ArticlePDF AvailableLiterature Review

The Impact of Social Media on the Sexual and Social Wellness of Adolescents



For most adolescents in the United States, the use of social media is an integral part of daily life. While the advent of the Internet has enhanced information dispersal and communication worldwide, it has also had a negative impact on the sexual and social wellness of many of its adolescent users. The objective of this review is to describe the role of social media in the evolution of social norms, to illustrate how online activity can negatively impact adolescent self-esteem and contribute to high-risk adolescent behaviors, to elucidate how this activity can result in real-world consequences with life-long results, and to provide guidance regarding social media use for those who care for adolescents. Although research is now aimed at use of social media for positive health and wellness interventions, much work needs to be done to determine the utility of these programs. Adolescent healthcare providers are important contributors to this new field of study and must resolve to stay informed and to engage this up-and-coming generation on the benefits and risks of social media use.
The Impact of Social Media on the Sexual and Social Wellness
of Adolescents
Lisa M. Cookingham MD, Ginny L. Ryan MD, MA *
Department of Obstetrics & Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA
For most adolescents in the United States, the use of social media is an integral part of daily life. While the advent of the Internet has
enhanced information dispersal and communication worldwide, it has also had a negative impact on the sexual and social wellness of
many of its adolescent users. The objective of this review is to describe the role of social media in the evolution of social norms, to illustrate
how online activity can negatively impact adolescent self-esteem and contribute to high-risk adolescent behaviors, to elucidate how this
activity can result in real-world consequences with life-long results, and to provide guidance regarding social media use for those who care
for adolescents. Although research is now aimed at use of social media for positive health and wellness interventions, much work needs to
be done to determine the utility of these programs. Adolescent healthcare providers are important contributors to this new eld of study
and must resolve to stay informed and to engage this up-and-coming generation on the benets and risks of social media use.
Key Words: Adolescent health, Sexuality, Social media, Internet
Adolescence is a time of self-discovery, increased social
independence, and transformation into a unique individual.
While peers, parents, and educators have a direct impact on
adolescents during daily face-to-face interactions, Internet-
based entities are playing an increasingly large role during
this critical life stage.
Internet use for social purposes has
increased dramatically over recent years, with 95% of US
adolescents between the ages of 12 and 17 regularly going
online, and 80% participating in some type of social media
Social networking sites (SNS) are a relatively new phe-
nomenon andincreasingly popular among adolescents. These
are websites that permit social interaction among users
allow users to create online proles that may (or may not)
represent the user's real-life identity. Users personalize pro-
le pages with images, audio, and text, and can designate
friendsand other relationships. These websites are attractive
to adolescents because they allow for individualized self-
promotion as well as inclusion into a group that may not be
attainable in physical reality. During a time when it is as
important to be unique as it is to t in, SNSs allow adolescents
to manufacture an image they want the world to see.
One model proposed to explain how adolescents inte-
grate media into their development of self is the Media
Practice Model.
This model assumes 3 key features in un-
derstanding the effect of media on adolescents: (1) that
most media use is active or interactive; (2) that media use
and its effects are in an active reciprocal relationship with
the user; and (3) that the adolescent's current and evolving
sense of identity is the basis for how media is chosen and
applied in daily life.
The media dietchosen by the
adolescent, therefore, is a reection of who they believe
they are and who they want to be.
While an SNS may seem
to provide the ideal venue for adolescent identity explora-
tion without committing to real-world consequences, this
model supports the notion that SNS behavior truly reects
real-life behaviors or intent.
As this model suggests, social media use may have a sig-
nicant impact on the social and sexual well-being of ado-
lescents. Many adolescents display limited self-regulation
and judgment skills that are not yet fully mature, which lead
to risky behaviors, especially on SNSs.
Adolescents can fall
easy prey to the online disinhibition effect,meaning that
personal details and private information are more readily
released into the public domain than they would be face-to-
face interactions due to the dissociative anonymity SNSs
SNSs provide an all too attractive outlet for
adolescents during a time in development where self-
expression and validation are important, and this expres-
sion may translate into risky social and sexual behavior.
