Girl2Girl: Harnessing Text Messaging to Reduce Teenage Pregnancy Among LGB Girls

An estimated one in four teen women will become pregnant by the time she is 20 years of age. That said, significant disparity in rates exist for lesbian, gay, bisexual and other sexual minority women (LGB) versus non-LGB teen women: Research suggests that lesbian and bisexual teen women are between two and four times more likely to report having been pregnant than teen women who identified as exclusively heterosexual. Despite this compelling evidence that lesbian and bisexual adolescent women are at risk for teen pregnancy, programs tailored to the unique needs of adolescent LGB women are nonexistent. Evidence-based teen pregnancy prevention (TPP) programs targeting LGB teen women are urgently needed.

The Girl2Girl intervention text messaging-based TPP program designed specifically for LGB women ages 14-18 years, nation-wide. The investigators will test the intervention in a randomized control trial (RCT) of 840 LGB teenage women randomly assigned to either the intervention (n = 420) or control (n = 420) arms. Our primary efficacy outcome measures, measured at 12-months post-intervention, will be: (a) abstinence from penile-vaginal sex; (b) condom use during penile-vaginal sex, (c) use of other birth control methods during penile-vaginal sex, and (d) pregnancy.

If effective, Girl2Girl has promise to be quickly and cost-effectively implemented to scale to help to curb the spread of teenage pregnancy among women who identify as LGB.

Inclusion criteria

• endorse a non-heterosexual sexual identity (i.e., lesbian/gay, bisexual, queer, questioning, unsure);
• be cisgender (i.e., be assigned a female sex at birth and endorse a female gender identity);
• be aged 14-18;
• in high school or equivalent (including those who did not finish school/dropped out);
• be English speaking;
• be exclusive owners of a cell phone with an unlimited text messaging plan;
• have used text messaging for at least six months;
• intend to have the same cell number for the next six months; and,
• be able to provide informed assent, including an acceptable score for "capacity to consent" and the self-safety assessment.

Exclusion criteria

• not having the capacity to assent
• not passing the self-safety assessment
• previously participating in another study activity (with the exception of the baseline and intervention end survey pilot tests)
• knowing someone who is already enrolled in the program
• non-cisgender