Association of Sexting With Sexual Behaviors and Mental Health Among Adolescents: A Systematic Review and Meta-analysis

New Brunswick's mental health action plan: A quantitative exploration of program efficacy in children and youth using the Canadian Community Health Survey

In 2011, the New Brunswick government released the New Brunswick Mental Health Action Plan 2011-2018 (Action Plan). Following the release of the Action Plan in 2011, two progress reports were released in 2013 and 2015, highlighting the implementation status of the Action Plan. While vague in their language, these reports indicated considerable progress in implementing the Action Plan, as various initiatives were undertaken to raise awareness and provide additional resources to facilitate early prevention and intervention in children and youth. However, whether these initiatives have yielded measurable improvements in population-level mental health outcomes in children and youth remains unclear. The current study explored the impact of the Action Plan by visualizing the trend in psychosocial outcomes and service utilization of vulnerable populations in New Brunswick before and after the implementation of the Action Plan using multiple datasets from the Canadian Community Health Survey. Survey-weighted ordinary least square regression analyses were performed to investigate measurable improvements in available mental health outcomes. The result revealed a declining trend in the mental wellness of vulnerable youth despite them consistently reporting higher frequencies of mental health service use. This study highlights the need for a concerted effort in providing effective mental health services to New Brunswick youth and, more broadly, Canadian youth, as well as ensuring rigorous routine outcome monitoring and evaluation plans are consistently implemented for future mental health strategies at the time of their initiation.

School prevention of non-consensual sexting among middle adolescents: Does sexual preoccupation awareness matter?

Although non-consensual sexting seems to concern not only adults but also middle adolescent students, with detrimental consequences on their well-being, the related research-based effective school prevention programs are almost absent. Furthermore, there is an unanswered research question as to whether sex-related issues, such as sexual preoccupation, matters in adolescents' non-consensual sexting and its prevention. The present study investigated the effectiveness of a school-based intervention against non-consensual sexting among middle adolescents, based on the European funded program TABBY (Threat Assessment of Bullying Behavior in Youth). Furthermore, the predictive role of sexual preoccupation was examined. Overall, 280 Greek students from randomly selected junior high school responded to self-report scales on non-consensual sexting and sexual preoccupation. Based on an experimental longitudinal research design, only the experimental (N = 131), but not the control group of students (N = 149), participated in the intervention. To test the effectiveness of the intervention, both student groups completed the scales before (1st phase), immediately after (2nd phase), and six months after the intervention (3rd phase), which was implemented by trained teachers. The results showed both, the short-term and long-term effectiveness of the intervention. Also, the study highlighted the significant contribution of sexual preoccupation awareness in reducing non-consensual sexting, especially immediately after and six months after the intervention. The study implies the necessity to adapt existed prevention programs to the specific parameters of non-consensual sexting, integrating at the same time sexual preoccupation awareness activities to better address this issue.

A Latent Profile Analysis of the Consensual and Non-Consensual Sexting Experiences among Canadian Adolescents

Different patterns of sexting behaviors were examined to provide a more nuanced understanding of the context in which sexting occurs among adolescents. Participants were 1,000 Canadian adolescents (50.2% girls) between 12 and 18 years (Mage = 15.21, SD = 2.00) who completed measures of sexting, cyber bullying and victimization, problematic social media use, self-regulation, and demographics. Contrary to our hypotheses, three latent profiles of sexting represented the frequency of sexting rather than whether the sexting was consensual versus non-consensual or with a partner versus non-partner. Participants in the moderate and high sexting profiles representing one fifth of youth, reported less self-regulation, experienced more cyber victimization, and engaged in more cyber bullying and problematic social media use than those in the no/low sexting profile. Our findings support the normalcy approach to education, which considers some sexting among healthy developmental behaviors.

Associations between receiving non-consensual image and video sexts and average sleep duration among adolescents and young adults

Background Sexting is the sending and receiving of nude or partially nude images or videos. Despite it being a part of contemporary relationships, it can have adverse effects. This is particularly the case when receiving non-consensual sexts. To date, there remains a gap in the literature on whether receiving non-consensual sexts is associated with poor sleep. Therefore, the aim of this study was to determine the association between receiving non-consensual sexts and average sleep duration. Methods Data from Wave 2 (2022) of the Canadian Study of Adolescent Health Behaviours (N =906) were analysed. Multinomial logistic regression analyses were used to determine the association between receiving non-consensual sexts (both image and video) in the past 12months and average sleep duration (≤5h, 6h, 7h, 8h, and ≥9h) in the past 2weeks. Analyses were stratified by gender. Results Girls and women who received non-consensual image and video sexts, compared to those who did not, were more likely to report ≤5h of average sleep in the past 2weeks, relative to 8h of average sleep. There were no significant findings among boys and men. Conclusion Findings underscore that receiving non-consensual image and video sexts may negatively impact sleep among girls and women, which may be contextualised by trauma responses experienced because of gender-based sexual violence. Healthcare and mental health professionals should be made aware of this association to provide effective care to girls and women.

What are practitioners' views of how digital health interventions may play a role in online child sexual abuse service delivery?

Introduction

Online child sexual abuse (OCSA) affects considerable numbers of children globally and is associated with a variety of mental health problems. Existing practitioner studies suggest that young people are infrequently asked about online abuse and practitioners have a fragmented understanding of the problems experienced or how they might approach them. There are very few evidence-based interventions that guide clinical assessment or practice. Digital Health Interventions (DHIs) have the potential to be an effective option where children and young people's services are challenged, including accessibility and anonymity. The aim of this study was to explore mental health practitioners' views of how DHIs may play a role in supporting young people who have experienced OCSA, and the role they can play in healthcare delivery.

Method

In-depth qualitative interviews and one focus group were conducted with 25 child mental health professionals across two sites (Manchester and Edinburgh). Data was analyzed using reflexive thematic analysis.

Results

Three overarching themes and 9 sub-themes were identified: (1) feeling a little bit lost; (2) seeing potential problems; and (3) knowing what works. Practitioners expressed interest in a DHI to support this client group and saw it as a way of managing waiting lists and complementing existing therapies. They felt that many young people would see this as a preferred medium to in-person therapy, would be empowering, and offers new ways of learning how to stay safe online. However, there were concerns about how much time would be needed by staff to deliver a DHI, anxieties about safety issues in relation to content and data protection, some of which may be unique to this population of young people, and concerns about the absence of a therapeutic relationship with vulnerable children.

Discussion

Our findings indicated that practitioners were uncertain about working with children subjected to OCSA but were receptive to the possibility of using a DHI to support their practice and to reduce waiting lists. Concerns were expressed about the time needed for staff training and support as well as concerns over patient safety and the lack of evidence about the effectiveness of an unsupported DHI.