Well before the advent of SNS popularity, adolescents
have been vulnerable to negative outcomes from poor
sexual choices. Adolescents are the highest risk group for
contracting a sexually transmitted infection (STI)
nearly 3 million adolescents are infected annually.
common practices contribute to this high risk of contracting
an STI, including: concurrent sexual partners, multiple
sexual partners, and lack of consistent condom use.
We are
now beginning to see that social media may be increasing
these risky sexual behaviors and decreasing the overall
social and sexual wellness in adolescents.
The authors indicate no conicts of interest.
*Address correspondence to: Ginny L. Ryan, MD, MA, Department of Obstetrics &
Gynecology, University of Iowa Carver College of Medicine, 200 Hawkins Dr, 31332
PFP, Iowa City, IA 52242; Phone: (319) 384-9170; fax: (319) 384-9367
E-mail address: (G.L. Ryan).
1083-3188/$ - see front matter Ó2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
Impact on Self-Esteem
In this digital age, popularity is measured by how many
friendsor likesare collected on a SNS. Social media
encourage adolescents to compete for attention in order to
increase their likesand enhance their self-worth. If a post
or a picdoesn't garner enough comments, the adolescent is
encouraged to shareit to make it more newsworthy. Bolder
and more daring behavior is rewarded when the audience
applauds the actions of the performer, and the cycle per-
petuates. These seemingly innocuous online behaviors can
be quite damaging themselves, and they are easily trans-
lated into a risky ofine reality.
While individual conduct can damage self-esteem, so too
can the actions of an online adversary or cyberbully.This
era's equivalent of a schoolyard bully, a cyberbully is some-
one who deliberately uses social media to perpetuate false,
humiliating, or malevolent information about another in-
Similar to traditional ofine bullying, studies have
shown cyberbullying can lead to depression, anxiety, severe
isolation, and poor self-esteem for the bullied individual.
Cyberbullying can be even more pervasive, however,
because SNSs provide a forum any time of the day or night
for anyone and everyone to see.
Perhaps not surprisingly, it
has also been shown that individuals who participate in
cyberbullying are more likely to participate in ofine
Changing Social Norms and Promotion of High-Risk Behavior
Social norms that evolve over time and are peculiar to a
culture and behavior deemed unacceptable 50 years ago may
now be conventional. Psychological theorists suggest
behavior is strongly inuenced by the perception of peers'
actions, whether or not this is the reality. As such, subjective
norms contribute signicantly to behavioral intentions and
subsequent actions.
Research supports the normative in-
uence that social media, specically SNSs, have on today's
adolescents. It has been suggested, for example, that SNSs
may actually serve as a media super-peerby endorsing and
establishing social and behavioral norms of an adolescent's
If an adolescent believes that her peers are
participating in a particular behaviordeven high-risk
behaviordshe is more likely to participate in it as well
because it is perceived as normal.
Much research is being done to highlight the inuence of
SNSs on evolving social norms and promotion of high-risk
behavior. In a recent study assessing the relationship be-
tween the perception and the reality of high-risk sexual
behavior among peers using SNSs, the authors found that
adolescents consistently over-report high-risk sexual
behavior and under-report protective behaviors of their
This suggests that adolescents overestimate their
peers' high risk behaviors.
Another study demonstrated
that adolescents who viewed SNS photos with minimal or no
sexually suggestive content perceived that their peers were
participating in safer sex practices, such as condom use, and
reported that it would inuence their future behavior to do
the same.
In the same study, adolescents who viewed
sexually-suggestive SNS photos perceived that their peers
were having sex without protection or with strangers, and
they were more likely to report personal engagement in
these same high-risk behaviors.
These ndings suggest
that high-risk behavior displayed on SNSs may encourage
similar high-risk behavior in others and simultaneously
endorse such behavior as normal.
While high-risk behavior by adolescents is not new,
SNSs allow for a new manifestation of this behavior that
has been labeled self-exploitationby some.
