Ybarra Michele, Rosario Margaret, Saewyc Elizabeth, Goodenow Carol, Dunsiger Shira
Center for Innovative Public Health Research, San Clemente, California.
The City University of New York - City College and Graduate Center, New York.
Pediatrics. 2023 Apr 1;151(4). doi: 10.1542/peds.2022-059172.
Lesbian, gay, bisexual, and other sexual minority (LGB+) girls are more likely than heterosexual girls to be pregnant during adolescence. Nonetheless, LGB+ inclusive pregnancy prevention programming is lacking.
Between January 2017 and January 2018, 948, 14 to 18 year-old cisgender LGB+ girls were enrolled in a national randomized controlled trial. Girls were assigned either to Girl2Girl or an attention-matched control group. They were recruited via social media and enrolled over the telephone. The 5-month intervention consisted of a 7-week program (4-12 text messages sent daily) and a 1-week booster delivered 12 weeks later. Longitudinal models of protected sex events had a negative binomial distribution and a log link function. Longitudinal models examining use of birth control assumed a Bernoulli distribution of the outcome variable and a logit link function. Models adjusted for baseline rate of the outcome, age, and a time-varying indicator of sexual experience.
Girl2Girl participants had higher rates of protected penile-vaginal sex events over time compared with controls. Girl2Girl participants also were more likely than control participants to report use of birth control other than condoms. Models of abstinence and pregnancy rates did not suggest statistically significant group differences across time. However, effect sizes were in the small to medium range and point estimates favored Girl2Girl versus control in both cases.
Girl2Girl is associated with sustained pregnancy preventive behaviors for LGB+ girls through 12 months postintervention. Text messaging could be considered as a viable method to increase access to sexual health programming to adolescents nationally.
女同性恋、男同性恋、双性恋及其他性少数群体（LGB+）女孩在青春期怀孕的可能性高于异性恋女孩。尽管如此，针对LGB+群体的预防怀孕项目仍很缺乏。
在2017年1月至2018年1月期间，948名14至18岁的顺性别LGB+女孩参与了一项全国随机对照试验。女孩们被分配到“女孩对女孩”项目组或注意力匹配的对照组。她们通过社交媒体招募，并通过电话登记入组。为期5个月的干预包括一个为期7周的项目（每天发送4 - 12条短信），以及12周后进行的为期1周的强化干预。安全性行为事件的纵向模型采用负二项分布和对数链接函数。研究避孕药具使用情况的纵向模型假设结果变量为伯努利分布和对数链接函数。模型对结果的基线率、年龄和性经历的时变指标进行了调整。
随着时间推移，“女孩对女孩”项目组的参与者进行安全性行为（阴茎 - 阴道性行为）的比例高于对照组。“女孩对女孩”项目组的参与者也比对照组参与者更有可能报告使用除避孕套以外的避孕药具。禁欲和怀孕率模型未显示出各时间点上具有统计学意义的组间差异。然而，效应量处于小到中等范围，且两种情况下的点估计均表明“女孩对女孩”项目组优于对照组。
“女孩对女孩”项目与LGB+女孩在干预后12个月内持续的预防怀孕行为相关。短信可被视为一种可行的方法，以增加全国青少年获得性健康项目的机会。
