Associations between adolescents' use of sexually explicit material and risky sexual behavior: A longitudinal assessment

Exposure to Pornography and Adolescent Sexual Behavior: Systematic Review

BACKGROUND

Formative experiences in adolescence lay the foundation for healthy and pleasurable romantic and sexual relationships. Exposure to pornography may affect these experiences.

OBJECTIVE

We aimed to synthesize evidence published in the past decade on the relationship between exposure to pornography and sexual behavior (earlier age of first sex [<16 years], condomless sex, past-year multiple partners [>1], lifetime multiple partners [>1], group sex, sexual aggression including forced sex, paid sex, teenage pregnancy, and history of sexually transmitted infection) in adolescents aged between 10 and 19 years.

METHODS

We identified 19 eligible studies by searching MEDLINE, PsycINFO, Cochrane, CINAHL, Embase, and Web of Science databases from January 2010 to November 2022.

RESULTS

Out of 8 studies that assessed earlier age of first sex, 5 studies, including 1 longitudinal study, found a statistically significant association with exposure to pornography. Given that most studies were cross-sectional or had substantial limitations, causal inference could not be made. Also, exposure to pornography was not measured consistently. The evidence was conflicting or insufficient to draw any conclusions regarding other outcomes.

CONCLUSIONS

More quantitative research is needed to elucidate the association between pornography exposure and sexual behavior, and sex education should adopt evidence-based approaches to minimize the potential harms from pornography.

TRIAL REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews CRD42021227390; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227390.

Risky sexual behavior and associated factors among sexually-experienced adolescents in Bangkok, Thailand: findings from a school web-based survey

Background

The risk of sexually transmitted infections (STI) arises when there is unsafe sexual activity. Unsafe sex often begins in the teenage years, and it will persist as long as there is the opportunity for risky sexual activity. The purpose of this study was to assess the sexual risk behaviors and related factors of sexually-active adolescents in educational institutions in Thailand.

Methods

This was cross-sectional survey using an Internet-based application in schools in Bangkok from November 2020 to February 2021 with a total of 6,167 high school and vocational students. The schools were selected by simple random sampling among institutions, and the students were systematically randomly selected, with an equal number of males and females. We used multivariable logistic regression to analyze associations and control confounding variables. Indicators of risky sex include: (1) Not using a condom; (2) Having more than one sex partner; (3) Having sex in exchange for cash or in-kind compensation; and (4) Having sex without consent.

Results

Of a total of 872 sexually-active participants, the mean age was 15.6 years, 66.9% were vocational students, 42.1% were male, 57.9% were female, and 69.5% had sex risk behavior. The multivariate logistic regression analysis identified the following statistically-significant factors related to risky sex: smokes cigarettes (AOR = 1.79; 95% CI 1.12–2.88); uses cannabis (AOR = 2.84; 95% CI 1.23–6.56); gambles (AOR = 1.81; 95% CI 1.28–2.55); has sex without contraception (AOR = 2.74; 95% CI 2.91–3.93); has a history of childhood sex abuse (AOR = 1.60; 95% CI 1.03–2.56).

Conclusions

Our findings suggest that, in designing and implementing sexual risk prevention programs for adolescents in educational settings, there is a need to highlight the role of substance abuse in relation to sexual risk behaviors. Programs should target both male and female students. Teenagers who use marijuana are more likely to be sexually active than those who have never used marijuana. These potential risks should be taken into account with respect to legalization of marijuana and recreational use of this drug.

Risky sexual behavior (RSB) is engaging in sexual practices that may increase vulnerability to a reproductive health problem. This study was conducted to assess the sexual risk behaviors of students living in Bangkok, which has the highest rates of STIs among regions in Thailand. Previous studies of RSB have focused on the general population age 18 years or older. By contrast, there is a dearth of studies on sex behavior among Thais under age 18 years. In addition, the present study aimed to explore the association of substance abuse and adverse childhood experiences (ACEs) with adolescent RSB. In this study, 14.1% of all students in the participating schools had ever had sex before. Using the study criteria, two out of three students in the sample had experienced RSB. The findings from this study may help inform programs and interventions aimed at reducing the negative health impacts associated with RSB, specifically STIs. The findings of the study should be relevant for health program managers, socio-behavioral researchers, and other stakeholders who design reproductive health intervention strategies for in-school adolescents.

Pornography Use Profiles and the Emergence of Sexual Behaviors in Adolescence

This research longitudinally explored adolescent pornography (porn) consumption and its association with sexual development in early and middle adolescence. A four-wave design with half-year intervals investigated pornography consumption and different (sexual) activities, such as masturbation, French kissing, petting, giving/receiving manual and oral sex, and intercourse, among 630 respondents (47.9% female, mean age 13.7 years; SD = 0.48) years at T1). A latent growth mixture analysis of pornography consumption revealed two groups with relatively low pornography (LP; 51.8% of the boys, 91.4% of the girls) versus high pornography (HP; 48.2% of the boys; 8.6% of the girls) consumption across time. At T1, HP boys on average watched pornography less than once a month, but more than once a year at T1. At T4, their average pornography use had increased to almost one to two times a week. LP boys never watched pornography at T1. At T4, their average pornography use was still less than once a year. At T1, HP girls never watched pornography, but consumption increased to almost one to three times a month at T4. Across waves of the study, LP girls (almost) never watched pornography. A discrete-time survival mixture analysis of sexual developmental patterning indicated that, compared to their LP peers, both girls and boys in the HP groups showed accelerated development of masturbation, petting, and receiving manual sex. Girls in the HP group were also more inclined to receive oral sex, whereas boys in the HP group also showed earlier and more frequent manual sex and intercourse. Thus, whereas the HP group of boys was substantially larger compared to that of girls, pornography consumption was related to accelerated development of sexual activities for both genders across early and middle adolescence. The discussion deliberates on pornography as a driving force in adolescent sexual development versus pornography as a medium of choice for sexually advanced adolescents.