Longitudinal Associations between Different Types of Sexting, Adolescent Mental Health, and Sexual Risk Behaviors: Moderating Effects of Gender, Ethnicity, Disability Status, and Sexual Minority Status

The present study investigated the moderating effect of adolescent demographic variables in the longitudinal associations among different types of sexting, mental health (i.e., depression, self-harm, subjective health complaints), and sexual risk behaviors. There were 1113 adolescents (ages 14-17 years; Mage = 16.36; SDage = .81; 50% female) from six high schools located in the United States included in this study. Adolescents completed questionnaires on their sexting behaviors, mental health, and sexual risk behaviors during the ninth grade; in tenth grade, they completed questionnaires on mental health and sexual risk behaviors. Non-consensual sexting and pressured sexting were both related positively to each of the mental health variables and sexual risk behaviors. The relationship between non-consensual sexting and depressive symptoms was stronger for girls, ethnic minorities, those adolescents with disabilities, and sexual minorities. Similar patterns were found for pressured sexting, non-suicidal self-harm, and subjective health complaints. The relationships between pressured sexting and sexual risk behaviors were stronger for girls, ethnic minorities, those adolescents with disabilities, and those who identified as sexual minorities. Research focused on the relationships among different types of sexting, mental health, and sexual risk behaviors is important as such research facilitates the development of evidence-based recommendations for sexting harm prevention and sexual education programs.

Sexual health variation among gang-involved youth in Washington state: Social ecological implications for research and practice

INTRODUCTION

Gang-involved youth experience greater disparities in sexual health compared to non-gang-involved youth. Yet, little is known about how and why sexual behaviors vary within the youth gang population. Developing relevant and effective service approaches requires an understanding of this variation and the environmental factors that influence patterns of sexual health risk.

METHODOLOGY AND RESULTS

Using latent class analysis, we identified four sexual behavior classes within a school-based sample of gang-involved youth in Washington State (N = 2060): Non-Sexually Active (54%), Limited Partners with Condom Use (14%), Multiple Partner with Sexting (19%), and High Sexual Vulnerability (13%). These classes were distinguished by age at sexual debut, number of sexual partners, condom use, and sexting. Interpersonal and macrosocial factors differentiated the classes, including multiform violence exposures, limited social support, and socioeconomic instability. We also found differences according to sexual identity and substance use.

DISCUSSION

Findings highlight the need for service approaches that are responsive to both the individual needs of gang-involved youth and the factors that shape their living environments. We discuss the implications for research and practice, including the potential utility of a harm reduction framework to promote sexual health and reduce disparities in the youth gang population.

Nonconsensual Sexting: Are the Moral Processes the Same If Boys or Girls Appear in the Forwarded Content?

Sexting is a form of intimate communication available in today's digital society consisting of exchanging erotic-sexual content online. However, doing it without the consent of the person appearing in the content is becoming a normalized form of cyberviolence among adolescents. To advance our understanding of this phenomenon, further research is needed on its facilitating factors, which may include those related to its potential moral dimension and online disinhibition. This study aims to analyze, according to gender and age, the relationship between nonconsensual forwarding of erotic-sexual content, differentiating between the type of content and the gender of the person appearing in it, moral disengagement, and toxic online disinhibition. A total of 1,611 adolescents (47.9 percent girls) aged 12-15 years (M = 13.4; SD = 1.0) participated in the study. Moral disengagement and toxic disinhibition have been shown to facilitate nonconsensual forwarding of erotic-sexual content, but their relevance varies depending on the type of content, and whether girls or boys appear in it. Facilitating factors for nonconsensual forwarding of content featuring boys include age, the diffusion of the consequences, and toxic online disinhibition. For girls, identifying with the male gender and cognitive restructuring were the main facilitators. These findings represent an original advance in the field of study by discriminating between the type of content forwarded and the gender of the person who appears in it. The differences found contribute toward explaining the processes that lead to making immoral decisions when sexting and help lay the foundations for designing psychoeducational programs in the future.

How Risky is Online Sexting by Minors?

What proportion of minors who engage in sexting find themselves involved in an episode of image abuse? The data come from a US nationally representative sample of 2639 respondents aged 18-28 reporting about experiences before the age of 18, of whom 23% had engaged in sexting as minors. Among those who sexted the rate of image abuse was 37%, a risk ratio of 13.2 compared to those who did not engage in sexting. For females who sexted the victimization rate was particularly high, but sexting increased risk for females and males. Among the minors who only sexted occasionally (vs those who sexted frequently) the rate of abuse was still high (35%) and the reduction in risk modest. When we controlled for other background and demographic risk factors like adversities and prior sexual abuse, it did not substantially reduce the large risk entailed with sexting. Various harm reduction strategies may be needed to supplement messages about dangers and risks.

An umbrella review of the benefits and risks associated with youths' interactions with electronic screens

The influence of electronic screens on the health of children and adolescents and their education is not well understood. In this prospectively registered umbrella review (PROSPERO identifier CRD42017076051 ), we harmonized effects from 102 meta-analyses (2,451 primary studies; 1,937,501 participants) of screen time and outcomes. In total, 43 effects from 32 meta-analyses met our criteria for statistical certainty. Meta-analyses of associations between screen use and outcomes showed small-to-moderate effects (range: r = -0.14 to 0.33). In education, results were mixed; for example, screen use was negatively associated with literacy (r = -0.14, 95% confidence interval (CI) = -0.20 to -0.09, P ≤ 0.001, k = 38, N = 18,318), but this effect was positive when parents watched with their children (r = 0.15, 95% CI = 0.02 to 0.28, P = 0.028, k = 12, N = 6,083). In health, we found evidence for several small negative associations; for example, social media was associated with depression (r = 0.12, 95% CI = 0.05 to 0.19, P ≤ 0.001, k = 12, N = 93,740). Limitations of our review include the limited number of studies for each outcome, medium-to-high risk of bias in 95 out of 102 included meta-analyses and high heterogeneity (17 out of 22 in education and 20 out of 21 in health with I2 > 50%). We recommend that caregivers and policymakers carefully weigh the evidence for potential harms and benefits of specific types of screen use.

The Role of Sexting on the Perception of Image-Based Sexual Abuse

Gender-based violence is a widespread phenomenon that significantly impacts many women around the world. Among the different forms that it might take, image-based sexual abuse represents one of the most common forms nowadays. According to the literature, sexting-the sharing of sexually explicit messages or images-is one of the most important risk factors for image-based sexual abuse because sexts can be forwarded or published without the authorization of the originator. Nevertheless, sexting can play a role in sexual and relational development and serve as a first step in experimenting with sexual contact in real life. In this study (N = 603 from the general population), we examined the relations between people's beliefs about sexting, attitudes toward it, and sexting behavior on the one hand, and reactions to a situation of nonconsensual dissemination of sexts on the other hand. Results showed that social pressure exerted by peers and partners to sext was associated with both positive attitudes toward sexting and sexting behaviors. Attitudes toward sexting, then, have a spillover effect on the reactions toward a victim of nonconsensual dissemination of sexts, in terms of empathy, victim blaming, and affective reactions. Implications for both research and policymaking regarding this form of gender-based violence are discussed.

Estimating the Prevalence and Identifying the Correlates of Sexting Behaviors Among Cambodian Male Adolescents

Male youths are more likely to experience peer pressure that encourages them to engage in risky behaviors than female youths, and this pressure can lead to an increased risk of sexting among male youths. This study aimed to investigate the prevalence of and factors associated with sexting among Cambodian male youths. The correlational cross-sectional study design was utilized. This study surveyed 647 Cambodian male youths aged 15 to 24 years. The measurement included sending or receiving messages (sexts) that contain sexually explicit messages, images, or videos, and affecting factors to sexting. Around 32.5% of participants sent sexts, and 38.9% received them. Open relationships, pornographic website use, perception of friends' sexual activity, frequent thoughts about sex, higher sexual sensation-seeking tendencies, positive attitudes toward sex, and sexual experience were associated with increased likelihood of sending and receiving sexts. Based on the findings of this study, by offering suitable education, guidance, and intervention programs, we can effectively mitigate the adverse repercussions of sexting while fostering healthy sexual behaviors among youths.

