‘I see it everywhere’: young Australians unintended exposure to sexual content online (2018)

Larissa Lewis, Julie Mooney Somers, Rebecca Guy, Lucy Watchirs-Smith and S. Rachel Skinner

Sexual Health – https://doi.org/10.1071/SH17132

Submitted: 1 August 2017  Accepted: 9 February 2018   Published online: 21 June 2018

Abstract

Background:

There are wide variations in the reported prevalence of exposure to sexual content online, but the literature tends not to distinguish between intended and unintended exposure. Moreover, there is little research exploring the pathways through which exposure occurs or descriptions of such content. While there is much public concern regarding exposure to sexual content, Australian students receive little or no education on mitigating the effect of sexual content online.

Methods:

Eleven focus group discussions with high school students aged 14–18 years were conducted to discover young people’s experiences of exposure to sexual content in social media. In this paper, we describe these pathways to sexual content exposure, the nature of the sexual content young people are exposed to and their views about this exposure.

Results:

Focus groups showed that exposure to sexual content through social media occurred through networks of ‘friends’ or followers, and paid-for advertising. Content ranged from subtle messages or photos to explicit pornographic pictures/videos. Most of the exposure young people described was unintended.

Conclusions:

Exposure to sexual content, no matter the scope and intensity, was almost unavoidable among young people who use social media. Utilising this information to educate young people on mitigating the effect of sexual content, rather than trying to prevent young people from viewing it, could be a more effective approach.

Background

 

Using social media (e.g. Facebook, Instagram, Snapchat, Twitter) has become part of modern day adolescence.1,2 Smartphones and easy access to the Internet makes digital communication a part of daily life in many countries.18 Studies from the United States, United Kingdom and Australia show that up to 97% of young people ranging in age between 13 and 17 years are active on some form of social media, many across several social media sites.2,6,8 More than one-third report using their main social networking sites several times a day.2 A 2013 survey found almost all the Australian young people surveyed had used a social networking site (97% of 14- to 15-year-olds, 99% of 16- to 17-year-olds), and 62% described accessing social media daily.6

The EU Kids Online project found that 14% of 9- to 16-year-olds had seen some form of sexual content online, with older adolescents four-fold more likely than younger adolescents to have seen such content.8 While it is commonly accepted that young people may seek out sexual content online, recent literature shows that much of the exposure may be classified as accidental or unsought.3,911 One study conducted in the United States found that 15% of 10- to 12-year-olds and 28% of 16- to 17-year-olds had been exposed to sexual content online without intentionally seeking it out.12 Social media, in particular, creates the potential for young people to be exposed to high levels of sexual content, while it’s individualised and often private nature means that control by parents or schools can be difficult.

While development milestones vary, exposure to online sexual content occurs concomitantly with young people beginning to recognise sexual feelings and develop their own individual value systems.4 It is also a time when many young people will begin to actively explore their sexuality.13 There is concern that online sexual content may influence young people’s behavioural and social norms, body image and expectations of sexual activity, in a potentially harmful way.14,15 Cross-sectional surveys suggest an association between adolescents’ exposure to sexual content, specifically pornography, and less progressive gender norms, changes in sexual norms, earlier age of first sexual intercourse and greater sexual risk-taking.1517

In this study, we explore young people’s experiences of exposure to sexual content in social media to describe the various pathways that lead young people to view sexual content in social media, the nature of the sexual content young people are exposed to and their views about this exposure; such insights are important to inform the development of interventions to educate and safeguard young people.

 

 

Methods

 

We used purposive sampling to target government (public), religious and private schools in Sydney, New South Wales, Australia, and contacted school principals through an introductory email. Researchers followed up schools that expressed interest and introduced the study to students during a school assembly or via teachers during class. Interested students were asked to pick up an information pack containing study information for themselves and parents, and a parental consent form. We obtained explicit written consent from parents and verbal consent from adolescents. Ethics approval was obtained from the NSW Department of Education through the State Education Research Approvals Process (McCarthy, Seraphine et al.), the University of Sydney Human Research Ethics Committee, University of New South Wales Human Research Ethics Committee and from individual school principals.

