Sexting Among Young Adults

PurposeSexting has stirred debate over its legality and safety, but few researchers have documented the relationship between sexting and health. We describe the sexting behavior of young adults in the United States, and examine its association with sexual behavior and psychological well-being.MethodsUsing an adapted Web version of respondent-driven sampling, we recruited a sample of U.S. young adults (aged 18–24 years, N = 3,447). We examined participant sexting behavior using four categories of sexting: (1) nonsexters, (2) receivers, (3) senders, and (4) two-way sexters. We then assessed the relationships between sexting categories and sociodemographic characteristics, sexual behavior, and psychological well-being.ResultsMore than half (57%) of the respondents were nonsexters, 28.2% were two-way sexters, 12.6% were receivers, and 2% were senders. Male respondents were more likely to be receivers than their female counterparts. Sexually active respondents were more likely to be two-way sexters than non–sexually active ones. Among participants who were sexually active in the past 30 days, we found no differences across sexting groups in the number of sexual partners or the number of unprotected sex partners in the past 30 days. We also found no relationship between sexting and psychological well-being.ConclusionsOur results suggest that sexting is not related to sexual risk behavior or psychological well-being. We discuss the findings of this study and propose directions for further research on sexting.     

Sexting,Substance Use,and Sexual Risk Behavior in Young Adults

PurposeCell phone use has become more widespread over the past decade. Young adults are frequently early adopters of new technologies, including cell phones. Most previous research examining sexting, the act of sending sexually explicit or suggestive images via text message, has focused on the legal or social consequences of this behavior. The current study focused on the public health implications of sexting by examining associations between sexting, substance use, and sexual risk behavior in youth.MethodsYoung adults (N = 763) completed online questionnaires assessing demographics, cell phone use (e.g., texting, sexting), substance use, and sexual risk behaviors.ResultsSexting was reported by a substantial minority of participants (44%). Compared with their nonsexting counterparts, participants who engaged in sexting were more likely to report recent substance use and high-risk sexual behaviors, including unprotected sex and sex with multiple partners. Of those who engaged in sexting, a considerable percentage (31.8%) reported having sex with a new partner for the first time after sexting with that person. In multivariate analyses, sexting was associated with high-risk sexual behavior, after accounting for demographic factors, total texting behaviors, and substance use.ConclusionsResults suggest that sexting is robustly associated with high-risk sexual behavior. Many individuals exchange explicit or provocative photos with long-term sexual partners, but at least some participants in this study were incurring new sexual risks after sexting. Additional research is needed to understand the contexts in which sexting occurs, motivations for sexting, and relationship of sexting to risk behavior.     

Sexting Among Young Men Who Have Sex With Men: Results From a National Survey

PurposeWe know little about the prevalence of sexting behavior among young men who have sex with men (YMSM) or its association with their sexual behaviors.MethodsTo address these gaps, we used data from an online study examining the partner-seeking behaviors of single YMSM (N = 1,502; ages 18–24 years) in the United States. Most participants (87.5%) reported sexting, with 75.7% of the sample reporting having sent and received a sext.ResultsSexting was more frequent among sexually active YMSM, with YMSM who had sent and received a sext being more likely to report insertive anal intercourse, with and without condoms, than those who had not sexted. We found no association between sexting and receptive anal intercourse.ConclusionsOur findings suggest that sexting may vary by YMSM's sexual roles. We discuss our findings with attention to their implications for sexual health promotion.     

“I keep hearing reports on the news that it's a real problem at the moment”: Public health nurses’ understandings of sexting practices among young people

Over the past decade, the potential harms regarding young people's use of technology have attracted mounting political, media and research attention worldwide. One practice engaged in by many young people is that of “sexting” and the sharing of partially, or complete nude images (“selfies”). Such images are not always retained within private spaces and are prone to be shared, with significant psychosocial consequences for young people involved. A significant risk is the hidden nature of some online interactions, with potential for grooming and child sexual exploitation. As key professionals working with young people, public health nurses have potential to educate and explore the risks with them. Yet to date, to our knowledge there has been no research in relation to public health nurses’ understandings of the practices involved or their potential harms. A qualitative study was undertaken drawing theoretically on the common‐sense model (CSM) to frame the analysis. Eighteen semi‐structured interviews were conducted with public health nurses in a region of England in 2016. Data were analysed through thematic analysis, and mapped to the five domains of CSM. Public health nurses’ understandings of young people's sexting practices were shaped largely by media reports, rather than scientific, disciplinary knowledge. Sexting did not resonate with many public health nurses’ own experiences of being a young person and was therefore difficult to understand. All were able to express an opinion about the causes and consequences of sexting and we present these as a “perceived hierarchy of risk”. All public health nurses acknowledged the importance of their role in dealing with harm reduction associated with sexting among young people, but they need education and support to do this effectively and confidently. Findings can be transferred carefully to many contexts and countries because sexting is a practice among young people that transcends geographical boundaries.     