Effectiveness of a Theory-Based Digital Animated Video Intervention to Reduce Intention and Willingness to Sext Among Diploma Students: Cluster Randomized Controlled Trial

BACKGROUND

Sexting refers to the exchange of sexually explicit digital content in the form of texts, photos, or videos. In recent years, sexting has become a public health concern. Surveys in Malaysia show a high prevalence of young adults engaged in sexting. Given that sexting is associated with sexual risk behavior, cyberbullying, and mental health issues, this behavior needs intervention to alleviate the resulting public health burden. However, there is a scarcity of theory-based intervention programs on the prevention of intention and willingness to sext among young adults.

OBJECTIVE

This study aimed to develop and implement a sexting intervention module guided by the prototype willingness model (PWM), delivered using web-based animated video, and evaluate its effectiveness among diploma students from a public higher educational institution. The primary outcomes were intention and willingness to sext, while the secondary outcomes were knowledge, attitude, perceived norms, and prototype perceptions of sexting.

METHODS

This 2-armed, parallel, single-blinded cluster randomized controlled trial was conducted in a public higher educational institution in the state of Melaka, Malaysia. Diploma students from 12 programs were randomly allocated into intervention and control groups. Both groups answered a self-administered web-based questionnaire assessing the outcomes at the baseline. The intervention group received a newly developed intervention module based on the PWM in the form of 5 animated videos posted on a private YouTube platform, while the control group was put on the waitlist. The intervention group was encouraged to discuss any issues raised with the researchers via WhatsApp private chat after viewing the videos. All participants were observed immediately and 3 months postintervention. Data analysis was performed with SPSS (version 26; IBM Corp). A generalized linear mixed model was used to determine the effectiveness of the intervention.

RESULTS

There were a total of 300 participants with an attrition rate of 8.3% (n=25). After adjusting for age, sex, relationship status, and the amount of time spent on the web, there were significant differences in the intention to sext (β=-.12; P=.002; Cohen d=0.23), willingness to sext (β=-.16; P<.001; Cohen d=0.40), knowledge (β=.12; P<.001; Cohen d=0.39), attitude (β=-.11; P=.001; Cohen d=0.31), perceived norms (β=-.06; P=.04; Cohen d=0.18), and prototype perceptions (β=-.11; P<.001; Cohen d=0.35) between the intervention and control groups over 3 months.

CONCLUSIONS

In this study, the sexting intervention module using the PWM that was delivered via web-based animated videos was effective in reducing intention and willingness to sext as well as in improving knowledge of sexting, attitudes, perceived norms, and prototype perceptions. Therefore, relevant agencies involved in the promotion of sexual and reproductive health among young adults in Malaysia can consider the implementation of this module.

TRIAL REGISTRATION

Thai Clinical Trial Registry TCTR20201010002; https://www.thaiclinicaltrials.org/show/TCTR20201002001.

Exposure to sexual content and problematic sexual behaviors in children and adolescents: A systematic review and meta-analysis

BACKGROUND

Exposure to sexual content, such as online pornography or live sexual content, has been posited in the literature as a risk factor for problematic sexual behaviors (PSBs) in children and adolescents, and has been identified as an important avenue for research and intervention, particularly given the ubiquitous access to technology among children.

OBJECTIVE

To examine the association between live/violent and non-violent sexual content exposure and PSB among children and adolescents. Objectives also include informing future research on sexual content exposure as a risk factor for PSB, and providing clinical recommendations related to prevention and intervention.

PARTICIPANTS AND SETTING

Results are based on 16,200 participants (28.65 % female; Mage = 14.26; range = 4.74-17.92) and 27 studies conducted in North America, Europe, Asia, and Africa.

METHODS

A systematic review was conducted of available literature published up to September 2021. Abstract and full-text review were conducted to assess whether studies met inclusion criteria. Random-effects meta-analyses were conducted on included studies.

RESULTS

Significant associations were found between exposure to non-violent sexual content and likelihood of engaging in PSB (OR = 1.82; p < .001; 95 % CI: 1.50-2.21), and between exposure to violent/live sexual content and PSB (OR = 2.52; p < .001; 95 % CI: 1.75-3.61). Sex emerged as a moderator of the association between exposure to non-violent sexual content and PSB, such that the association was stronger in studies with a greater proportion of females.

CONCLUSIONS

Results support the need for future research on risk factors and mechanisms implicated in PSB. Prevention and intervention programs for children with PSB and their families could benefit from incorporating education on sexual content exposure.

A systematic review of social processes and mechanisms in the community that influence risky sexual behaviour among adolescents and young adults

AIMS

To examine the associations between social processes and mechanisms within the community and risky sexual behaviour (RSB) among adolescents and young adults.

DESIGN

Systematic review.

METHODS

We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and conducted a literature search in August 2020. From 11,216 identified articles, 605 were for full-text screen. We used 24 articles, 22 after applying inclusion criteria and 2 manually searched relevant articles.

RESULTS

Social processes and mechanisms within the community included collective efficiency and social support, community safety and community norm. Collective efficacy and social support and community safety were examined using 10 and 16 studies, respectively. We found that collective efficiency and social support, and community norms partially supported the occurrences of RSB among adolescents and young adults. Community safety displayed inconclusive relationships with RSB.

CONCLUSIONS

The findings highlight the importance of social processes and mechanisms within the community in preventing RSB among adolescents and young adults. Community-based programs to improve community efficacy and social support would be effective strategies to reduce such RSB and to promote better reproductive health among adolescents and young adults.

COVID-19 Restrictions Resulted in Both Positive and Negative Effects on Digital Media Use, Mental Health, and Lifestyle Habits

While studies have reported effects on digital media during the COVID-19 restrictions, few have included data prior to the pandemic, and most have only measured screen time. We therefore investigated changes in specific digital media activities, as well as mental health and lifestyle habits, in a longitudinal study of adolescents spanning from before the pandemic (T1) to one month into restrictions (T2) and one year later when schools had reopened (T3). Adolescents (16-19 years) rated smartphone use, problematic/addictive media use, negative experiences (e.g., victimization), mental health (i.e., irritability, stress, and closeness), and protective lifestyle habits (i.e., sleep and exercise). Results showed initial decreases in irritability and negative digital experiences, increases in sleep and exercise, as well as a decrease in closeness during remote learning (T2). However, these changes returned to, or superseded, their initial levels at follow-up (T3). There were also increases in digital media use and stress at T3. Conclusively, by investigating specific digital media activities and collecting data both prior to and during different phases of the pandemic, we were able to find both positive and negative effects.

Adolescent Sexting, Violence, and Sexual Behaviors: An Analysis of 2014 and 2016 Pennsylvania Youth Risk Behavior Survey Data

BACKGROUND

Sexting is common among adolescents and is associated with numerous health risk behaviors and negative psychosocial constructs. This study examined the relationships between high school students' experiences with sexual violence victimization, dating violence victimization, and engagement in risky sexual behaviors with experiences of receiving sexts.

METHODS

Cross-sectional data from the 2014 to 2016 data from Pennsylvania Youth Risk Behavior. Participants were selected using an independent 2-stage cluster sample design to produce a statewide population-based sample. The pencil and paper surveys were conducted in school. Participants included 6734 Pennsylvania high school students in grades 9-12.

