High school student sexting associated with sexual risk behavior

Background: Sexting (i.e., the sending and/or receiving of sexually-explicit cell phone texts and images) may be associated with sexual risk behavior among adolescents. However, to date, no published data from a probability-based sample has examined associations between sexting and sexual activity and risk behavior. Methods: A supplemental questionnaire was administered alongside the 2011 CDC Youth Risk Behavior Survey in the Los Angeles Unified School District, yielding a probability sample of 1,839 high school students. Logistic regressions were used to assess the correlates of sexting behavior and associations between sexting and sexual risk-taking. Results: Fifteen percent of high school students who had access to a cell phone reported sexting; 53% reported knowing someone who had sent or received a sext. Adolescents whose peers sexted were almost 17 times more likely to sext themselves. Adolescents who themselves sexted were almost seven times more likely to report being sexually active and were more likely to not have used a condom at last intercourse. Non-heterosexual students were almost three times more likely to report sexting, and more likely to have engaged in sexual activity and had unprotected sex at last intercourse. Conclusions: Sexting, rather than functioning as an alternative to “real world” sexual behavior, appears to be part of a cluster of risky sexual behaviors among adolescents, especially amongst non-heterosexual adolescents. We recommend that clinicians and school-based programs discuss sexting as an adolescent-friendly way of engaging patients in conversations about sexual activity, and prevention of sexually transmitted infections and unwanted pregnancy.