title: Sexually explicit cell phone messaging associated with sexual risk among adolescents.
abstract: OBJECTIVE
  Sexting (sending/receiving sexually explicit texts and images via cell phone) may be associated with sexual health consequences among adolescents. However, to date, no published data from a probability-based sample has examined associations between sexting and sexual activity.
  
  
  METHODS
  A probability sample of 1839 students was collected alongside the 2011 Youth Risk Behavior Survey in Los Angeles high schools. Logistic regressions were used to assess the correlates of sexting behavior and associations between sexting and sexual risk-taking.
  
  
  RESULTS
  Fifteen percent of adolescents with cell phone access reported sexting, and 54% reported knowing someone who had sent a sext. Adolescents whose peers sexted were more likely to sext themselves (odds ratio [OR] = 16.87, 95% confidence interval [CI]: 9.62-29.59). Adolescents who themselves sexted were more likely to report being sexually active (OR = 7.17, 95% CI: 5.01-10.25). Nonheterosexual students were more likely to report sexting (OR = 2.74, 95% CI: 1.86-4.04), sexual activity (OR = 1.52, 95% CI: 1.07-2.15), and unprotected sex at last sexual encounter (OR = 1.84, 95% CI: 1.17-2.89).
  
  
  CONCLUSIONS
  Sexting, rather than functioning as an alternative to "real world" sexual risk behavior, appears to be part of a cluster of risky sexual behaviors among adolescents. We recommend that clinicians discuss sexting as an adolescent-friendly way of engaging patients in conversations about sexual activity, prevention of sexually transmitted infections, and unwanted pregnancy. We further recommend that discussion about sexting and its associated risk behavior be included in school-based sexual health curricula.
authors.affiliation: School of Social Work, University of Southern California, 1149 South Hill St, Suite 360, Los Angeles, CA 90015, USA. ericr@usc.edu
authors.forename: Eric
authors.initials: E
authors.lastname: Rice
authors.forename: Harmony
authors.initials: H
authors.lastname: Rhoades
authors.forename: Hailey
authors.initials: H
authors.lastname: Winetrobe
authors.forename: Monica
authors.initials: M
authors.lastname: Sanchez
authors.forename: Jorge
authors.initials: J
authors.lastname: Montoya
authors.forename: Aaron
authors.initials: A
authors.lastname: Plant
authors.forename: Timothy
authors.initials: T
authors.lastname: Kordic
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D015141:Los Angeles; D008297:Male; D016017:Odds Ratio; D010379:Peer Group; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D060145:Text Messaging / Q000706:statistics & numerical data; D047568:Unsafe Sex / Q000706:statistics & numerical data