Although lesbian, gay, bisexual and other sexual minority (LGB+) girls are more likely than heterosexual girls to be pregnant during adolescence, relevant pregnancy prevention programming is lacking.
A national randomized controlled trial was conducted with 948 14- to 18-year-old cisgender LGB+ girls assigned to either Girl2Girl or an attention-matched control group. Participants were recruited on social media between January 2017 and January 2018 and enrolled over the telephone. Between 5 and 10 text messages were sent daily for 7 weeks. Both experimental arms ended with a 1-week booster delivered 12 weeks subsequently.
A total of 799 (84%) participants completed the intervention end survey. Participants were, on average, 16.1 years of age (SD: 1.2 years). Forty-three percent were minority race; 24% were Hispanic ethnicity. Fifteen percent lived in a rural area and 29% came from a low-income household. Girl2Girl was associated with significantly higher rates of condom-protected sex (adjusted odds ratio [aOR] = 1.48, P < .001), current use of birth control other than condoms (aOR = 1.60, P = .02), and intentions to use birth control among those not currently on birth control (aOR = 1.93, P = .001). Differences in pregnancy were clinically but not statistically significant (aOR = 0.43, P = .23). Abstinence (aOR = 0.82, P = .34), intentions to be abstinent (aOR = 0.95, P = .77), and intentions to use condoms (aOR = 1.09, P = .59) were similar by study arm.
Girl2Girl appears to be associated with increases in pregnancy preventive behaviors for LGB+ girls, at least in the short-term. Comprehensive text messaging–based interventions could be used more widely to promote adolescent sexual health behaviors across the United States.
Michele Ybarra, Carol Goodenow, Margaret Rosario, Elizabeth Saewyc and Tonya Prescott. Pediatrics (February 2021) e2020013607; DOI: https://doi.org/10.1542/peds.2020-013607