Is Sexting Associated with Sexual Behaviors During Adolescence? A Systematic Literature Review and Meta-Analysis.
Caroline Handschuh, Allison La Cross, Arlene Smaldone
PMID 30521135WHAT IT FOUND
Adolescents who had sent a sext were much more likely to report vaginal intercourse in the studies than those who had not.
The review cannot show sexting caused sexual activity, but it supports asking teens about sexting in health visits.
Key findings
01Among adolescents who reported sending a sext, the odds of reporting past or current vaginal intercourse were 6.3 times higher than among those who did not send a sext.
02In the pooled data, 22% of adolescents reported sending a sext and 44% reported receiving one.
03The association was present for both males and females, and the review found no statistically significant difference by sex.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included studies were cross-sectional or cohort surveys, so they show an association but cannot show that sexting caused sexual activity. Heterogeneity was greater than expected by chance (I2 = 65.1), and subgroup analyses by country, age, and definition of sexual activity did not explain it. Studies defined sexting and sexual activity differently, and the pooled association used only vaginal intercourse, not oral sex, anal sex, condom use, or number of partners. The meta-analysis used only 6 of the 9 included studies and 9,676 of the 29,115 adolescents, so the pooled estimate reflects a subset. Internal validity was the most problematic quality category; only one of two cohort studies adjusted for follow-up length. Most studies were conducted in the United States, and attitudes and legal contexts may differ across cultures. Sexual orientation was reported in only four studies, so associations for gay, lesbian, bisexual, transgender, or questioning adolescents could not be evaluated.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not conclude that sexting causes adolescents to become sexually active. The included studies were mainly cross-sectional surveys, and the authors state that causation cannot be inferred.