Sexting among high school students in a metropolis in Ghana: an exploratory and descriptive study

ABSTRACT

The sharing of sexually explicit materials using internet-enabled devices by adolescents (sexting) is an issue of global concern. Very little is known about it in sub-Saharan Africa. We conducted a self-administered survey among a randomly selected group of high school students in Tema, Ghana. Students’ self-esteem was assessed using the Rosenberg Self-Esteem Scale. Analysis including logistic regression explored prevalence and determinants of sexting, as well as its effect on sexual behavior. Five hundred and seventy-six (53% females) students participated. About 24.7% had shared sext materials using mobile phones. The predictors of sexting were being male (adjusted OR = 6.01, 95% CI 3.49–10.35), being in a “serious” (5.91, 2.77–12.64) or “casual” (2.82, 1.67–4.75) relationship and owning a mobile phone (1.82, 1.10–3.02). Students aged >16years (1.48, 0.94-2-34) and students with low self-esteem (1.24, 0.74–2.05) were more likely to be involved in sexting. Sexters were more likely to be sexually active (3.79, 2.33–6.14). Self-gratification and social pressures were the reasons for sexting. Fear that materials could go viral, religiosity and possible reprimand were the reasons students did not engage in sexting. Sexting among adolescents in this population is high and similar to levels in developed countries. Given the possible adverse short and long-term impact, school-based interventions are needed.     

Childhood Behavior Problems and Adolescent Sexual Risk Behavior: Familial Confounding in the Child and Adolescent Twin Study in Sweden (CATSS)

ObjectivePrevious studies have found associations between childhood behavior problems and adolescent sexual risk behavior. Using a quasi-experimental approach, we examined the extent to which this association may be due to between-family differences (i.e., unmeasured familial confounds) not adequately explored in prior research.MethodsWe used data from a longitudinal, population-based cohort of young twins in Sweden (first assessment: age 9 or 12 years; second assessment: age 15; n = 2,388). We explored the nature of the association between symptom scores for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) at age 9 or 12 and the likelihood of having had sexual intercourse and number of sexual partners by age 15. Two-level mixed-effects models were used to estimate the effect of symptom score on each outcome after controlling for potential unmeasured familial confounds.ResultsHigher ADHD, ODD, and CD scores were associated with significantly increased likelihood of sexual intercourse by age 15. Higher ADHD and ODD scores were also associated with increased number of sexual partners. After controlling for unmeasured familial confounds, however, behavior problems were no longer significantly associated with either outcome.ConclusionThe association between childhood behavior problems and sexual risk behaviors may be due to characteristics shared within families. Hence, prevention strategies aimed at reducing these behaviors might need to address broader risk factors that contribute to both behavior problems and a greater likelihood of sexual risk behavior.     

Development and Validation of the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults

PurposeWe developed and validated a measure that assesses the latent construct of sexual and reproductive empowerment among adolescents and young adults. A specific measure for this group is critical because of their unique life stage and circumstances, which often includes frequent changes in sexual partners and involvement from parents in decision-making.MethodsAfter formative qualitative research, a review of the literature, and cognitive interviews, we developed 95 items representing nine dimensions of sexual and reproductive empowerment. Items were then fielded among a national sample of young people aged 15–24 years, and those who identified as sexually active completed a 3-month follow-up survey. We conducted psychometric analysis and scale validation.ResultsExploratory factor analysis on responses from 1,117 participants resulted in the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults, containing 23 items captured by seven subscales: comfort talking with partner; choice of partners, marriage, and children; parental support; sexual safety; self-love; sense of future; and sexual pleasure. Validation using logistic regression demonstrated that the subscales were consistently associated with sexual and reproductive health information and access to sexual and reproductive health services measured at baseline and moderately associated with the use of desired contraceptive methods at 3-month follow-up.ConclusionsThe Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults is a new measure that assesses young people’s empowerment regarding sexual and reproductive health. It can be used by researchers, public health practitioners, and clinicians to measure sexual and reproductive empowerment among young people.     

