Texting LGB+ teen girls to promote pregnancy prevention behavior


Lesbian, gay, bisexual, or other sexual minority (LGB+) teenaged girls are more likely to get pregnant than their peers. Could a text message program help reduce this?

The efforts to curb adolescent pregnancy have been fairly effective with a continual decline since the early 1990s when the teenaged pregnancy rate spiked. However, adolescent girls who are lesbian, gay, bisexual, or another sexual minority continue to have higher pregnancy rates than their heterosexual peers. A trial assessed whether a mobile health program could help bring the pregnancy numbers in these particular groups down to align more with their peers.1

The researchers ran a national randomized controlled trial that enrolled cisgender lesbian, gay, bisexual, or other sexual minority girls who were aged 14 to 18 years. Social media was used to recruit participants and enrollment was carried out by phone. Participants were randomized to either the Girl2Girl intervention or an attention-matched control group. During the trial, between 5 to 10 text messages were sent every day for 7 weeks, which included messages encouraging them to reach out for social support as well as links to short instructive videos on topics such as how to use a female condom. Both groups ended with a 1-week booster that was delivered 12 weeks subsequently.

A total of 799 participants completed the trial and intervention end survey. The participants were aged an average of 16.1 years; 43% were minority race/ethnicity; 29% were from low-income households; and 15% lived in a rural area. The investigators found that the Girl2Girl program was linked to significantly higher rates of condom-protected sex (adjusted odds ratio [aOR] = 1.48, P < .001), intent to use birth control among participants who were not currently on birth control (aOR = 1.93, P = .001), and current use of birth control other than condoms (aOR = 1.60, P = .02). The difference in pregnancy was not statistically significant, but it was clinically significant (aOR = 0.43, P = .23). Both study arms had similar rates of intentions to be abstinent (aOR = 0.95, P = .77), intentions to use condoms (aOR = 1.09, P = .59), and abstinence (aOR = 0.82, P = .34).

The researchers concluded that the Girl2Girl program was tied to an increase in pregnancy prevention behaviors in lesbian, gay, bisexual, or other sexual minority girls. Further study could identify whether this effect could be long-term. It also indicates that text message interventions could be an effective way to promote positive sexual health behaviors in teenagers.


1. Ybarra M, Goodenow C, Rosario M, Saewyc E, Prescott T. An mHealth intervention for pregnancy prevention for LGB teens: an RCT. Pediatrics. February 10, 2021. Epub ahead of print. doi:10.1542/peds.2020-013607

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