Feasibility, Acceptability, and Initial Efficacy of an Online Sexual Health Promotion Program for LGBT Youth: The Queer Sex Ed Intervention

Abstract

Lesbian, gay, bisexual, and transgender (LGBT) youth experience multiple sexual health inequities driven, in part, by deficits in parental and peer support, school-based sex education programs, and community services. Research suggests that the Internet may be an important resource in the development of sexual health among LGBT youth. We examined the feasibility of recruiting youth in same-sex relationships into an online sexual health intervention, evaluated intervention acceptability, and obtained initial estimates of intervention efficacy. LGBT youth (16 to 20 years old) completed Queer Sex Ed (QSE), an online, multimedia sexual health intervention consisting of five modules. The final sample (N = 202) completed the pretest, intervention, and posttest assessments. The primary study outcomes were sexual orientation identity and self-acceptance (e.g., coming-out self-efficacy), sexual health knowledge (e.g., sexual functioning), relationship variables (e.g., communication skills), and safer sex (e.g., sexual assertiveness). Analyses indicated that 15 of the 17 outcomes were found to be significant (p < .05). Effect sizes ranged from small for sexual orientation (e.g., internalized homophobia) and relationship variables (e.g., communication skills) to moderate for safer sex (e.g., contraceptive knowledge) outcomes. This study demonstrated the feasibility, acceptability, and initial efficacy of QSE, an innovative online comprehensive sexual health program for LGBT youth.

Acknowledgments

We thank the TrevorSpace team for their gracious assistance with recruitment and the participants for helping evaluate QSE. We also thank Farrin Abbott for her role in the design of the content.

Notes

Note. HIV = human immunodeficiency virus; LGBT = lesbian, gay, bisexual, and transgender; QSE = queer sex education; STD = sexually transmitted disease.

^a See Table 4 for the complete list of goals.

Note. HIV = human immunodeficiency virus; LGBT = lesbian, gay, bisexual, and transgender; QSE = queer sex education; STD = sexually transmitted disease.

^a Measure was developed by the queer sex education research team for purposes of this study. Measures without alpha are knowledge or behavior questionnaires where alpha is not an appropriate psychometric statistic.

^a Data are missing for one female-born participant.

^b Data are missing for one male-born and two female-born participants.

Note. Each participant was required to select three individualized sexual health improvement goals. Confidence in meeting the goal was reported on a scale of 3 = Very confident; 2 = Somewhat confident; and 1 = Not at all confident. HIV = human immunodeficiency virus; HPV = human papillomavirus; LGBT = lesbian, gay, bisexual, and transgender.

Note. Variability in sample size for each scale is due to missingness. Unless otherwise noted changes were tested using Wilcoxon signed-rank tests. HIV = human immunodeficiency virus; LGBT = lesbian, gay, bisexual, and transgender; STD = sexually transmitted disease.

^a Indicates McNemar's test was used.