This refers to
the creation and distribution of explicit or inappropriate
materialdphotos, comments, suggestionsdon SNSs, social
media websites, other Internet sites, or through personal
cell phones.
There are several specic types of self-
exploitation common to adolescent SNS proles. In a cross-
sectional study evaluating risk behavior promotion on SNSs,
for example, 54% of proles were found to contain 1 or more
references to a high-risk behavior such as sexual activity,
substance abuse, or violence.
These practices may open
the door for similar behavior in both online and ofine
Studies show it is common for adolescents to self-report
high-risk sexual behavior on personal SNS proles, with
references to sex displayed on 24% of proles reviewed in 1
Other adolescents may not directly reference sexual
behavior but will partake in a practice known as sexting.
This refers to the sending, receiving, or forwarding of
sexually explicit messages, photographs, images, or videos
via the Internet, a cell phone, or another digital device.
survey found that 20% of adolescents between 13-19 years
old have sent or posted a nude or semi-nude photo or video
of themselves to another adolescent.
In a more recent
longitudinal study, the authors reported that 28% of their
subjects had received a sextand 57% had been asked to
send a sext.
More disconcerting was the nding that
male and female adolescents who engaged in sexting were
more likely to have had sex, and that sexting was associated
with high-risk sexual behaviors in females (this association
was not seen in males).
Adolescents also engage in risk-taking related to sub-
stance abuse and SNS proles have become a popular site for
the promotion of this behavior. In a study examining the
prevalence of risky behaviors displayed on an SNS, substance
abuse was the most frequently cited high-risk behavior, with
41% of proles having some reference to alcohol, tobacco, or
drug use.
A more recent study measuring online and ofine
inuences on adolescent smoking and alcohol use demon-
strated that exposure to SNS images of partying or drinking
increased both smoking and alcohol use in study subjects.
These data again highlight the concern that online behavior
can readily translate into real world behavior and potential
Ofine Consequences of Online Behavior
While the cost of risky online behavior is clearly high
when it comes to social and sexual health, there are also
potential legal ramications. Laws originally created to
protect children are being used to criminalize them as por-
nographers in many states.
One disturbing illustration in-
volves a 14-year-old girl who posted nude photos of herself
L.M. Cookingham, G.L. Ryan / J Pediatr Adolesc Gynecol 28 (2015) 2e53
on a SNS and was subsequently charged with possession and
distribution of child pornography.
Another example in-
volves a teen who received unsolicited explicit photos of his
girlfriend via text message and then mass-e-mailed the nude
photos after their breakup to get back at her.
This teen
was subsequently convicted of transmitting child pornog-
raphy and labeled a sex offender.
While it seems right that
some punishment should be incurred for such unwise and
often hurtful decisions, few adolescents are aware that the
act of simply hitting sendcan cause serious ramications.
Inappropriate online behavior can lead to lifelong
repercussions, whether or not the actions are prosecuted.
Images and commentary posted on SNSs are freely accessible
and leave a digital footprint, allowing college admission
committees and employers to pre-screen their applicants.
More distressing than the potential negative impact of SNS
personal disclosure on professional success is the fact that
sexual predators troll SNSs for vulnerable adolescents who
don't understand the effects of haphazard Internet use.
While recent studies suggest that sexual solicitation is more
likely to occur between 2 adolescents (versus an adult
soliciting an adolescent), the threat very much exists.
Utilization of Social Media for Education
Notwithstanding these potential negative outcomes of
SNS use, new research has discovered some positive health
outcomes attributable to SNS use. From studies utilizing
SNSs to prevent the decline of condom use among adoles-
to investigators utilizing SNSs to provide accurate
and age-appropriate STI information,
educators are work-
ing to take advantage of SNS popularity in adolescents. SNSs
should be considered valuable tools for adolescent care
providers, especially when it comes to dissemination of
sensitive information that adolescents may not feel
comfortable discussing in face-to-face interactions, such as
those issues mentioned above. However, because online
resources may be unreliable or biased, utilization of these
outlets for dispersal of health information should not
replace comprehensive sexual education programs or
individualized education by health care providers. Media
literacy should also be taught to adolescents in schools and
at home to help them identify balanced and medically ac-
curate educational resources to ll in the gaps and continue
their life-long learning.
