Purpose: This research has two aims: (1) assess how often bisexual and lesbian women are screened for alcohol use and offered brief counseling in primary care settings compared to their heterosexual peers; and (2) understand how bisexual and lesbian women respond to information that alcohol increases breast cancer risk compared to heterosexual women.

Methods: The study population consisted of 5,027 adult U.S. women who responded to an online, cross-sectional Qualtrics survey. The survey included the Alcohol Use Disorders Identification Test (AUDIT), questions about alcohol screening and brief counseling in primary care, and questions to assess awareness of the link between alcohol and breast cancer. Bivariate analyses and logistic regression were conducted.

Results: Bisexual and lesbian women had higher odds of harmful drinking (based on an AUDIT score >=8) compared to heterosexual women (adjusted odds ratio [AOR] = 1.25, 95% confidence interval [CI] = 1.00-1.56 for bisexual women; AOR =1.72; 95% CI = 1.19-2.48 for lesbian women). However, bisexual and lesbian women were no more likely to be advised about drinking in primary care compared to heterosexual women, but women across all groups (33.29% of non-harmful drinkers and 51.05% of harmful drinkers) indicated they would talk to a medical professional about this association.

Conclusion: Alcohol screening and brief counseling in primary care is an under-utilized opportunity to inform bisexual and lesbian women about the harms of drinking. After seeing information on the association between alcohol and breast cancer, many women agreed they would talk to a health care professional about this link.