequency of alcohol use, sexual victimization, and psychological distress (anxiety, depression). Follow-up assessments are completed at 2- and 4-months following program completion. The intervention is compared to a wait list control group.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the REACH Program treatment for preventing alcohol misuse and sexual assault in bisexual women?

The research highlights the importance of tailored interventions for bisexual women, who face unique health disparities and higher risks of alcohol misuse and sexual victimization. Programs that address these specific needs and provide bisexual-affirmative care, like the REACH Program, may be more effective in reducing these risks. ^{1 2 3 4 5}

Is the REACH Program safe for humans?

The research does not provide specific safety data for the REACH Program, but a study on a similar integrated trauma-focused intervention for women in substance abuse treatment found it to be safe, with minimal adverse events reported. ^{2 4 6 7 8}

How is the REACH Program treatment different from other treatments for preventing alcohol misuse and sexual assault in bisexual women?

The REACH Program is unique because it specifically addresses the drinking norms and sexual assault risks faced by bisexual women, which are often overlooked in other treatments. It focuses on providing bisexual-affirmative care and interventions tailored to the unique stressors and stigmatization (negative stereotypes and discrimination) that bisexual women experience, which can contribute to alcohol misuse and increased vulnerability to sexual assault. ^{2 4 6 9 10}

Eligibility Criteria

This trial is for bisexual+ women aged 18-24 who drink more than the recommended limit on multiple occasions, have been sexually active in the past month, and have a history of sexual victimization. Participants must not be at current suicide risk or experiencing alcohol withdrawal symptoms.

Inclusion Criteria

I am between 18 and 24 years old.

I identify as female, fluid, non-conforming, queer, or non-binary.

Report a history of attempted or completed penetrative acts of sexual victimization (i.e., oral, vaginal, anal) since age 14 via coercion, incapacitation or force

Exclusion Criteria

Current suicide risk on the Beck Depression Inventory

Current symptoms of alcohol use withdrawal on the Alcohol Use Withdrawal Checklist

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive the REACH program intervention addressing alcohol use, sexual assault risk, and psychological distress

2 months

Follow-up

Participants are monitored for reductions in alcohol use, sexual victimization, and psychological distress at 2- and 4-month follow-up periods

4 months

Treatment Details

Interventions

• REACH Program

Trial Overview The REACH Program aims to reduce alcohol use, prevent sexual revictimization, and alleviate psychological distress among bisexual+ women. The study compares this intervention's effectiveness with a wait list control group over follow-ups at 2 and 4 months.

Participant Groups

Group I: REACH Program Experimental Treatment 1 Intervention

The REACH program addresses alcohol use, sexual assault risk, and experiences relating to experiences of harm among bisexual women.

Group II: Wait List Control Group Active Control 1 Intervention

The Wait List Control Group will have the opportunity to complete the REACH program after completing study assessments at the 4-month follow-up.

Who Is Running the Clinical Trial?

Lifespan

Lead Sponsor

Trials

43

Recruited

41,100+

Findings from Research

Bisexual and lesbian women reported higher rates of harmful drinking compared to heterosexual women, with adjusted odds ratios indicating a significant risk (1.26 for bisexual women and 1.78 for lesbian women).

Despite their higher rates of harmful drinking, bisexual and lesbian women were not more likely to receive advice about alcohol use in primary care settings, highlighting a gap in healthcare support for these populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptability of Primary Care Counseling and Brief Educational Messages to Increase Awareness about Alcohol and Breast Cancer Risks among Bisexual and Lesbian Women. Balenger, A., Scott, LC., Swahn, MH., et al.[2023]

Bisexual individuals face significant mental health and substance use disparities, largely due to a lack of bisexual-specific training among clinicians, which limits their ability to provide competent care.

The article proposes a multi-level approach to improve bisexual health, including micro-level strategies for clinicians to support clients, mezzo-level adaptations in clinical training, and macro-level advocacy to reduce societal prejudice, emphasizing the urgent need for tailored interventions and training programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Multilevel Approach for Reducing Mental Health and Substance Use Disparities Affecting Bisexual Individuals. Feinstein, BA., Dyar, C., Pachankis, JE.[2023]

A study of 206 young adult Mexican-American women found that those who engage in sex with both men and women (WSWM) face significantly higher rates of incarceration, stressful life events, and substance use compared to those with exclusively male partners.

WSWM also showed increased rates of injection drug use and related health issues, such as Hepatitis C Virus infection, along with higher levels of depression, PTSD, and suicidal thoughts, highlighting the urgent need for targeted health interventions for this vulnerable group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Examination of multilevel domains of minority stress: Implications for drug use and mental and physical health among Latina women who have sex with women and men. Cepeda, A., Nowotny, KM., Frankeberger, J., et al.[2021]

A study of 179 bisexual women aged 18 to 30 found that they perceive higher alcohol use among bisexual and heterosexual women compared to lesbian women, which correlates with their own drinking behaviors.

