title: Sexting and sexual behavior in at-risk adolescents.
abstract: OBJECTIVE
  This study aimed to examine the prevalence of sexting behaviors (sexually explicit messages and/or pictures) among an at-risk 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 computer-based 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 (χ(2)[2] = 7.33, P = .03) and Latinos (χ(2)[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.
authors.affiliation: Bradley/Hasbro Children's Research Center, Rhode Island Hospital, and The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Houck
authors.forename: David
authors.initials: D
authors.lastname: Barker
authors.forename: Christie
authors.initials: C
authors.lastname: Rizzo
authors.forename: Evan
authors.initials: E
authors.lastname: Hancock
authors.forename: Alicia
authors.initials: A
authors.lastname: Norton
authors.forename: Larry K
authors.initials: LK
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012309:Risk-Taking; D012725:Sexual Behavior; D060145:Text Messaging / Q000706:statistics & numerical data*
keywords: early adolescence; sexting; sexual behavior