Enhancing LGBTQ+ Inclusivity in an AI-Powered Sexual Health Chatbot: User-Centered Design Approach Through a Nonprofit and Academic Partnership.

LGBTQ+ teenagers expressed both skepticism and curiosity about AI's role in delivering sexual health information.

• A Youth Advisory Council comprising 15 LGBTQ+ teenagers independently explored and interacted with Roo, Planned Parenthood Federation of America's AI-powered sexual education chatbot.
• Feedback was gathered through a week-long asynchronous discussion on a private Discord server.
• The research team posed open-ended questions prompting participants to reflect on Roo's inclusivity, usability, and content priorities.
• Participants offered critical insights on the chatbot's language, trustworthiness, and relevance.

Teenagers identified key limitations in Roo's inclusivity, tone, and interface, particularly around transgender-specific content, conversational depth, and stigma reduction.

• Concerns were specifically raised about transgender-specific content being insufficient or inadequate.
• Participants noted limitations in the chatbot's conversational depth.
• Stigma reduction was identified as an area needing improvement.
• These findings were gathered using rapid qualitative analysis organized around the study's research questions.

Participatory feedback from LGBTQ+ teenagers directly informed targeted updates to the Roo chatbot implemented by Planned Parenthood Federation of America.

• Specific changes included expanding LGBTQ+ affirming content.
• Language was revised to eliminate gendered assumptions.
• Concrete statistics and contextualized examples were incorporated to reduce stigma.
• Clearer disclosures around Roo's AI capabilities and limitations were added.
• These changes were implemented by PPFA to enhance Roo for broader use beyond the study context.

The study was embedded within a larger hybrid effectiveness implementation trial of a digital HIV prevention intervention for LGBTQ+ teenagers.

• The parent study is called Sharing Health Education Resources (SHER), described as a hybrid effectiveness implementation trial.
• The trial focused on a digital HIV prevention intervention for LGBTQ+ teenagers.
• The researchers collaborated with PPFA to create a customized instance of Roo for integration into this study.
• The Youth Advisory Council comprised 15 LGBTQ+ teenagers who served as co-designers rather than only as testers.

Academic and nonprofit collaborations using participatory methods offer a scalable model for integrating community voice into the development of inclusive AI-enabled health technologies.

• The partnership between a nonprofit (PPFA) and an academic team is described as a model for real-world digital health tool enhancement.
• LGBTQ+ teenagers served not only as testers but as co-designers, shaping the chatbot's evolution.
• The study surfaced broader lessons about trust, AI literacy, and health equity.
• The authors conclude that 'marginalized teenagers possess the critical insights needed to meaningfully shape AI-enabled health interventions when provided with structured opportunities for engagement.'

Many existing digital sexual health tools fail to meet the needs of LGBTQ+ teenagers, who often lack access to inclusive, affirming resources.

• AI-enabled chatbots have emerged as promising tools to address these gaps.
• Concerns remain around bias, usability, and trustworthiness of AI tools, particularly for queer and transgender teenagers.
• Few studies have systematically engaged LGBTQ+ teenagers in the co-design of AI-powered sexual health interventions prior to this work.
• Participatory design approaches centered around marginalized teenagers are described as critical to ensuring tools are relevant, trustworthy, and equitable.