Brief interventions to prevent sexually transmitted infections suitable for in-service use: A systematic review

BackgroundSexually transmitted infections (STIs) are more common in young people and men who have sex with men (MSM) and effective in-service interventions are needed.MethodsA systematic review of randomized controlled trials (RCTs) of waiting-room-delivered, self-delivered and brief healthcare-provider-delivered interventions designed to reduce STIs, increase use of home-based STI testing, or reduce STI-risk behavior was conducted. Six databases were searched between January 2000 and October 2014.Results17,916 articles were screened. 23 RCTs of interventions for young people met our inclusion criteria. Significant STI reductions were found in four RCTs of interventions using brief one-to-one counselling (2 RCTs), video (1 RCT) and a STI home-testing kit (1 RCT). Increase in STI test uptake was found in five studies using video (1 RCT), one-to-one counselling (1 RCT), home test kit (2 RCTs) and a web-based intervention (1 RCT). Reduction in STI-risk behavior was found in seven RCTs of interventions using digital online (web-based) and offline (computer software) (3 RCTs), printed materials (1 RCT) and video (3 RCTs). Ten RCTs of interventions for MSM met our inclusion criteria. Three tested for STI reductions but none found significant differences between intervention and control groups. Increased STI test uptake was found in two studies using brief one-to-one counselling (1 RCT) and an online web-based intervention (1 RCT). Reduction in STI-risk behavior was found in six studies using digital online (web-based) interventions (4 RCTs) and brief one-to-one counselling (2 RCTs).ConclusionA small number of interventions which could be used, or adapted for use, in sexual health clinics were found to be effective in reducing STIs among young people and in promoting self-reported STI-risk behavior change in MSM.     

Reporting the whole story: Analysis of the ‘out‐of‐scope’ questions from the James Lind Alliance Teenage and Young Adult Cancer Priority Setting Partnership Survey

ObjectiveWe conducted a UK‐wide survey to identify the top 10 research questions for young people''s cancer. We conducted secondary analysis of questions submitted, which were ‘out‐of‐scope’ of the original survey aim. We sought to disseminate these questions, to inform practice, policy and the development of potential interventions to support young people with cancer.DesignJames Lind Alliance Priority Setting Partnership.ParticipantsYoung people aged 13‐24 with a current/previous cancer diagnosis, their families/friends/partners and professionals who work with this population.MethodsEight hundred and fifty‐five potential research questions were submitted, and 326 were classified as ‘out‐of‐scope’. These questions, along with 49 ‘free‐text’ comments, were analysed using thematic analysis.ResultsThe 375 out‐of‐scope questions and comments were submitted by: 68 young people, 81 family members/partners/friends and 42 professionals. Ten overarching themes were identified: diagnostic experience; communication; coordination of care; information needs and lack of information; service provision; long‐term effects and aftercare support; family support; financial impact; end‐of life care; and research methods and current research.ConclusionsThe need to tailor services, information and communication is a striking thread evidenced across the ‘out‐of‐scope’ questions. Gaps in information highlight implications for practice in revisiting information needs throughout the cancer trajectory. We must advocate for specialist care for young people and promote the research priorities and these findings to funding bodies, charities, young people and health and social care policymakers, in order to generate an evidence base to inform effective interventions across the cancer trajectory and improve outcomes.Patient/public contributionsPatients and carers were equal stakeholders throughout.     

“Supposed to make you better but it doesn’t really”: HIV-positive youths’ perceptions of HIV treatment

PurposeHalf of new HIV infections worldwide occur among young people. Youth, particularly young women aged 15–29 years, represent a growing population to experience HIV. This study investigated HIV-positive youths’ perceptions of, and experiences with, antiretroviral treatment.MethodsA community-based, participatory approach was used to conduct a mixed methods research study. Thirty-four qualitative, in-depth, semi-structured interviews were conducted with HIV-positive youth (ages 12–24 years) in Ontario, Canada. Brief structured demographic surveys were also administered. A research team of HIV-positive youth, professionals, and researchers collaboratively analyzed the data for emerging themes.ResultsFour major themes emerged: Treatment knowledge: confusion and skepticism. Many participants did not understand, or believe in, antiretroviral treatment. Some youth on treatment did not understand why they were taking medications. Treatment decision-making: lack of choice and feeling emotionally unprepared. Some youth did not feel that they had choices about treatment, and others did not feel ready to make treatment decisions. Difficulties taking medications. Youth had problems with social routine disruption, feeling “different” and side effects. Many viewed costs of medications as a barrier to treatment. Inconsistent treatment adherence and treatment interruptions, which were common amongst participants.ConclusionsYouth may need support for managing difficulties with treatments, such as side effects, social impacts, and adherence. Developmentally appropriate, empowerment-based treatment education may be helpful for HIV-positive youth. The availability of social programs to provide treatment access does not guarantee that youth will be aware of them. This may indicate a need for youth-specific outreach.     