RESULTS

Overall, 29.0% of Pennsylvania high school students had received a sext, which varied by sex, race/ethnicity, school grade, and sexual identity. Students who engaged in sexual risk behaviors, experienced dating violence, or experienced lifetime sexual violence outside of the dating context had a significantly higher prevalence of receiving a sext than students who did not engage in those behaviors or have those experiences.

CONCLUSIONS

Early screening and prevention efforts that include discussions about sexting behaviors may help prevent other negative outcomes, such as risky sexual behaviors and interpersonal violence. Addressing sexting in the education and health sectors may help to prevent other related harmful health and violence experiences during adolescence.

The Role of Consent and Motivations in Sext Dissemination

Sext dissemination (i.e., the online sharing of sexually explicit images) has the potential to result in legal, social, and psychological harms. Recent research has shown that this behavior can be consensual or non-consensual in nature; yet little is known about how motivations or attitudes may differ between these forms, or with gender. This study is based on a cross-sectional online survey investigating consensual and non-consensual sext dissemination and associated demographic, behavioral, attitudinal, and psychological factors. Participants were 2,126 cisgendered adults aged 18 to 30 years (M = 22.97, SD = 3.21, 55% women, 45% men), resident in Western, English-speaking nations, particularly Australia. Around 10% of respondents reported disseminating texts, and of these, only 19.8% indicated they had permission for this, with no differences across gender. When sexts were disseminated "to gossip," this was significantly more likely to be non-consensual. There were no significant differences between consensual and non-consensual dissemination in subjective attitudes or norms toward dissemination, nor levels of psychological distress. Women were more likely to non-consensually disseminate sexts that had been received as unwanted or unwelcome. Consensual dissemination was weakly associated with being sexually active and having given consent to having one's own images disseminated. We discuss implications for future research regarding consent, and relationship and sexuality education.

Sexting Among Australian Adolescents: Risk and Protective Factors

Although consensual sending of sexts between adolescents is considered developmentally appropriate, it may also entail a range of negative consequences. Current sexting research lacks a comprehensive theoretical framework identifying a range of risk and protective factors underpinning adolescent consensual sending of sexts across individual, interpersonal, and distal levels. Further, there is a lack of systematic evaluation of how the importance of these factors may vary across adolescent age. This study investigated the utility of the Social Development Model to predict a range of risk and protective factors across individual, family, peer, school, and community-level factors. The sample included 1302 teenagers from Victoria, Australia (M_age = 14.54, SD = 1.14, 50.8% girls). Results indicated that 146 (11.7%) participants sent a sext (76 boys and 70 girls). Logistic regression analyses revealed that the Social Development Model accounted for 45.8% of variance in sexting, with greater likelihood of sending sexts being associated with older age, prior sexual activity, school sector, physical activity, lifetime substance use, greater depressive symptoms, sensation seeking, and perceived substance availability in the community. Multigroup analyses revealed that lifetime substance use was associated with a greater likelihood of sending sexts among younger teens. Among older adolescents, adaptive coping was associated with reduced engagement in sexting, while higher parental overcontrol and family conflict increased the odds of sending sexts. Overall, sexting is associated with a range of modifiable factors potentially amenable to intervention.

Meta-Analysis of Cyber Intimate Partner Violence Perpetration and Victimization: Different Types and their Associations with Face-to-Face IPV among Men and Women

Cyber intimate partner violence (C-IPV) is a technology-mediated form of violence. It has been examined only in the last 10 years as a form of violence that can cause psychological damage to its victims. How this phenomenon connects to and differs from face-to-face IPV (F2F-IPV) has been, as yet, little studied. Research has not made clear whether sex differences may impact its use, particularly in light of the fact that no physical coercion is used in C-IPV. Thus, the current research aimed to investigate through a meta-analysis: differences between the average levels of different types of C-IPV victimization and perpetration; the association between C-IPV and F2F-IPV victimization and perpetration; and whether the answers to these questions were dependent on sex. The current meta-analysis drew on 46 studies, within 44 papers, with a total sample of 27,491 participants. Findings from 22 of these studies showed no significant sex differences between the average levels of different types of C-IPV victimization and between different types of C-IPV perpetration. These 22 studies showed positive large effect sizes for the correlation between C-IPV and F2F-IPV perpetration and victimization. Moreover, in both perpetration and victimization, sex did not impact the level of association. The findings suggested that C-IPV and F2F-IPV are highly correlated, and though not the same, they may share similar characteristics. Additionally, the results suggested that sex differences do not impact non-physical aggression, such as C-IPV. The implications for preventive strategies include that IPV interventions should also focus on alleviating instances of C-IPV.

A Non-Clinical Referral Tool to Help Identify Problematic Child Sexual Behavior: Development, Training, and Initial User Feedback

Early identification of children and youth who engage in problematic sexual behavior is important for all parties involved, such as children who exhibit and are impacted by the behavior. There are several reliable and valid identification tools that can be used to recognize problematic sexual behavior in children and youth (PSB-CY) in clinical practice; however, professionals who work with children in non-clinical settings (i.e., child development centers, youth programs, and schools) often have limited resources and tools when they encounter PSB-CY. This paper describes the development, content, and user feedback of a referral tool (RT) that was designed to help identify incidents of PSB-CY for use with military agencies and schools. Specifically, the RT was designed to help professionals, who may have observed or who may have been made aware of sexual behaviors in children and youth, organize their observations of the behavior in alignment with evidence-based information about PSB-CY and consistently document these occurrences. The RT guides users in determining if the observed behavior is normative, cautionary, or problematic and promotes informed decisions about whether the behavior needs to be referred to those who have experience using clinical tools for further review and the identification of next steps for supporting the children and families involved. Early adopters provided feedback on the use of the RT. The feedback suggested that the tool was user-friendly, understandable, and helpful as they made objective decisions about how to identify and handle referrals of PSB-CY.

Sexting among British adults: a qualitative analysis of sexting as emotion work governed by 'feeling rules'

Sexting has generated considerable public and professional interest with concerns centring on young people, and potential harms to mental and sexual health. Little research thus far has explored the practice among adults and none has focused on the cultural norms relating to the emotional experience of sexting across different ages and genders. We conducted 40 semi-structured interviews with a diverse sample of adults aged 18-59 years in Britain on the role of digital technologies in participants' sexual lives. In this paper, we draw on the accounts of 34 people with experience of sexting. We identified three main themes in participants' accounts related to the emotional aspects of sexting: (1) trust, (2) desire/intimacy and (3) shame. Under each theme, we identified motivations, 'feeling rules', and examples of 'emotion work' relating to the self, the other and the dyad. We conclude that there are shared cultural norms that constitute what appropriate sexting should feel like. Interventions aiming to minimise harms arising from sexting need to build on commonly held cultural conventions regarding the 'rules of the game' concerning feelings as well as behaviours.

Relations between peer influence, perceived costs versus benefits, and sexual offending among adolescents aware of sex offender registration risk

A policy's general deterrent effect requires would-be offenders to be aware of the policy, yet many adolescents do not know they could be registered as sex offenders, and even adolescents who do know may still commit registerable sexual offenses. We tested whether peer influences shape the perceived costs/benefits of certain sexual offenses and, subsequently, registration policy's general deterrent potential in a sample of policy-aware adolescents. The more adolescents believed their peers approve of sexting of nude images, the more likely they were to have sexted. For forcible touching, having more positive peer expectations about sex and perceiving forcible touching as more prevalent among peers related to adolescents' likelihood of engaging in that behavior. Perceiving registration as a possible consequence was unrelated to sexual offending. Findings highlight the nuanced roles peers play in adolescent sexual decision-making and support emerging evidence that juvenile registration policy has limited general deterrent efficacy.