How Adults Can Stay Engaged and Prevent Harm
Inquiring about adolescents' online participation in
activities such as sexting will provide valuable insight into
intention and/or engagement in high-risk behaviors and
afford an opportunity to intervene before irreparable dam-
age occurs. The American Academy of Pediatrics (AAP) rec-
ommends that health care providers ask parents/guardians
two specic media history questions at every well-child
1. How much recreational screen time does your child or
teenager consume daily?
2. Is there a television set or Internet-connected device in
the child's bedroom?
The AAP also encourages providers to recommend the
following to parents/guardians of adolescents (as summa-
rized by the authors)
Total entertainment screen time should be limited to
less than 2 hours per day
Television sets and Internet-connected devices should
be kept out of the bedroom
Use of Web sites and social media sites should be
A plan for media use should be established and rules for
inappropriate use enforced (ie, at mealtime, bedtime)
It is important for adolescent care providers to not only
teach parents/guardians about the benets and risks of social
media use, but to remain engaged and educated themselves.
In a rapidly changing world of technology, they must stay up
to date on Internet-based exposures and trends in order to
support adolescents and their parents/guardians as they
navigate this challenging time of development.
Social media have become an integral part of today's
culture and have helped dene the latest generation of
youth. Despite the promise of enhanced socialization,
communication, and education, however, many adoles-
cents' lived experience of social media use has been nega-
tive on balance. From lowering self-esteem to creating new
social norms that encourage increasingly risky behavior,
SNS use jeopardizes the sexual and social wellness of ado-
lescents. New research is aimed at utilizing social media for
positive and effective health and wellness interventions,
but much more work needs to be done to enhance the
positive and mitigate the negative potential of this resource.
One thing is certain: as healthcare providers for this newest
technologically savvy population, it is imperative that we
keep up with the rapid evolution of social media and are
pro-active in managing health outcomes for adolescents.
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L.M. Cookingham, G.L. Ryan / J Pediatr Adolesc Gynecol 28 (2015) 2e55
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... Interestingly, while participants pointed out that Facebook can be used as a platform for members to misrepresent their achievements or lifestyles, they also admitted that the exposure to what they see on the social networking site has a huge influence on how they see themselves and subsequently how they make decisions regarding their sexual behaviour. This was reiterated by Victoria (female, 23-years old) who said: This observation is also expressed in the work of Cookingham (2015:3) who reports that young people who view sexually suggestive material on social networks perceive that their peers are engaging in unprotected sex or in sex with strangers, and as a consequence, these young people are more likely to report engaging in the same high risk behaviour. While participants seem to be fully aware of the possibility that some of the members on the site misrepresent their everyday lives, this does not however discourage the sense of envy that comes with observing what they regard as aspiration, especially with regards to sexual relationships. ...
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South Africa has made strides in its fight against HIV and AIDS but research shows that the country still carries the heaviest burden of disease within Sub-Saharan Africa and the entire world (UNAIDS 2006). While the epidemic in South Africa has impacted across all age groups, youth, especially young women are the most impacted by new HIV infections. The Human Sciences Research Council (2014) reports that amongst young women (15-24 years), new HIV infections are reported to be 2.54% while for young men within the same age range new HIV infections are approximately 0.55% (HSRC, 2014:58). Even though it has been well established that social and behavioural factors are the major driving force behind the proliferation of HIV amongst young women, the role played by popular culture in either inhibiting or disinhibiting new HIV infections has not received sufficient attention. This study aimed at exploring and describing the impact of popular culture in HIV prevention amongst youth in Kagiso, West Rand. Drawing on literature around popular culture as well as HIV amongst youth, the study provides a contextual background within which the study is located. Many researchers including Selikow, Lerclec-Madlala and Dickinson have argued that while HIV prevention knowledge forms the basis for an HIV prevention competent community, it is also important to note that HIV prevention knowledge alone is not sufficient to change sexual behaviour. Indigenous knowledge and interpretation of disease plays a critical role in determining whether knowledge will be successfully translated into sexual behaviour change. The study employed the use of a qualitative research methodology, hence semi-structured interviews were conducted as part of the data collection process. The findings of this study show that the role played by mass media through television, internet and music in influencing the decision making process of young people with regards to their sexual behaviour should be a key component in our attempt to understand young people and the design of appropriate HIV prevention programmes. This research argues that popular culture has a huge impact on the lives of young people. The internet and related social media platforms have revolutionised the way sex and sexuality are viewed by young people. Moreover, the role played by celebrity figures on television and through music has had an impact in casualising sex amongst young people. By drawing on the findings, the study recommends that young people need to be involved in the design and implementation of prevention programmes. Furthermore, innovative approaches such as the use of modern communication methods including Apps and interactive games need to be considered for the purpose of reaching young people.
