title: Is sexual content in new media linked to sexual risk behaviour in young people? A systematic review and meta-analysis.
abstract: Social networking and digital media increasingly have an impact on the lives of young people. We undertook a systematic review and meta-analysis of studies that examined the relationship between exposure to sexually explicit websites (SEWs) and 'sexting' (i.e. sending semi-nude or nude photos from a mobile phone) and the sexual attitudes and practices of young people.
  
  
  
  In accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses statement, Medline, EMBASE and PsycINFO were searched for papers that described the statistical association between viewing SEWs or sexting by young people (defined as 10-24 years) and their sexual attitudes and behaviours.
  
  
  
  Fourteen studies, all cross-sectional in design, met the inclusion criteria. Six studies (10352 participants) examined young people's exposure to SEWs and eight (10429 participants) examined sexting. There was substantial variation across studies in exposure and outcome definitions. Meta-analyses found that SEW exposure was correlated with condomless sexual intercourse (odds ratio (OR) 1.23, 95% confidence interval (CI): 1.08-1.38, two studies); sexting was correlated with ever having had sexual intercourse (OR 5.58, 95% CI: 4.46-6.71, five studies), recent sexual activity (OR 4.79, 95% CI: 3.55-6.04, two studies), alcohol and other drug use before sexual intercourse (OR 2.65, 95% CI: 1.99-3.32, two studies) and multiple recent sexual partners (OR 2.79, 95% CI: 1.95-3.63, two studies). Most studies had limited adjustment for important potential confounders.
  
  
  
  Cross-sectional studies show a strong association between self-reported exposure to sexual content in new media and sexual behaviours in young people. Longitudinal studies would provide a greater opportunity to adjust for confounding, and better insight into the causal pathways underlying the observed associations.
authors: Kirby Institute, Wallace Wurth Building, University of New South Wales, NSW 2052, Australia.
authors: Lucy Watchirs
authors: LW
authors: Smith
authors: School of Public Health and Community Medicine, Samuels Building, University of New South Wales, NSW 2052, Australia.
authors: Bette
authors: B
authors: Liu
authors: National Drug and Alcohol Research Centre (NDARC), University of New South Wales, 22-32 King Street, Randwick, NSW 2031, Australia.
authors: Louisa
authors: L
authors: Degenhardt
authors: School of Public Health and Community Medicine, Samuels Building, University of New South Wales, NSW 2052, Australia.
authors: Juliet
authors: J
authors: Richters
authors: Department of Paediatrics, University of Melbourne, Royal Children's Hospital, 50 Flemington Road, Parkville, Vic. 3052, Australia.
authors: George
authors: G
authors: Patton
authors: Kirby Institute, Wallace Wurth Building, University of New South Wales, NSW 2052, Australia.
authors: Handan
authors: H
authors: Wand
authors: Telethon Kids Institute, 100 Roberts Road, Subiaco, WA 6008, Australia.
authors: Donna
authors: D
authors: Cross
authors: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, 3/207 Bouverie Street, Carlton, Vic. 3010, Australia.
authors: Jane S
authors: JS
authors: Hocking
authors: Discipline of Child and Adolescent Health, University of Sydney, Children's Hospital Westmead, 212 Hawkesbury Road, Westmead, NSW 2145, Australia.
authors: S Rachel
authors: SR
authors: Skinner
authors: School of Public Health, City University of New York, 55W 125th Street, New York, NY 10027, USA.
authors: Spring
authors: S
authors: Cooper
authors: Kirby Institute, Wallace Wurth Building, University of New South Wales, NSW 2052, Australia.
authors: Catharine
authors: C
authors: Lumby
authors: Kirby Institute, Wallace Wurth Building, University of New South Wales, NSW 2052, Australia.
authors: John M
authors: JM
authors: Kaldor
authors: Kirby Institute, Wallace Wurth Building, University of New South Wales, NSW 2052, Australia.
authors: Rebecca
authors: R
authors: Guy
mesh_terms: D000293:Adolescent; D001290:Attitude; D002648:Child; D003430:Cross-Sectional Studies; D006801:Humans; D020407:Internet; D012309:Risk-Taking; D012725:Sexual Behavior; D061108:Social Media; D060145:Text Messaging; D055815:Young Adult