Young mothers' lived experiences prior to becoming pregnant in rural Victoria: a phenomenological study

Objective: To explore the lived experiences and social context prior to becoming pregnant, of women who became mothers during adolescence in rural Victoria. Design: Qualitative interpretive phenomenological study using semistructured interviews. Setting: Rural community in North East Victoria, Australia. Participants: Four rural women who gave birth to a child between the ages of 15 and 19. Results: Five themes emerged from the data as being essential to the participants' experiences prior to pregnancy. These included feeling isolated; life change: transition into adulthood; support and understanding in sexual relationships; feeling dissatisfied; and overcoming adversity. Participants' provided practical recommendations to improve life for young people in rural areas through reflecting on their own experiences. Conclusion: These findings highlight the complex nature of rural young women's experiences leading up to pregnancy and suggest that early motherhood might be largely reflective of the social environment in which one lives prior to pregnancy. Providing somewhere safe to go, organised and appropriate social activities and increasing access to health services were identified as being pertinent to improving experiences for rural young people prior to pregnancy. Health professionals should consider the importance of supporting young women through non‐judgemental, approachable and accessible services.     

CCopeY: A Mixed-Methods Coproduced Study on the Mental Health Status and Coping Strategies of Young People During COVID-19 UK Lockdown

PurposeExploring the impact of the COVID-19 pandemic on young people’s mental health is an increasing priority. Studies to date are largely surveys and lack meaningful involvement from service users in their design, planning, and delivery. The study aimed to examine the mental health status and coping strategies of young people during the first UK COVID-19 lockdown using coproduction methodology.MethodsThe mental health status of young people (aged 16–24) in April 2020 was established utilizing a sequential explanatory coproduced mixed methods design. Factors associated with poor mental health status, including coping strategies, were also examined using an online survey and semi-structured interviews.ResultsSince the lockdown, 30.3% had poor mental health, and 10.8% had self-harmed. Young people identifying as Black/Black-British ethnicity had the highest increased odds of experiencing poor mental health (odds ratio [OR] 3.688, 95% CI .54–25.40). Behavioral disengagement (OR 1.462, 95% CI 1.22–1.76), self-blame (OR 1.307 95% CI 1.10–1.55), and substance use (OR 1.211 95% CI 1.02–1.44) coping strategies, negative affect (OR 1.109, 95% CI 1.07–1.15), sleep problems (OR .915 95% CI .88–.95) and conscientiousness personality trait (OR .819 95% CI .69–.98) were significantly associated with poor mental health. Three qualitative themes were identified: (1) pre-existing/developed helpful coping strategies employed, (2) mental health difficulties worsened, and (3) mental health and nonmental health support needed during and after lockdown.ConclusionPoor mental health is associated with dysfunctional coping strategies. Innovative coping strategies can help other young people cope during and after lockdowns, with digital and school promotion and application.     

Is Your Teen at Risk? Discourses of adolescent sexting in United States television news

“Sexting” is the term commonly used to refer to the transfer of nude or semi-nude pictures or videos between mobile devices. This paper contextualizes the reaction to the practice of sexting among adolescents by exploring legal responses and reviewing the literature on teens and cell phone use. The purpose of the paper is to identify, explore and analyze the key themes emerging from the coverage of teen sexting by television news in the United States. The author explores three primary themes that emerge from the broadcast discourse: preference for technologically deterministic explanations; reliance on gender-differentiated scenarios; and, a preference for solutions involving surveillance. This paper further explores whether the discourse around sexting can be understood using media panic theory. Noting the problematic conflation of risk and harm in the discourse, the author concludes by suggesting avenues for future research regarding the creation and transmission of sexual images using digital devices.     

Scanning and synthesizing Canadian policies that address the school-to-work transition of youth and young adults with disabilities

BackgroundDisability faced by a young person can impact the school-to-work transition and shape health and well-being over the life course. Unique barriers to entry and advancement within the labor market that are relevant to young people with disabilities underscore the need for tailored policy-level supports.ObjectivesTo examine and describe policies that support the school-to-work transition of young people with disabilities in Canada.MethodsA scan of policies which focused on the school-to-work transition of young people with disabilities across Canada was conducted between June 2019 and January 2020. Searches were completed within federal, provincial and territorial policy portals. Each policy relating to employment participation of people with disabilities was summarized. Policies that focused on the school-to-work-specific were synthesized using Bemelmans-Vidic, Rist and Vedung's policy tool framework.ResultsA total of 36 policies were identified by our scan that focused on the employment of people with disabilities. Only five policies explicitly addressed the school-to-work transition. All existing policies were implemented at the provincial level and aimed to promote entry into employment. The synthesis of policies revealed that financial policy tools were primarily used to incentivize employment, provision of workplace accommodations, or the development and implementation of job readiness programs.ConclusionOur analysis of federal, provincial and territorial policies in Canada uncovered a limited number of policies that specifically support the school-to-work transition. Addressing these policy gaps can increase the inclusion of young people with disabilities in the labor market.     