... This observation was also confirmed by Zawada et al., who showed that the higher the level of Facebook addiction was, the lower one's satisfaction with their relationship status was [24]. In addition, social media has many other negative impacts on every user, from lowering self-esteem to creating new social norms that encourage increasingly risky behaviors [25]. In addition, our findings are similar to those of Alimoradi et al., who also revealed that social media addiction negatively affects women's sexual functioning [26]. ...
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In this study, we investigated the relationship between social media use and women’s sexual functioning during the COVID-19 pandemic. Data were collected between April and November 2021. Online surveys including the Female Sexual Functioning Index (FSFI) and Bergen Social Media Addiction Scale (BSMAS) questionnaires were distributed to young, sexually active women. Information was collected on their demographics, sexual life, and use of social media. We enrolled 546 women (mean age 23.07 ± 4.69). In general, 5.68% of the women were at high risk of social media addiction. Social media addiction had a negative impact on FSFI scores, while pornography use had a positive effect on women’s sexual functioning. Users of dating apps also obtained lower FSFI scores than non-users. No differences in FSFI scores were observed between gamers and non-gamers. The impact of time spent on social media on FSFI scores was not significant. We conclude that social media addiction negatively affected women’s sexual functioning during the COVID-19 pandemic.
Introduction: Nowadays adolescents and children are more and more exposed to sexually explicit internet material (SEIM), but most parents and healthcare professionals neglect this issue. The aim of the present study was to evaluate the impact of online pornography on minors' health with a specific focus on the effects produced on their behavioural, psychophysical and social development. Evidence acquisition: A literature search was performed on PubMed and ScienceDirect in March 2018 with the query "(pornography OR sexually explicit internet material) AND (adolescent OR child OR young) AND (impact OR behaviour OR health)." Results published between 2013 and 2018 were analysed and compared with previous evidence. Evidence synthesis: According to selected studies (N.=19), an association between consumption of online pornography and several behavioral, psychophysical and social outcomes - earlier sexual debut, engaging with multiple and/or occasional partners, emulating risky sexual behaviors, assimilating distorted gender roles, dysfunctional body perception, aggressiveness, anxious or depressive symptoms, compulsive pornography use - is confirmed. Conclusions: The impact of online pornography on minors' health appears to be relevant. The issue can no longer be neglected and must be targeted by global and multidisciplinary interventions. Empowering parents, teachers and healthcare professionals by means of educational programs targeting this issue will allow them to assist minors in developing critical thinking skills about pornography, decreasing its use and obtaining an affective and sex education that is more suitable for their developmental needs.
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Media, from television to the "new media" (including cell phones, iPads, and social media), are a dominant force in children's lives. Although television is still the predominant medium for children and adolescents, new technologies are increasingly popular. The American Academy of Pediatrics continues to be concerned by evidence about the potential harmful effects of media messages and images; however, important positive and prosocial effects of media use should also be recognized. Pediatricians are encouraged to take a media history and ask 2 media questions at every well-child visit: How much recreational screen time does your child or teenager consume daily? Is there a television set or Internet-connected device in the child's bedroom? Parents are encouraged to establish a family home use plan for all media. Media influences on children and teenagers should be recognized by schools, policymakers, product advertisers, and entertainment producers. Pediatrics 2013;132:958-961.
