Sexting a Reliable Indicator of Risky Sexual Behavior

Fran Lowry

July 05, 2012

July 5, 2012 — The practice of sending sexually explicit photos or messages electronically, otherwise known as "sexting," is prevalent and may be linked to sexual behaviors of adolescents.

A study of 7 public high schools conducted by investigators at the University of Texas Medical Branch, in Galveston, showed that 1 in 4 teens sent a nude picture of themselves via electronic means, that about 50% have been asked to send a nude photograph, and that about one third asked for a nude picture to be sent to them.

"Sexting is fairly prevalent behavior among teens," lead researcher Jeff R. Temple, PhD, told Medscape Medical News. "And teens who engage in sexting behaviors may be more likely to have also had sex. In other words, sexting may be a fairly reliable indicator of sexual behaviors, although it may not necessarily be a cause or a consequence, just an association."

Dr. Jeff Temple

The study was published online July 2 in Archives of Pediatrics & Adolescent Medicine.

Lack of Knowledge

The study was prompted by of a lack of empirical knowledge of sexting behaviors, said Dr. Temple.

"Pediatricians, parents, teachers, and policy makers were handicapped by insufficient information about the occurrence and nature of sexting, and I wanted to bring data to the conversation," he said.

The investigators conducted a longitudinal study that included 948 public high school students, most of whom (55.9%) were female. The study sample was 26.6% black, 30.3% white, 31.7% Hispanic, 3.4% Asian, and 8.0% of mixed or other ethnicities.

The participants ranged in age from 14 to 19 years and self-reported their history of dating, sexual behaviors, and sexting.

Boys were more likely to ask for a "sext" (a sexually explicit photo or message), and girls were more likely to have been asked for a sext, Dr. Temple said.

Specifics of the findings include the following:

  • 28% of boys and girls have sexted a nude picture of themselves

  • 21% of girls and 46% of boys asked another teen for a nude picture to be sent

  • 68% of girls and 42% of boys have been asked to send a nude picture of themselves

  • More than one half of all girls were bothered "a lot" by being asked

  • Boys were less bothered by being asked, but more than one half were bothered at least "a little bit"

Talk About Sex

The researchers also conclude that sexting behaviors may be a fairly reliable indicator of offline sexual behaviors. For both boys and girls, teens who sexted were more likely to have begun dating and to have had sex than those who did not sext (P < .001).

The study also found that white/non-Hispanic and black teens were more likely than the other racial/ethnic groups to have both been asked and to have sent a sext.

Dr. Temple had some advice for doctors when seeing their teen patients.

"After acknowledging that sexting is a fairly common behavior among teens, I would suggest talking with the patient about potential legal and social consequences of sexting and ask for their feedback," he said.

"I would also suggest using this as an opportunity to talk about sex and especially safe sex."

Dr. Temple hopes "more than anything" that the reporting of this study will encourage parents to talk with their children about sexting, sex, and safe sex.

"I hope some parents will ask their kids what they think of this study; is this happening with teens they know? Parents can use this as an opportunity to encourage their kids to think about potential consequences before pressing "send," and they can talk to them about how they would respond if someone asked them to send a nude picture.

"Parents need to be talking with their kids about sex and safe sex, and hopefully this study can act as a springboard to that conversation," he said.

New Opportunity

In an accompanying editorial, Megan A. Moreno, MD, from the University of Wisconsin-Madison, and Jennifer M. Whitehill, PhD, from the University of Washington, Seattle, state that pediatricians should view social media as part of the integrated self of the adolescent patient.

"Pediatricians have new opportunities to ask their patients about social media, including questions about how time is spent in this environment. Discussing social media with patients may provide new ways to identify intentions or engagements in risky health behaviors," they write.

Dr. Temple says he agrees wholeheartedly with his editorialists.

"Absolutely. Sexting appears to be an extension of existing offline relationships, and a reflection of adolescents' offline sexual intentions or behaviors. Pediatricians can use a conversation about sexting as an avenue to engage their patient in a conversation about other risky health behaviors."

Dr. Temple, Dr. Moreno, and Dr. Whitehill have disclosed no relevant financial relationships.

Arch Pediatr Adolesc Med. Published online July 2, 2012.Full article, Editorial

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