Participants

 

A total of 68 young people aged 14–18 years participated. Slightly over half (54%) of the young people were male (Table 1). Schools (n = 4) were selected from four culturally, and economically diverse areas of Sydney, New South Wales. These schools included one government (public) school, one selective school (students academically selected), one independent (private) school and one independent religious school. Two schools were all-boy schools, one was an all-girl school and one was co-educational (mixed boy and girls). By targeting and selecting schools from inner city and outer suburbs, we were able to capture a mix of cultural and socioeconomic backgrounds.

Table 1.  Number of focus groups and participants by school grade, age and gender
T1

Data collection

 

We conducted 11 single gender focus groups (six to eight students each) between March 2013 and May 2014 across four high schools. They took place in schools during lunch break or class time, each lasting ~60 min. Each focus group consisted of students from the same grade level. While researchers encouraged participants to lead discussions, assisted by open-ended prompts (Table 2) and allowed participants to raise new topics of interest, groups were carefully moderated to capture discourse from each participant and avoid over representation by more assertive personalities. As the research progressed, we reviewed the emerging data and modified prompts and topic guides to further explore new areas of inquiry.

Table 2.  Summary of interview questions
T2

Data analysis

 

We analysed focus group findings using a descriptive analytical approach inspired by Grounded Theory18 in an effort to create an understanding that was centred on young people’s experiences. We utilised an iterative process of transcribing and line-by-line coding of focus group transcripts. During data analysis, we added, disregarded or modified existing codes to accommodate new insights about those data. We used memos to diagram and map where associations and comparisons were made across groups. This process involved discussions between two of the authors (L. Lewis, J. M. Somers), which lead to a shared description and interpretation of young people’s interactions with sexual content in social media.

 

 

Results

 

What did young people mean by ‘social media’?

 

Social media generally means websites and applications (‘apps’) used to share content and/or allow social networking; common sites/apps at the time of this research include Facebook, Instagram and Snapchat. When we asked our participants about ‘social media’, they most often spoke about social networking sites such as Facebook, Instagram, etc., but some also talked about YouTube and music downloading sites. Instant messaging services such as Facebook Messenger, where participants described sharing photos and texts, also featured in their accounts. Following our participants, we use social media here as a broad category encompassing various tools young people used to interact with each other and share and/or consume content.

Significance of social media in the lives of young people

 

Knowledge of young people’s exposure to sexual content in social media cannot be fully explored without understanding the importance that young people place on social media relationships and how their social media interactions occur.

It was not uncommon for participants to report having thousands of friends/followers on social media sites such as Facebook. Participants described their friends/followers as people who were both older and younger than themselves (if their age was known at all) and being from different schools, cities and countries.

I have two thousand friends now….a lot of them I don’t know.’ (Boy – Grade 10)

‘…the goal would be to get 1000 followers…So you are able to get more likes….’ (Girl – Grade 11)

Participant’s social media networks typically comprised: a small number of close friends; people who were known to them but not considered close; people who were friends of friends who they may or may not have met in person; and finally, people they did not know and had never met.

Yeah like I would have my close friends and I would have friends and I would have acquaintances.’ (Girl – Grade 9)

Sometimes a stranger adds you [as a ‘friend’ or follower on a social media site] and if you know of them and might not know who they are – so they are not strangers – they are acquaintances.’ (Boy – Grade 9)

Several young people in our study, especially girls, described the number of friends/followers as an indicator of how popular they were perceived to be. More friends/followers meant they could receive more ‘likes’ on the content (photos, messages) they posted. Having positive feedback – often simply via ‘likes’ – on photos they posted was described as important to many participants.

You just don’t get the ‘likes’ unless you have hundreds of friends and so you just do.’ (Girl – Grade 10)

‘…the average is one thousand likes on a photo on Facebook…it’s like a virtual popularity…’ (Girl – Grade 9)

And a lot of people feel like I don’t have enough likes in this photo I should delete it.’ (Girl – Grade 11)

Participants typically described engaging with social media numerous times a day; checking social media was the first thing they did in the morning and the last thing they did before going to bed.

