Sexting and sexual behavior among middle school students.

OBJECTIVE It is unknown if "sexting" (i.e., sending/receiving sexually explicit cell phone text or picture messages) is associated with sexual activity and sexual risk behavior among early adolescents, as has been found for high school students. To date, no published data have examined these relationships exclusively among a probability sample of middle school students. METHODS A probability sample of 1285 students was collected alongside the 2012 Youth Risk Behavior Survey in Los Angeles middle schools. Logistic regressions assessed the correlates of sexting behavior and associations between sexting and sexual activity and risk behavior (ie, unprotected sex). RESULTS Twenty percent of students with text-capable cell phone access reported receiving a sext and 5% reported sending a sext. Students who text at least 100 times per day were more likely to report both receiving (odds ratio [OR]: 2.4) and sending (OR: 4.5) sexts and to be sexually active (OR: 4.1). Students who sent sexts (OR: 3.2) and students who received sexts (OR: 7.0) were more likely to report sexual activity. Compared with not being sexually active, excessive texting and receiving sexts were associated with both unprotected sex (ORs: 4.7 and 12.1, respectively) and with condom use (ORs: 3.7 and 5.5, respectively). CONCLUSIONS Because early sexual debut is correlated with higher rates of sexually transmitted infections and teen pregnancies, pediatricians should discuss sexting with young adolescents because this may facilitate conversations about sexually transmitted infection and pregnancy prevention. Sexting and associated risks should be considered for inclusion in middle school sex education curricula.