Descriptive drinking norms for bisexual women were linked to increased frequency of alcohol consumption and binge drinking, suggesting that tailored interventions addressing these norms could help reduce hazardous drinking among bisexual women.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bisexual Women's Reports of Descriptive Drinking Norms for Heterosexual, Bisexual, and Lesbian Women. Ehlke, SJ., Stamates, AL., Kelley, ML., et al.[2020]

Bisexual women experience worse mental health outcomes, such as increased posttraumatic stress, depression, and substance use, linked to higher rates of lifetime sexual violence compared to lesbian and heterosexual women, based on a review of 15 studies.

There is a significant gap in research specifically addressing the mental health impacts of sexual victimization on bisexual women, highlighting the need for more focused studies and the importance of providing bisexual-affirmative care in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sexual Victimization Outcomes and Adjustment Among Bisexual Women: A Review of the Quantitative Literature. Salim, SR., McConnell, AA., Messman, T.[2023]

In a study of 107 self-identified bisexual women, over half reported experiences of sexual coercion, which was linked to negative alcohol-related consequences through the motive of drinking to cope.

Negative affect heightened the relationship between sexual coercion and drinking to cope, suggesting that women with higher negative feelings are more likely to use alcohol as a coping mechanism after experiencing coercion.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sexual Coercion, Drinking to Cope Motives, and Alcohol-Related Consequences among Self-Identified Bisexual Women. Kelley, ML., Ehlke, SJ., Lewis, RJ., et al.[2019]

Research on the health concerns of bisexual individuals is limited, despite them reporting higher rates of negative health outcomes such as mood disorders, substance use, and healthcare access issues compared to heterosexual and gay/lesbian individuals.

This Special Section aims to highlight new research focused on the health of bisexual individuals, using diverse methodologies to better understand their unique health disparities and inform future health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Introduction to the Special Section on Bisexual Health: Can You See Us Now? Bostwick, WB., Dodge, B.[2023]

In a study involving 353 women in substance abuse treatment, the integrated PTSD treatment (Seeking Safety) did not result in significantly more adverse events compared to a non-trauma-focused intervention (Women's Health Education), indicating that it is safe to implement PTSD treatment in these settings.

Both interventions had low rates of adverse events (9.6% for Seeking Safety and 7.2% for Women's Health Education), suggesting that addressing PTSD in substance abuse programs does not worsen psychiatric or substance use symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events in an integrated trauma-focused intervention for women in community substance abuse treatment. Killeen, T., Hien, D., Campbell, A., et al.[2021]

Bisexual college women experience significantly higher rates of sexual assault compared to heterosexual women, indicating a critical area of concern for campus safety.

Factors such as perceived sexual disrespect, alcohol use, and earlier sexual debut contribute to the elevated risk of sexual assault for bisexual women, suggesting that targeted interventions may be necessary to address these specific vulnerabilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Need for More Research: How to Understand Elevated Rates of Sexual Assault Among Bisexual College Women. Ford, JV., Shefner, R.[2023]

A study involving 225 bisexual women aged 18 to 30 found that the stereotype of sexual irresponsibility (viewing bisexual individuals as promiscuous) is the strongest predictor of alcohol use and drinking to cope motivations.

The findings suggest that bisexual women face significant risks for problematic alcohol use due to binegativity, particularly from oversexualized stigmatization, highlighting the need for targeted prevention and intervention strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dimensions of binegativity differentially predict drinking to cope motivations and alcohol use severity among bisexual women. Schulz, CT., Stamates, AL., Ehlke, SJ., et al.[2023]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Acceptability of Primary Care Counseling and Brief Educational Messages to Increase Awareness about Alcohol and Breast Cancer Risks among Bisexual and Lesbian Women. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

A Multilevel Approach for Reducing Mental Health and Substance Use Disparities Affecting Bisexual Individuals. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Examination of multilevel domains of minority stress: Implications for drug use and mental and physical health among Latina women who have sex with women and men. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Bisexual Women's Reports of Descriptive Drinking Norms for Heterosexual, Bisexual, and Lesbian Women. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Sexual Victimization Outcomes and Adjustment Among Bisexual Women: A Review of the Quantitative Literature. [2023]

6. England pubmed.ncbi.nlm.nih.gov

Sexual Coercion, Drinking to Cope Motives, and Alcohol-Related Consequences among Self-Identified Bisexual Women. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Introduction to the Special Section on Bisexual Health: Can You See Us Now? [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Adverse events in an integrated trauma-focused intervention for women in community substance abuse treatment. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

A Need for More Research: How to Understand Elevated Rates of Sexual Assault Among Bisexual College Women. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Dimensions of binegativity differentially predict drinking to cope motivations and alcohol use severity among bisexual women. [2023]