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The media can be a powerful teacher of children and adolescents and have a profound impact on their health. The media are not the leading cause of any major health problem in the United States, but they do contribute to a variety of pediatric and adolescent health problems. Given that children and teens spend >7 hours a day with media, one would think that adult society would recognize its impact on young people's attitudes and behaviors. Too little has been done to protect children and adolescents from harmful media effects and to maximize the powerfully prosocial aspects of modern media.
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Online social networking sites (SNSs) have become a popular mode of communication among adolescents. However, little is known about the effects of social online activity on health behaviors. The authors examined the use of SNSs among friends and the degree to which SNS activities relate to face-to-face peer influences and adolescent risk behaviors. Longitudinal egocentric friendship network data along with adolescent social media use and risk behaviors were collected from 1,563 10th-grade students across five Southern California high schools. Measures of online and offline peer influences were computed and assessed using fixed-effects models. The frequency of adolescent SNS use and the number of their closest friends on the same SNSs were not significantly associated with risk behaviors. However, exposure to friends' online pictures of partying or drinking was significantly associated with both smoking (β = .11, p < .001) and alcohol use (β = .06, p < .05). Whereas adolescents with drinking friends had higher risk levels for drinking, adolescents without drinking friends were more likely to be affected by higher exposure to risky online pictures (β = -.10, p < .05). Myspace and Facebook had demographically distinct user characteristics and differential effects on risk behaviors. Exposure to risky online content had a direct impact on adolescents' risk behaviors and significantly interacted with risk behaviors of their friends. These results provide evidence that friends' online behaviors should be considered a viable source of peer influence and that increased efforts should focus on educating adolescents on the negative effects of risky online displays.
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Abstract Two studies tested whether online social networking technologies influence health behavioral social norms, and in turn, personal health behavioral intentions. In Study 1, experimental participants browsed peers' Facebook photos on a college network with a low prevalence of sexually suggestive content. Participants estimated the percentage of their peers who have sex without condoms, and rated their own future intentions to use condoms. Experimental participants, compared to controls who did not view photos, estimated that a larger percentage of their peers use condoms, and indicated a greater intention to use condoms themselves in the future. In Study 2, participants were randomly assigned to view sexually suggestive or nonsexually suggestive Facebook photos, and responded to sexual risk behavioral questions. Compared to participants viewing nonsuggestive photos, those who viewed sexually suggestive Facebook photos estimated that a larger percentage of their peers have unprotected sexual intercourse and sex with strangers and were more likely to report that they themselves would engage in these behaviors. Thus, online social networks can influence perceptions of the peer prevalence of sexual risk behaviors, and can influence users' own intentions with regard to such behaviors. These studies suggest the potential power of social networks to affect health behaviors by altering perceptions of peer norms.
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Youth are using social media regularly and represent a group facing substantial risk for sexually transmitted infection (STI). Although there is evidence that the Internet can be used effectively in supporting healthy sexual behavior, this has not yet extended to social networking sites. To determine whether STI prevention messages delivered via Facebook are efficacious in preventing increases in sexual risk behavior at 2 and 6 months. Cluster RCT, October 2010-May 2011. Individuals (seeds) recruited in multiple settings (online, via newspaper ads and face-to-face) were asked to recruit three friends, who in turn recruited additional friends, extending three waves from the seed. Seeds and waves of friends were considered networks and exposed to either the intervention or control condition. Exposure to Just/Us, a Facebook page developed with youth input, or to control content on 18-24 News, a Facebook page with current events for 2 months. Condom use at last sex and proportion of sex acts protected by condoms. Repeated measures of nested data were used to model main effects of exposure to Just/Us and time by treatment interaction. A total of 1578 participants enrolled, with 14% Latino and 35% African-American; 75% of participants completed at least one study follow-up. Time by treatment effects were observed at 2 months for condom use (intervention 68% vs control 56%, p=0.04) and proportion of sex acts protected by condoms (intervention 63% vs control 57%, p=0.03) where intervention participation reduced the tendency for condom use to decrease over time. No effects were seen at 6 months. Social networking sites may be venues for efficacious health education interventions. More work is needed to understand what elements of social media are compelling, how network membership influences effects, and whether linking social media to clinical and social services can be beneficial. This study is registered at www.clinicaltrials.govNCT00725959.