Time Goes Back-Time Perspective in Polish Men with Compulsive Sexual Behavior Disorder and Risky Sexual Behavior

Many relationships between time perspective and a propensity to engage in risky behaviors or developing addictions have been demonstrated. The aim of our study was to determine the differences in intensity of individual time perspectives in people with compulsive sexual behavior disorder (CSBD) and risky sexual behavior (RSB). The analysis includes 425 men: 98 CSBD (age M = 37.99 years), 63 RSB (age M = 35.70 years), 264 without CSBD and RSB features constituting the control group (age M = 35.08 years). We used the Zimbardo Time Perspective Inventory, the Sexual Addiction Screening Test-Revised, the Risky Sexual Behavior Scale and a self-constructed survey. The comparative analysis showed a higher intensity of past-negative (p = 0.040), a lower of past-positive (p < 0.001) and a present-fatalistic (p = 0.040) outlook in the CSBD group compared to the control group. Compared to the participants with RSB, the CSBD group was characterized by a higher intensity of past-negative (p = 0.010), a lower of past-positive (p = 0.004) and a present-hedonistic perspective (p = 0.014). The RSB group also achieved higher results from the present-hedonistic perspective (p = 0.046) compared to the control group. The CSBD patients indicate a stronger tendency to focus on negative past compared to non-CSBD men, both taking and not taking RSB. The time perspective profiles of RSB men are similar to those who do not engage in RSB. The distinguishing feature of men with RSB without CSBD is a greater ability to enjoy current experiences.

Sexting Behaviors Before and During COVID-19 in Italian and Colombian Young Adults

Introduction

Recent research highlight increasing at-risk online sexual activities and behaviors during the COVID-19 pandemic among young adults. Specifically, sexting refers to exchanging sexually suggestive messages, photos, and videos through technological devices, and it can be placed on a continuum from safer to riskier behavior. This study aims to improve our knowledge about sexting behaviors in Italian and Colombian young adults before and during the COVID-19 pandemic.

Methods

A survey online was filled in by all recruited participants through a snowball sampling procedure (from December 2019 to June 2021) both in Italy and Colombia, resulting in a total of 2931 participants (2051 from Italy and 880 from Colombia) aged 18 to 35 years old (Mage = 23.85; SDage = 3.63; 67.6% girls).

Results

Italian youth were more engaged in risky sexting than Colombian participants, while Colombians indicated being more engaged in non-consensual sexting than Italians. Sexual minority people reported more sharing their own sexts, higher levels of sexting under pressure, and 3.2 times more risky sexting than exclusively heterosexual counterparts. During the pandemic period, participants sent their own sexts 1.5 times more and were less involved in non-consensual sexting than in the pre-pandemic era.

Conclusions

The present research could help understand better the cultural dynamics underlying the differences in sexting behaviors, suggesting the relevance of investigating how sexting behaviors and online at-risk activities have changed since the pandemic started.

Policy Implications

Results provide implications for educational and prevention programs to improve young people's awareness of sexting behaviors.

Shared Components of Worldwide Successful Sexuality Education Interventions for Adolescents: A Systematic Review of Randomized Trials

A crucial aspect of human development is sexuality which has implications for health, particularly in adolescence, since unfavorable sexual experiences may result in physical and mental problems. Sexuality education interventions (SEI) are one of the most used actions to promote sexual health in adolescents. Nevertheless, there is variability across their components; therefore, key elements for an effective SEI targeted at adolescents (A-SEI) are not well known. Based on this background, this study aims to identify the shared components of successful A-SEI through a systematic review of randomized controlled trials (RCT). This study followed the preferred reporting items for systematic reviews and meta-analyses statement. A search was conducted in CINAHL, PsycInfo, PubMed, and Web of Science between November and December 2021. A total of 21 studies passed the inclusion test after the review of 8318 reports. A total of 18 A-SEIs were identified in these studies. The components analyzed were the intervention's approach, dose, type of intervention, theoretical framework, facilitators' training, and intervention methodology. The results established that components that should be present in the design of an effective A-SEI are behavior change theoretical models, the use of participatory methodology, be targeted at mixed-sex groups, facilitators' training, and at least ten hours of weekly intervention.

Further Understanding the Correlations Between Sexting and Mental Health: Considerations for Sex and Sexual Identity

We explored how sexting (no sexting, sent only, received only, reciprocal) was associated with depression, anxiety, sleep problems, and compulsive sexual behaviors across sex and sexual identity groups. We also examined how substance use predicted sexting classifications. Data came from 2,160 college students living in the United States. Results indicated that 76.6 percent of the sample had engaged in sexting (primarily reciprocal). Participants who had engaged in sexting generally evidenced higher depression, anxiety, sleep problems, and compulsive sexual behaviors. Effect sizes were largest on compulsive sexual behavior indicators. Marijuana use was the only significant substance use predictor of reciprocal and "received only" sexting compared with no sexting. Illicit substance use (e.g., cocaine) was low base rate but descriptively was associated with sexting. Compulsive sexual behavior remained a robust positive correlate of sexting compared with non-sexting participants regardless of sex and sexual identity. Most other mental health indicators became nonsignificant correlates of sexting in nonheterosexual participants and were weak positive correlates in heterosexual participants. Marijuana use remained the only significant substance use predictor of reciprocal and "received only" sexting when adjusted for sex and sexual identity. We conclude that sexting is only weakly associated with depression, anxiety, and sleep problems but robustly associated with compulsive sexuality and marijuana use. These findings do not appear to vary meaningfully on the basis of sex or sexual identity, with the exception that the effect sizes between sexting and compulsive sexual behaviors were much stronger for females compared with males (regardless of sexual identity).

Sexting and sexual behaviour in Australian adolescents

BACKGROUND

Previous studies have tried to determine the relationship between sexting and risky behaviour to discover whether sexting fits into a deviance or normalcy discourse. This study investigated the relationship between sexting and sexual risk behaviours, contraception use and gender.

METHODS

The design was a cross-sectional analysis of data from the sixth National Survey of Secondary Student and Adolescent Sexual Health, collected in 2018. There were 8263 Australian adolescents (aged 14-18years). Participants were fairly evenly split by gender, and 73% identified as heterosexual. Participants were asked a series of questions about their engagement in sexting, sexual behaviour and sexual health behaviours.

RESULTS

A total of 52% of participants had sent a sext in the previous 2months, with most being text-based sexts. Sexters were 3.29times more likely to have engaged in anal or vaginal intercourse, and 2.88times more likely to have gotten pregnant than non-sexters. Sexters (M =2.76) had significantly more partners than non-sexters (M =2.35), t (3763)=-10.99, P X 2 (1)=0.38, P =0.535, or contraceptive use based on sexting status.

CONCLUSIONS

Sexters are more likely to have engaged in sexual intercourse and have more partners than non-sexters. Sexting is not strongly associated with other risky behaviours. Evidence for differences between sexters and non-sexters in protecting against STIs and pregnancy was not found, as there were no significant differences in contraceptive use.

