Objective: The use of online social networks like Facebook continues to increase rapidly among all age groups and segments of our society, presenting new opportunities for the exchange of sexual information as well as for potentially unsafe encounters between predators and the vulnerable or young. This study surveyed middle school, high school, and college-age students, as well as sexual offenders, regarding their use of social networking sites in order to provide information to better focus education and prevention efforts from nurses and other health care providers. Methods: Written questionnaires asking about various characteristics of participants' use of social networking sites were distributed to each group and filled out by 404 middle school students, 2,077 high school students, 1,284 students drawn from five traditional four-year colleges, and 466 adults who had committed either an Internet sexual offense or a hands-on sexual offense (in some cases both). Results: Notable findings emerging from our analysis of the questionnaire responses included the following: offenders and students both frequent social networking sites, although at the time of the study offenders reported that they preferred Myspace and students that they preferred Facebook; nearly two-thirds of the Internet offenders said they'd initiated the topic of sex in their first chat session; more than half of the Internet offenders disguised their identity when online; most Internet offenders we surveyed said they preferred communicating with teenage girls rather than teenage boys; high school students' experience with "sexting" (sharing nude photos of themselves or others on cell phones or online) differed significantly according to their sex; a small number of students are being threatened and assaulted by people they meet online; avatar sites such as Second Life were used both by students and offenders, with both child molesters and Internet offenders expressing interest in Second Life. Conclusions: The use of the Internet presents relatively new and complex issues related to the safety and privacy of adolescents and young adults, and it's crucial that our understanding keep pace with these changes. Possible nurse-initiated policy recommendations include designing technologies and educational programs to help in the identification of suspicious online behaviors; strengthening Internet filters and privacy options for protecting students online; and school outreach for students who are harassed, threatened, or assaulted as a consequence of meeting someone online.
