Preventing Drug Use Among Sexual-Minority Youths: Findings from a Tailored, Web-Based Intervention

Introduction: Rates of drug use among sexual-minority youths (youths who self-identify as lesbian, gay, bisexual, transgender, or questioning) are higher than those of their heterosexual peers. Yet, expressly designed prevention programs targeting this population are absent and sorely needed. Effective programming for sexual-minority youths must address non-specific drug use risk factors with scenarios and messaging that resonate with these youths. Additional content is necessary to help youths cope with specific risks related to negative reactions from disclosure, victimization, and internalized homophobia. This study is the first RCT to test a tailored drug abuse prevention program for sexual-minority youths.

Methods: A national sample (N = 236) of sexual-minority youths were recruited via Facebook. When youths clicked on an ad, they were directed to our secure recruitment page, on which they read a brief study description and answered eligibility questions. Owing to the potential barriers and risks associated obtaining parental permission for studies involving sexual-minority youth, Columbia University’s IRB approved a waiver of parental permission. Online, all youths completed pretests; youths randomly assigned to the intervention received a 3-session prevention program; and all youths completed posttest and 3-month follow-up measurements.

Results: Youths’ ethnic-racial background was White (61.4%), Black (9.7%), Hispanic (14%), Asian (7.2%), and Other (7.6%). Slightly more than one-half of the sample identified as female (51.3%), 32.3% as male, 10.6% as gender queer/fluid/neutral, and 5.9% as other or not sure. Youths did not differ at pretest on demographics, covariates, mediating variables, or drug use behavior. Sample retention across the 4-month study was 85% (all attrition occurred at posttest; no additional youths were lost to 3-month follow-up). Attrition rates failed to differ by arm.

At 3-month follow-up and compared to youths in the control arm, intervention-arm youths reported less stress (t = 2.27, p < .05), reduced peer drug use (t = 2.12, p < .05), lower rates of past 30-day other drug use (t = 2.16, p < .05), and higher coping (t = 2.04, p < .05), problem solving (t = 2.15, p < .05), and drug-use refusal skills (t = 2.10, p < .05).

Conclusions: Outcome data suggest the potential of tailored intervention content to address sexual-minority youths’ drug use rates and related risk factors. Moreover, study procedures lend support to the feasibility of using the Internet to recruit sexual-minority youths, collect data, and deliver intervention.