What are the predictors of sexting behavior among adolescents? The positive youth development approach

INTRODUCTION

Research supporting adolescent sexual health and empowerment is needed. The study investigates sexting among adolescents using the resources that characterized the Positive Youth Development Approach (PYD) and considering the impact of parental monitoring. The study aims to describe sexting among three different groups of adolescents (i.e., Non Sexters [NS], Passive Sexters [PS], and Active Sexters [AS]) considering age and sex (first aim). It also seeks to identify predictors among the PYD's resources and parental monitoring that explain the probability of falling into the sexter or the non sexter groups (second aim) as well as the probability of falling into the active or the passive sexter groups (third aim).

METHOD

The national representative sample was composed of 1866 Italian adolescents: 980 girls and 886 boys aged between 13 and 19 years old (M = 16.26; SD = 1.49). Participants completed a questionnaire that measured sexting behavior, PYD resources, and parental monitoring scales. Chi-squared and multivariate logistic regressions were performed.

RESULTS

Almost half of the participants (46.0%) were NS, 36.2% were PS, and 17.8% were AS. Results show that sex, age, Connection, and Child Disclosure are significant predictors of sexting behavior.

CONCLUSIONS

Results highlighted that sexting can be seen as a relational activity that adolescents use to establish connections as part as their sexual exploration. A parenting approach that promotes disclosure may help adolescents explore safely their sexuality and be accountable. Results also indicate that parents need to build educational alliances with schools to promote sexual health and empowerment among teenagers while preventing risk of harm.

Motivations, Behaviors and Expectancies of Sexting: The Role of Defensive Strategies and Social Media Addiction in a Sample of Adolescents

Adolescents and young adults engage in sexting behaviors. Research has mainly emphasized the relationship between motivations and sexting behaviors, with little attention paid to sexting expectations and the potential role of coping strategies. This study aims to explore the measure of emotional-behavioral functioning with the Youth/Adult Self Report (based on the subject's age), the use of defensive strategies measured with the Response Evaluation Measure (REM-71), social media addiction with the Bergen Social Media Addiction Scale (BSMAS) and all dimensions of sexting: motivations, behavior and expectations measured with the Sexting Motivation Questionnaire (SMQ), Sexting Behavior Questionnaire (SBQ) and Sexpectancies Questionnaire (SQ), respectively. N = 209 adolescents and young adults were recruited from high schools and universities in Rome to complete the self-report questionnaires. Results show that males tend to have higher expectations of sexting than females. We also found that expectations play a role in determining sexting behaviors and motivations. Our hypotheses on social media addiction and sexting were confirmed, while the relationship between the defensive strategies and sexting was not significant as expected. Further studies on this topic are desirable in the future.

Sexting at an Early Age: Patterns and Poor Health-Related Consequences of Pressured Sexting in Middle and High School

BACKGROUND

Sexting is sending, receiving, or forwarding sexually explicit messages, images, or videos through electronic means. Research has examined sexting in high school and college students. This study seeks to add to the existing literature by exploring the nature of pressured or problematic sexting in middle school-aged subjects.

METHODS

We asked participants in public colleges in Massachusetts, Colorado, and Virginia, to recall their sexting-related experiences in middle and high school. We utilized an online survey tool for data collection. We performed bivariate quantitative statistical analyses to examine attitudinal and behavioral differences, as well as motivations and consequences of adolescent sexting.

RESULTS

The study revealed unique patterns of early-onset sexting compared to sexting in later adolescence. Early-onset adolescents typically start sexting before they become sexually active and are at a higher risk for poor outcomes associated with sexting, they are more likely to seek therapy. Early sexting is significantly more pressured than sexting in later adolescence.

CONCLUSIONS

The study is an important contribution to the existing research on pressured sexting. Exploring pressured sexting at very early ages finds that early sexting activity is more likely pressured, creates more stress than later in life, and hence, it needs attention from school mental health professionals and education programs. The authors suggest that comprehensive sex education, including sexting should begin earlier than middle school to prevent risky online sexual behavior and provide for learning coping mechanisms for adolescents.

Predictors of consistent condom use among young psychoactive substance users in Kampala's informal settlements, Uganda

Introduction

The use of psychoactive substances increases the likelihood of unprotected sexual intercourse with individuals whose health status is not known, and consequently sexually transmitted infections, especially among young people. Despite this risk, there is limited evidence of the predictors of consistent condom use among young psychoactive substance users (YPSUs) in informal settings. This study examined the predictors of condom use among YPSUs in Kampala's informal settlements, Uganda.

Methods

A cross-sectional study was conducted among 768 YPSUs. Respondent-driven sampling was used to recruit respondents. A structured questionnaire was used to collect respondent data on condom use. Data were analysed using Stata version 15.0. Prevalence ratios (PR) were used to determine the predictors of consistent condom use.

Results

Out of the 744 YPSUs, only 37.4% of the respondents reported consistent condom use in the last 30 days. The prevalence of condom use was statistically lower among young people aged 20-24 years (35.4%) compared to those aged 18-19 years (43.7%), and among the married (17.3%) compared to respondents with a "single" marital status (43.0%). Being married (PR 0.42, 95% CI: 0.30-0.59), longer duration between meeting the most recent partner and having initial sexual contact with them (7 months to 1 year: PR 0.56, 95% CI: 0.36-0.88; more than a year: PR 0.36, 95% CI: 0.17-0.75) was negatively associated with consistent condom use. Spending less than 24 h between meeting the most recent partner and having initial sexual contact was positively associated with consistent condom use (PR 1.60, 95% CI: 1.24-2.08).

Conclusion

The prevalence of consistent condom use in the last 30 days among YPSUs was low. Marital status and the duration between meeting the most recent partner and initial sexual contact predicted consistent condom use. There is a need to intensify awareness on the importance of consistent condom use among young people.

Sexting with benefits? Exploration of sexting behaviours through the lens of protection motivation theory

Sexting is a common form of sexual communication that is often considered normative and beneficial despite some research highlighting its negative social, psychological, and legal repercussions. Using protection motivation theory (PMT), this study examines how young adults weigh the pros and cons of sending consensual sexts, sexting under pressure, and deciding against sending sexts, and whether body image dissatisfaction interacts with any of the decision-making processes. In total, 906 participants (554, 61.14% women), aged 18-25 years (M = 21.65, SD = 2.01), completed an online measure of sexting behaviours, body image, and protection motivation. Overall, 71.41% of respondents ever sent a sext. Of those, 45.07% and 36.32% felt pressure to sext or sent a sext because of pressure. Further, 63.90% participants ever considered and decided not to send a sext. All models predicting various sexting behaviours were significant and provided a partial support for the PMT. Body image was a unique predictor of 'pressured' sexting but its interactions with the PMT subscales for pressured sexting and decisions against sexting were non-significant. Our study illustrates the need for increasing young people's self-efficacy and body image to improve their sexting agency and experience.

Socially Disadvantaged Community Structures and Conditions Negatively Influence Risky Sexual Behavior in Adolescents and Young Adults: A Systematic Review

Objectives: This review aims to examine the association between community-level factors, namely, community structure and condition, and risky sexual behavior (RSB) including early sexual debut, having multiple sex partners, and unprotected sex, in adolescents and young adults.

Methods: In total, 17 observational studies were identified for review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Among the 11,216 identified articles, excluded articles comprised 8,361 duplicates, 2,855 articles by title screening, 893 by abstract screening, and 667 by full-text screening. Finally, eight additional articles were added by manual search.