Relationship between Perceived Peer and Adolescents' Sexual Behaviors: The Moderating Role of Gender

In Malaysia, sexual health risks such as unprotected sex, teenage pregnancies, abandoned babies, abortion, and sexually transmitted diseases are on the rise because adolescents are increasingly engaging in such sexual behaviors. The present study aimed to investigate the relationship between perceived peer sexual behaviors and sexual behaviors among adolescents as well as to examine the interacting role of gender in such a relationship. This cross-sectional study recruited a sample of 338 school-going adolescents (M_age = 16.7; SD_age = 1.53) using the purposive sampling method. Participants were required to complete questionnaires consisting of the modified Human Sexuality Questionnaire-Orgasmic Experience Scale and the Peer Norms Scale. Results indicated that adolescents who perceived their peers to be actively engaging in sexual behaviors were more prone to being sexually active themselves. The results also showed gender as a significant moderator in the relationship between adolescents' perceived peers' sexual behaviors and sexual behaviors. Besides, the impact of perceived peer sexual behaviors on sexual behaviors was found to be stronger in male than female adolescents. Overall, the findings from this study hinted at the importance of peers and gender differences during the planning and implementation of sexual and health education.

VR Porn as "Empathy Machine"? Perception of Self and Others in Virtual Reality Pornography

The usage of virtual reality (VR) pornography has risen in recent years. Anecdotal evidence suggests that the steep increase may be driven by an essential difference compared to traditional pornography, namely strong feelings of intimacy and the illusion of interaction with the porn actors. The present study is the first to systematically address this topic in an experimental design. Fifty healthy male participants watched two pornographic films on consecutive days in the laboratory, randomly one in VR and one traditional two-dimensional (2D) film. The perception of 2D and VR pornography was assessed using several self-report measures. Furthermore, the role of the social neuropeptide oxytocin in facilitating intimacy and interaction was studied. In the VR condition, participants felt more desired, more flirted with, more looked into the eyes. They were also more likely to feel connected with the actors and more likely to feel the urge to interact with them. Interestingly, saliva levels of oxytocin were related to the perceived eye-contact with the virtual persons indicating a role for the social neuropeptide in the perception of increased intimacy and interaction in VR. Thus, VR pornography seems to be a powerful tool to elicit the illusion of intimate sexual experiences.

Exposure to sexually explicit media in early adolescence is related to risky sexual behavior in emerging adulthood

Background

Sexually explicit media exposure during early adolescence has been found to be associated with risky sexual behavior. However, previous study suffered from methodological issue, such as selection bias. Furthermore, little is known about the effect of multi-modality sexually explicit media exposure on risky sexual behavior, and how this relationship can be applied to non-western societies.

Objectives

This study aimed to improve upon previous studies by using instrumental variable estimation. In addition, this study also included multi-modality of sexually explicit media and three risky sexual behavior measure from a sample of Taiwanese adolescents.

Methods

Participants were recruited from a prospective longitudinal study (Taiwan Youth Project). All were in 7^th grade (mean age = 13.3) when the study was initiated in 2000. Sexually explicit media exposure, including ever-exposure and number of modalities exposed to, was measured in wave 2 (8^th grade). Risky sexual behavior was measured in waves 8 (mean age = 20.3) and 10 (mean age = 24.3). A two-stage least squares regression was employed, with pubertal timing as the instrumental variable.

Results

About 50% of participants had been exposed to sexual media content by 8^th grade, from an average of one modality. Sexually explicit media exposure predicted early sexual debut, unsafe sex, and multiple sexual partners (all: p < .05). Furthermore, exposure to more media modalities increased the likelihood of risky sexual behaviors. However, only the effect on early sexual debut was gender invariant.

Conclusions

Exposure to sexually explicit media in early adolescence had a substantive relationship with risky sexual behavior in the emerging adulthood. Knowledge of this causal like effect provides a basis for building better preventive programs in early adolescence. One prominent way is early education on media literacy, and physicians themselves may need to be familiar with such content to initiate it.

Concerns and educational needs of Iranian parents regarding the sexual health of their male adolescents: a qualitative study

BACKGROUND

Parents play an important role in promoting the sexual health of their adolescents. However, many parents experience several challenges. The purpose of this study was to explore the concerns and educational needs of Iranian parents regarding the sexual health of their male adolescents.

METHODS

This qualitative study was designed based on the conventional content analysis approach. Semi-structured and in-depth interviews were conducted with 16 parents of male adolescents aged 12-18 years. All interviews were audio recorded and transcribed verbatim. The data were collected through purposeful sampling and continued until data saturation. Finally, the Graneheim and Landman strategies were used to analyze data.

RESULTS

According to the participants' comments, four main categories were extracted as follows: fear of emotional and sexual harms, quality of parent-child relationships, effect of media and cyberspace, and necessity of sexuality health education.

CONCLUSIONS

The findings highlighted the need for sexuality health education through cooperation with schools for offering appropriate education to the students, parents, and school staffs. The results showed that parents required training to enhance their knowledge and skills to improve their communication with their adolescents about sexuality issues. Therefore, it is necessary to design, implement, and evaluate culture-appropriate educational programs to address the parents' concerns regarding adolescents' sexual health.