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In the absence of effective sex education in the United States, the media have arguably become the leading sex educator for children and teenagers. Considerable research now exists that attests to the ability of the media to influence adolescents' attitudes and beliefs about sex and sexuality. In addition, new research has found a significant link between exposure to sexual content in the media and earlier onset of sexual intercourse. Although there is little research on the behavioral effects of "new" media, they are discussed as well. Suggestions for clinicians, parents, the federal government, and the entertainment industry are provided.
Despite national health initiatives to decrease sexually transmitted infections (STIs) in adolescents, they remain at high risk. Barriers exist for adolescents seeking sexual health information. They spend a great deal of time using the internet to obtain information and socialize. A social networking site for adolescents, Teen Sexual Health Information, that provides STI information was developed and evaluated in a Midwestern metropolitan county with high rates of adolescent STIs. This project aimed to provide confidential and accurate STI information via the Facebook social networking site to help adolescents make informed decisions about sexual health.
Perception of peer behaviors is an important predictor of actual risk behaviors among youth. However, we lack understanding of peer influence through social media and of actual and perceived peer behavior concordance. The purpose of this research is to document the relationship between individual perception of and actual peer sexual risk behavior using online social networks. The data are a result of a secondary analysis of baseline self-reported and peer-reported sexual risk behavior from a cluster randomized trial including 1,029 persons from 162 virtual networks. Individuals (seeds) recruited up to three friends who then recruited additional friends, extending three waves from the seed. ANOVA models compared network means of actual participant behavior across categories of perceived behavior. Concordance varied between reported and perceived behavior, with higher concordance between perceived and reported condom use, multiple partners, concurrent partners, sexual pressure, and drug and alcohol use during sex. Individuals significantly over-reported risk and under-reported protective peer behaviors related to sex.
Objective To examine the prevalence of sexting behaviors as well as their relation to dating, sex, and risky sexual behaviors using a large school-based sample of adolescents. Design Data are from time 2 of a 3-year longitudinal study. Participants self-reported their history of dating, sexual behaviors, and sexting (sent, asked, been asked, and/or bothered by being asked to send nude photographs of themselves). Setting Seven public high schools in southeast Texas. Participants A total of 948 public high school students (55.9% female) participated. The sample consisted of African American (26.6%), white (30.3%), Hispanic (31.7%), Asian (3.4%), and mixed/other (8.0%) teens. Main Outcome Measure Having ever engaged in sexting behaviors. Results Twenty-eight percent of the sample reported having sent a naked picture of themselves through text or e-mail (sext), and 31% reported having asked someone for a sext. More than half (57%) had been asked to send a sext, with most being bothered by having been asked. Adolescents who engaged in sexting behaviors were more likely to have begun dating and to have had sex than those who did not sext (all P < .001). For girls, sexting was also associated with risky sexual behaviors. Conclusions The results suggest that teen sexting is prevalent and potentially indicative of teens' sexual behaviors. Teen-focused health care providers should consider screening for sexting behaviors to provide age-specific education about the potential consequences of sexting and as a mechanism for discussing sexual behaviors.
There is substantial literature on the impact of the mass media on children's and adolescents' health and development. The question of what role new technology plays in the media's influence is now a subject of both review and discussion, particularly regarding health risks and intervention. This article takes a brief look at online usage and the theoretical mechanisms that might make Internet access more problematic in terms of risks, compared with more traditional media such as television and film. One of these risks, known today as cyberbullying or Internet harassment, is scrutinized in detail.