Results: The community structural factors included social disadvantage, economic, employment, education status, racial or ethnic composition, residential stability, and physical environment. The current review found that social disadvantage (six studies) and economic status (10 studies) were most frequently examined. Particularly, higher levels of social disadvantage were associated with higher rates of early sexual initiation, inconsistent condom use, and multiple sexual partners.

Conclusion: This study highlights that community structure and conditions in terms of social disadvantages should be addressed to prevent RSB in the young population.

Sexual Consent Across Diverse Behaviors and Contexts: Gender Differences and Nonconsensual Sexual Experiences

Sexual consent refers to people's internal willingness to engage in sexual activity with another person-as well as their external communication of that willingness. Internal and external sexual consent can vary by type of sexual behavior; however, previous research on sexual consent has primarily only assessed "typical" sexual behaviors such as genital touching, oral sex, and vaginal-penile sex without providing further context or acknowledging people's sexual diversity. Therefore, we provided an initial account of people's sexual consent-and lack thereof-for a broader array of sexual behaviors and contexts in which they occur. Using an online cross-sectional survey of participants in the United Kingdom and the United States (N = 658, 50.5% women), we examined event-level internal and external sexual consent for 20 sexual behaviors or contexts. Women reported significantly lower levels of sexual consent feelings than men for 12 of the 20 sexual behaviors and lower levels of active consent communication for 7 of them. Almost a third of participants (31.0%) had experienced at least one of the listed sexual behaviors against their will. Of those, participants on average reported nonconsensual experiences with 3.1 of the 20 types of sexual behavior listed, ranging from 1 to 11. More women reported at least one nonconsensual experience with one of the sexual behaviors assessed compared with men (47.9% versus 22.3%, respectively). We discussed several behavior-specific findings regarding sexual consent and the lack thereof. We also made recommendations for initiatives aimed at promoting healthy sexual consent practices: embrace sexual diversity, emphasize sexual agency, and encourage active consent communication.

Sexual Modesty in Sexual Expression and Experience: A Scoping Review, 2000 - 2021

Sexual modesty is the social, cultural, interpersonal, and psychological systems - defined by the tenets of Script Theory - that regulate individuals' sexual expression and experience at the social, legal, and interpersonal boundaries of acceptable/not-acceptable, private/public, and personal/social. Almost all aspects of sexual expression and experience are touched by the pervasive modesty standards for sexual communication, sexual display, sexual relations, and sexual behaviors. Sexual modesty influences an array of sexual and reproductive health outcomes. Many aspects of sexual modesty are enforced by legal as well as social, cultural, and religious proscriptions, including social shaming and ostracism as well as corporal and capital punishments. The purpose of this paper is to summarize a diverse literature related to sexual modesty from the years 2000 to 2021 in order to clarify its role in sexual health and sexual wellbeing and to identify directions for new research.

Sexual Communication between Adolescent Partners: A Scoping Review and Directions for Future Research

Sexual communication between adolescent partners is an important component of sexual health and wellbeing. Over 40 years of research on adolescent sexual communication has yielded rich information, yet there remain gaps in our understanding of the communication process. The purpose of this scoping review was to synthesize the body of research on adolescent sexual communication to identify how communication has been conceptualized, how researchers have measured communication, and what theoretical frameworks have been applied across the literature. We identified 198 assessments of sexual communication across 119 quantitative studies. This work included 127,489 adolescents (M_age = 15.97) from 15 countries (81.5% U.S.-based). Most studies relied on self-reports (93.4%) and surveyed only one member of a couple (97.5%). The definition of sexual communication was highly varied across the literature: in half of assessments (52.0%) sexual communication was operationalized as a behavior-the verbal or nonverbal exchange of messages about sex-whereas the remaining half of assessments captured social-cognitive aspects of communication (e.g., communication self-efficacy, fear/anxiety). There was also a tendency for investigators to create their own idiosyncratic instruments: half of studies (48.9%) used instruments created by the research team with limited or no discussion of reliability/validity. Regarding the topic of communication, a third of assessments (33.8%) focused exclusively on condom communication and another quarter (24.0%) focused on other safer-sex issues (e.g., STDs, abstinence). Notably absent were studies focused on communication surrounding consent or sexual pleasure. Also absent was a guiding conceptual model or theory that could unify this body of work. Overall, results highlight gaps and inconsistencies in how partner sexual communication has been conceptualized, measured, and theorized about in previous work. We provide several recommendations for future theory-building efforts as well as rigorous, multimethod empirical investigations of adolescent sexual communication that would further our understanding of this important aspect of adolescent sexual wellbeing.

Characteristics of Cyber Sextortion in India: Content Analysis of Online Newspapers Published in 2019–2021

Introduction:

Smartphones and Internet connection help people to stay connected to virtual social media where predators may disguise and obtain intimate text, audio, photographs, and video from the victim. These are then used to extort money, sexual act, or any other favors.

Aim:

We aimed to observe the characteristics of cyber sextortion in India in recent years (2019–2021).

Methods:

This was a cross-sectional observational study conducted in February 2022. The cases of cyber sextortion reported in newspapers between 2019 and 2021 were considered for qualitative analysis. The cases were thematically analyzed by 2 authors individually and a consensus was reached for the finalization of the finding.

Results:

Social media and dating applications are used to lure the victims to exchange sexual text, intimate photo, or video. The contents are saved and used as a tool to extort money, sexual acts, or other favors. The males are commonly extorted for money but females are extorted for money and sexual acts. The victim may be called for a sexual act in a place and a group of extortionists may appear in the scene. Exchange of text messages or audio calls are also recorded for extortion. Personal intimate contents obtained from remote access of device or access through a third person or morphing videos are also used for sextortion.

Conclusion:

Social media engagement and a desire of exploring sexual relations with unknown persons expose the victims for sextortion. Storing and sharing intimate content should be avoided even when in trusted relations to minimize the risk.

An Exploratory Study of Online Early Sexual Initiation through Pressured and Unwanted Sexting

Sexting in young adolescents may be an online form of early sexual debut. We assess the link between potentially problematic sexting (i.e., pressured and receiving unwanted sexts) with known risky behaviors (i.e., substance use and early sexual behavior) among middle school students aged 12 and under. The ethnically diverse sample consisted of 1131 youth (53% female) enrolled in the 7th grade in one of 24 schools in southeast Texas. Participants self-identified as 31% Hispanic, 9% White, 24% Black, 19% Asian, 11% other, and 6% unknown. Participants self-reported pressured sexting, receiving unwanted sexts, history of sexual activity, and substance use. Two-point-one percent of adolescents reported sending a sext under pressure and 13.7% reported having received an unwanted sexting image. Participants with a history of sexual intercourse, relative to their non-sexually experienced counterparts, reported higher rates of being pressured into sexting and receiving unwanted sexts. Further, a portion of youth who experienced pressured or unwanted sexting also reported the use of various substances, relative to their non-sexting counterparts. Our study underscores the need for comprehensive sex education to begin at an early age and include age-appropriate information on sexting, digital citizenship, relationships, and substance use.

