Sexting and Sexual Behavior in At-Risk Adolescents

OBJECTIVES: This study aimed to examine the prevalence of sexting behaviors ( sexually explicit messages and/or pictures) among an atrisk sample of early adolescents as well as the associations between sexting behaviors and sexual behaviors, risk-related cognitions, and emotional regulation skills. It also aimed to determine whether differences in risk were associated with text-based versus photo-based sexts. METHODS: Seventh-grade adolescents participating in a sexual risk prevention trial for at-risk early adolescents completed a computerbased survey at baseline regarding sexting behavior ( having sent sexually explicit messages and/or pictures), sexual activities, intentions to have sex, perceived approval of sexual activity, and emotional regulation skills. RESULTS: Twenty-two percent of the sample reported having sexted in the past 6 months; sexual messages were endorsed by 17% ( n = 71), sexual messages and photos by 5% ( n = 21). Pictures were endorsed significantly more often by females ( x2[ 2] = 7.33, P =.03) and Latinos ( x2[ 2] = 7.27, P =.03). Sexting of any kind was associated with higher rates of engaging in a variety of sexual behaviors, and sending photos was associated with higher rates of sexual activity than sending text messages only. This was true for a range of behaviors from touching genitals over clothes ( odds ratio [ OR] = 1.98, P =.03) to oral sex ( OR = 2.66, P,.01) to vaginal sex ( OR = 2.23, P,.01). CONCLUSIONS: Sexting behavior ( both photo and text messages) was not uncommon among middle school youth and co-occurred with sexual behavior. These data suggest that phone behaviors, even flirtatious messages, may be an indicator of risk. Clinicians, parents, and health programs should discuss sexting with early adolescents. Pediatrics 2014; 133: e276-e282