Lines of Action for Sexting Prevention and Intervention: A Systematic Review

Sexting has become a new form of intimate interaction in line with contemporary communication methods. This phenomenon often leads to positive outcomes, but it can also have negative repercussions depending on the situation, such as the context of the relationship, and whether it is consensual or coercive. Despite this, the main types of sexting behaviors (sending, receiving, and third-party forwarding) must be addressed in order to promote safe and healthy practices. However, the approach to tackling this phenomenon remains unclear. This systematic review sought to summarize the lines of action proposed or conducted in the scientific literature to address sexting, to help researchers and educators create and evaluate effective programs. A systematic search of 21 databases was conducted; only articles relating to sexting education, prevention, and intervention among child and adolescent populations were considered. In total, 456 articles were identified, 91 of which were included for the purposes of this research. The results highlighted a need to respond to the aforementioned sexting behaviors and to tackle the resulting conflict situations. Although interventions across different areas are recommended (e.g., health, family, policies, legal advice, law enforcement, technology experts, and even society as a whole), most studies agree that school is the most practical setting for intervention. Thus, the 15 lines of action identified in this systematic review must all be considered to effectively address sexting in childhood and adolescence.

     

Sexting Rates and Predictors From an Urban Midwest High School

BACKGROUND

Risks associated with teen sexting draw increasing concern from teachers and communities as developments in communication software and devices make sharing private content faster and simpler each year. We examined rates, recipients, and predictors of teen sexting to better plan education and preventative policies and strategies. A comprehensive literature review was conducted to determine the most likely predictors of teen sexting using prior survey studies and theoretical conceptions.

METHODS

We surveyed 314 high school students in an urban area of a large Midwestern city.

RESULTS

Males were found to more frequently report sexting. Impulsivity, frequency of electronic communication, peer pressure, peer sexting, and social learning significantly predicted sexting beyond age, race, and sex. Self‐esteem did not moderate the effect of peer pressure to sext. Structural predictive models attained good fit to the data, and neither were moderated by sex.

CONCLUSIONS

Sexting was highly associated with reported peer pressure, perceived norms, and impulsive decision making. Adolescents in relationships may be at particular risk of sexting. These findings will help parents, teens, and educators take appropriate measures to inform about and encourage the safe use of technology.

     

A legal perspective on trust,control and privacy in the context of sexting among children in Europe

ABSTRACT

Children are engaging with technology to establish and maintain intimate relationships and explore their sexual identity. Sexting is one of the ways in which this exploration occurs, often on a consensual basis. In a first stage, this article reflects on the concepts of trust, control and privacy as prerequisites to engage in sexting. In a second stage, the authors explore the extent to which legislative instruments enable the legitimate exploration and expression of one’s sexual identity, and aim to minimise adverse consequences thereof. To that end, the fundamental right to privacy, data protection frameworks and criminal legislation on the non-consensual dissemination of sexual images were identified as potentially harnessing the concepts of trust, control and privacy. Questions were examined regarding the potential undermining thereof through the application of child sexual abuse material legislation to instances of (consensual) sexting between children.     

Sexting by High School Students: An Exploratory and Descriptive Study

Recently, a phenomenon known as sexting, defined here as the transfer of sexually explicit photos via cell phone, has received substantial attention in the U.S. national media. To determine the current and potential future impact of sexting, more information about the behavior and the attitudes and beliefs surrounding it must be gathered, particularly as it relates to sexting by minors. The present study was designed to provide preliminary information about this phenomenon. Participants were 606 high school students (representing 98 % of the available student body) recruited from a single private high school in the southwestern U.S. Nearly 20 % of all participants reported they had ever sent a sexually explicit image of themselves via cell phone while almost twice as many reported that they had ever received a sexually explicit picture via cell phone and, of these, over 25 % indicated that they had forwarded such a picture to others. Of those reporting having sent a sexually explicit cell phone picture, over a third did so despite believing that there could be serious legal and other consequences attached to the behavior. Given the potential legal and psychological risks associated with sexting, it is important for adolescents, parents, school administrators, and even legislators and law enforcement to understand this behavior.