Exploring the Protective Value of Using Sexting for Condom Negotiation on Condom use Determinants and Practices Among Forcibly Displaced Adolescents in the Slums of Kampala, Uganda

Given the global growth of adolescent texting, we evaluate texting-based sexual communication as a potential site for interventions encouraging condom use cascades, particularly among displaced adolescents-a population with disproportionate levels of sexually transmitted infections, including HIV. With data from 242 forcibly displaced adolescents in the slums of Kampala, Uganda, we used path analysis to examine pathways from gender/dating relationship to condom determinant (knowledge of where to access condoms) and practices (access/use of condoms), through sexting-based condom negotiation, controlling for sexting practices. We found direct pathways from gender (boys vs. girls) and from dating relationship (dating vs. not) to condom determinant. Sexting-based condom negotiation partially mediated the pathway from gender/dating relationship to condom determinant, and fully mediated the pathways from gender/dating relationship to condom practices. Future digital sexual health interventions should consider the utility of texting-based applications in promoting knowledge and use of condoms among adolescents.

Support for Texting-Based Condom Negotiation Among Forcibly Displaced Adolescents in the Slums of Kampala, Uganda: Cross-sectional Validation of the Condom Use Negotiated Experiences Through Technology Scale

Background

Promoting sexual health among forcibly displaced adolescents is a global public health priority. Digital sexual communication strategies (eg, sexting) may increase adolescents’ confidence in discussing sexual health issues and negotiating condom use. However, limited evidence exists describing validated measures for text-based condom negotiation in the literature.

Objective

This study helps fill this gap by adapting and examining the psychometric properties of a condom use experience through technology (condom use negotiated experiences through technology [CuNET]) scale.

Methods

Using peer network sampling, 242 forcibly displaced adolescents (aged 16-19 years) living in Kampala’s slums were recruited for participation between January and March 2018. A subscale (embarrassment to negotiate condom use) of the Multidimensional Condom Attitudes Scale was adapted to incorporate sexting, yielding CuNET. Participants were randomly assigned to calibration and validation subsamples to conduct exploratory and confirmatory factor analyses to establish and validate the scale. CuNET measured participants’ support levels for texting-based condom negotiation via sexting based on gender, and multivariable logistic regression was used to explore its associations with sexual health outcomes (recent consistent condom use, access to sexual and reproductive health services, and lifetime sexually transmitted infection testing).

Results

The one-factor CuNET with the validation sample was valid (χ²₄=5.3; P=.26; root mean square error of approximation=0.05, 90% CI 0.00-0.16; comparative fit index=0.99; Tucker-Lewis index=0.99; standardized root mean square residual=0.006), and reliability (Cronbach α=.98). Adolescent girls showed significantly lower levels of support for using sexting to negotiate condom use (mean 13.60, SE 0.70 vs mean 21.48, SE 1.23; P=.001). In multivariable analyses, a 1-point increase in the CuNET score was associated with increased odds of recent consistent condom use (adjusted odds ratio [aOR] 1.73, 95% CI 1.24-2.41) but not with access to sexual and reproductive health services (aOR 1.51, 95% CI 0.99-2.30) or lifetime sexually transmitted infection testing (aOR 0.90, 95% CI 0.64-1.26).

Conclusions

The unidimensional CuNET scale is valid and reliable for forcibly displaced adolescents living in slums in Kampala, gender-sensitive, and relevant for predicting consistent condom use among urban displaced and refugee adolescents. Further development of this scale will enable a better understanding of how adolescents use digital tools for condom negotiation.

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.

Are Youth Sexting Rates Still on the Rise? A Meta-analytic Update

A meta-analysis of 39 studies (110,380 participants) from 2009 to 2015 indicated that youth sexting increased over time. To inform current practice and policy initiatives, this meta-analytic update of studies since 2016 examined if rates of youth sexting have continued to rise and whether youth sexting differs by age, sex, sexting methods, and geographical location. Electronic searches were conducted in March 2020 in Embase, PsycINFO, MEDLINE, and Web of Science, yielding 1,101 nonduplicate records. Studies were included if they provided prevalence of youth sexting and data collection occurred ≥2016. Literature review and data extraction were conducted by following established PRISMA guidelines. All relevant data were extracted by two independent reviewers. To calculate mean prevalence rates, random-effects meta-analyses were conducted. Twenty-eight studies (N = 48,024) met inclusion criteria. The estimated pooled prevalence rates were as follows: (1) sending (19.3%), (2) receiving (34.8%), and (3) forwarding sexts without consent (14.5%). These prevalence rates are statistically similar to studies with data collected before 2016. In recent studies, females receive sexts at a higher rate than males, older youth are more likely to send sexts, and younger and older adolescents receive sexts at similar rates. Youth sexting rates have likely plateaued. Sexting education initiatives should begin early and encourage safe, ethical, and respectful online behavior.

Sending One's Own Intimate Image: Sexting Among Middle-School Teens

BACKGROUND

There is a gap in the literature regarding data on sexting among youth under the age of 16 whereas the problems related to this practice could affect them more because of their ongoing development. This study aims to determine the prevalence rate and characteristics of sending one's own sexually related image among middle-school teens.

METHODS

Data were obtained from a web-based in-school survey conducted between October 2019 and February 2020. The sample comprised 3006 (mean age 13.7; 50.2% males) 10th-grade pupils in the canton of Vaud (Switzerland). Participants were asked "Have you ever sent a sexually related/sexy image of yourself?". Analysis of variance/chi-square tests and multinomial regression analyses were used to compare the groups.

RESULTS

Overall, 93.0% reported never, 3.7% once and 3.3% several times. No gender differences were found. Sending was associated with older age, low academic performance, cyberbullying victimization and reception of unsolicited sexually related images.

CONCLUSIONS

Education and health professionals should be aware that it is necessary to discuss the theme, perhaps with a more global approach including pressure, consent, exchange of nonsexual images, and so on from an early age. The context and reasons for sending remain to be explored, particularly to determine if the pressure is greater at this age.

Sexual Boundary Violations via Digital Media Among Students

As digital media becomes more central to the lives of adolescents, it also becomes increasingly relevant for their sexual communication. Sexting as an important image-based digital medium provides opportunities for self-determined digital communication, but also carries specific risks for boundary violations. Accordingly, sexting is understood either as an everyday, or as risky and deviant behavior among adolescents. In the affectedness of boundary violations gender plays an important role. However, it is still unclear to what extent digital sexual communication restores stereotypical gender roles and restrictive sexuality norms or, alternatively, enables new spaces of possibility. In this sense, current research points to a desideratum regarding adolescents' orientations toward sexting as a practice between spaces of possibility and boundary violations. This paper discusses the possibilities, but also the risks, of intimate digital communication among adolescents. The main question is, how adolescents themselves perceive sexting practices and how they position themselves between both spaces for possibility and for the exchange of unwanted sexual content. For this purpose, orientations toward normalities and gender of students are reconstructed. To answer these questions, twelve single-sex, group discussions were carried out with students aged 16 and 17 at five different secondary schools in northern Germany. A total of 20 boys and 22 girls took part. The group discussions were structured by a narrative generating guideline. The analysis draws its methodology from the Documentary Method, regarding implicit and explicit forms of knowledge and discourse. It results in a typology of three types with different orientations. The study shows, that most of the students consider sexting to be a risky practice; only one type shows normality in the use of sexting. At the same time, some of the young people are interested in experimenting with image-based intimate digital communication. Further, gender differences in use and affectedness are also documented. In this way, orientations toward gender stereotypes "favor" both the attribution of responsibility to girls, and overlook the responsibility of students who perpetrated the boundary violation. The orientations of adolescents should be taken more into account in research as well as in educational programs for the prevention of sexual violence.