Sexually Explicit Cell Phone Messaging Associated With Sexual Risk Among Adolescents

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Sending and receiving sexually explicit picture and text messages via cell phone (ie, "sexting") among adolescents is publicized as a societal and public health concern, yet it is unknown whether sexting is associated with physical sexual activity or sexual risk behavior. WHAT THIS STUDY ADDS:This study is the first to examine sexting among a probability sample of adolescents and found that sexting is associated with sexual activity, sexual risk behavior, and knowing other person(s) who have sent a sext. abstract OBJECTIVES: Sexting (sending/receiving sexually explicit texts and images via cell phone) may be associated with sexual health consequences among adolescents. However, to date, no published data from a probability-based sample has examined associations between sexting and sexual activity.METHODS: A probability sample of 1839 students was collected alongside the 2011 Youth Risk Behavior Survey in Los Angeles high schools. Logistic regressions were used to assess the correlates of sexting behavior and associations between sexting and sexual risk-taking. RESULTS:Fifteen percent of adolescents with cell phone access reported sexting, and 54% reported knowing someone who had sent a sext. Adolescents whose peers sexted were more likely to sext themselves (odds ratio [OR] = 16.87, 95% confidence interval [CI]: 9.62-29.59). Adolescents who themselves sexted were more likely to report being sexually active (OR = 7.17, 95% CI: 5.01-10.25). Nonheterosexual students were more likely to report sexting (OR = 2.74, 95% CI: 1.86-4.04), sexual activity (OR = 1.52, 95% CI: 1.07-2.15), and unprotected sex at last sexual encounter (OR = 1.84, 95% CI: 1.17-2.89).CONCLUSIONS: Sexting, rather than functioning as an alternative to "real world" sexual risk behavior, appears to be part of a cluster of risky sexual behaviors among adolescents. We recommend that clinicians discuss sexting as an adolescent-friendly way of engaging patients in conversations about sexual activity, prevention of sexually transmitted infections, and unwanted pregnancy. We further recommend that discussion about sexting and its associated risk behavior be included in school-based sexual health curricula.

Sexting and Sexual Behavior in At-Risk Adolescents

“…For example, teenagers who had sexted were 5 times as likely to have had vaginal sex, putting them at greater risk for pregnancy or sexually transmitted infections. ARTICLE Consistent with previous literature, 6 sexting was also associated with same-sex sexual behaviors (making out, touching genitals). In short, sexting appears to co-occur with sexual behaviors and may represent an indicator of sexual risk.…”

Sexting and Sexual Behavior in At-Risk Adolescents

“…Rice and colleagues found that teenagers who sexted were 7 times more likely to be sexually active and nearly twice as likely to engage in unprotected sex than their peers. 6 Similarly, a study by Temple and colleagues found 10th and 11th graders who sexted were more likely to have had sex. They also found that girls who had sent naked photos of themselves had a higher chance of engaging in risky sex, including having multiple partners and using substances before sex.…”

“…5 To date only 1 study has examined the relationship of sexually explicit messages and photos with sexual behavior. 6 However, because sending messages and photos were measured as 1 item, the authors could not assess the equivalence of these 2 behaviors. This distinction may be important because sending a sexually explicit message may not have the same social consequences as sending a photo.…”

“…8 Other factors that may differentiate adolescents who sext versus those who do not include being nonheterosexual, white or African American, and older age. [6][7][8] Although research is limited regarding cognitive factors related to sexting, several studies have identified relationships between cognitions and other sex-related behaviors among adolescents. Reports of sexual intentions are related to sexual behaviors among youth with mental health problems, 11,12 but it is unknown whether teenagers with greater intentions to have sex engage in sexting.…”

“…We aimed to determine whether sexual activity (including a continuum of low-risk to high-risk behaviors), intentions to have sex, perceived approval of sexual activity, and affect regulation skills are related to sexting behavior. Also, as suggested by Rice and colleagues, 6 we examined the differing impact of sending sexually explicit messages versus photos to determine if these behaviors represent different levels of risk.…”