A qualitative study on the role of alcohol in the lives of a group of sexual minority women in South Africa

Despite extensive research on alcohol misuse in South Africa, a significant gap remains in the literature regarding the experiences of sexual minorities, defined as individuals whose sexual orientation or gender identity differs from heteronormative expectations. International studies have confirmed that sexual minority women are at a higher risk of harmful alcohol use compared with their heterosexual counterparts. This disparity is attributed to the distinctive and chronic stressors that sexual minorities face. There remains a paucity of research in South Africa on the experience of alcohol misuse among sexual minority women. This study aimed to address this gap in the literature. Twenty-five sexual minority women from diverse backgrounds residing in Cape Town, South Africa, participated in the study. Data collection occurred through semi-structured interviews. Using Interpretative Phenomenological Analysis, the study explored participants’ lived experiences of alcohol misuse and their perspectives of the reasons for initiating such use. The findings indicate that alcohol served as an emotional regulation strategy, helping them to manage emotional distress arising from experiences of rejection, stigma, and discrimination related to their sexual minority status. Rejection and ostracism from family and religious communities were identified as salient sources of distress precipitating alcohol misuse. In addition, participants identified childhood sexual abuse and internal conflicts related to reconciling their sexual identity with cultural and religious beliefs as key drivers of their alcohol misuse. The findings underscore the importance of addressing individual, familial, and societal-level factors in efforts to reduce harmful alcohol consumption within this population.