‘….literally, I’m checking it [Facebook] all the time…I’d say maybe a hundred times a day on the weekend.’ (Girl – Grade 11)

I feel I have to look [at Facebook]. You want to know what is going on in the world before going to bed.’ (Boy – Grade 8)

I look at my phone and check Facebook even before I get out of bed in the morning.’ (Boy- Grade 9)

The sense that social media was a way of engaging not only with peers and connecting to the world at large, with the goal of acceptance and popularity for many, may aid in understanding the high levels of engagement that participants reported.

Pathways to sexual content exposure

 

i.

Paid advertising

 

Much of the sexual content that young people described seeing was inadvertent, in that it originated through (paid) pop-up advertising or in the sidebars of social media sites when they were searching for music, watching videos or logged into Instagram or Twitter. Advertisements with sexual material ranged in content from nude photos to graphic pornographic photos and links to pornographic videos.

(Sexual) Images, videos, dating sites and when you ever download music and you go onto the websites and they are all down the sides.’ (Girl – Grade 10)

I see it everywhere, sexual innuendo, you see a housewife and you click on this link – just everywhere.’ (Girl – Grade 10)

Advertisements often offered a link to another site where more sexual material could be viewed. Young people reported seeing these advertisements across several sites and described them as intrusive.

I see heaps of [sexual] ads and it’s everywhere and they just pop up – it happens on Twitter and Instagram, you can’t stop that….’ (Girl – Grade 11)

Young people may not have been interested in viewing the material advertised; indeed, several participants described feeling uncomfortable, or irritated when seeing these advertisements.

It’s really uncomfortable and you feel you are trying to download music or something…and its [sexual content] just on the side.’ (Girl – Grade 9)

Although some participants reported seeing paid advertisements of a sexual nature across the more commonly described social media sites such as Facebook and Instagram, much of the reported content was described as being viewed on ‘torrent’ sites, which are illegal downloading sites for music or videos. This may be due to the regulations in place regarding paid advertising in highly popular social media sites such as Facebook.

ii.

User-generated content

 

While paid for advertising of a sexual nature is usually easily identified as an advertisement and often requires the user to click on a link to view further content, young people also saw sexual content directly in their social media ‘newsfeed’ or page. By its very nature, social media content here was a direct result of sharing among networks where friends or friends of friends posted or shared content. As with paid for advertising, many young people reported that much of the sexual user-generated content they saw was not explicitly sought out; some participants felt little control over what they saw.

It’s easy to view sexually explicit stuff and you don’t have to go out of your way, it will come to you.’ (Boy – Grade 9)

On Facebook, you have no control of what you are seeing.’ (Boy – Grade 9)

There is some pretty hard-core stuff like bestiality like how it just pops up because someone on some page just puts it up and a friend will comment on it and then it will pop up into your newsfeed.’ (Boy – Grade 12)

Shared sexual photos and/or videos of peers, celebrities or strangers were described within all focus groups. These photos or videos ranged from sexually suggestive – people with their clothes on, as well as nude and nearly nude images or videos – to those that young people described as ‘pornographic’, including photos and videos depicting sexual acts.

I’ve seen it sometimes, some of my friends like these older boys like a year above that share like these over 18 adult videos….’ (Boy – Grade 10)

‘…and she used to post photos, like naked photos on Facebook it was very obvious that she was naked but she’d be underneath a bedsheet ….’ (Girl – Grade 9)

‘…there’s a lot of porn that comes up and they have these things called gifs…like moving pictures …and those ones are usually porn just straight out pornographic stuff and you see it coming up everywhere….’ (Girl – Grade 9)

Several participants said that seeing sexual content appearing on their social media pages made them feel awkward or uncomfortable and required them to manage the situation, both so they did not have to engage with the content and to prevent questions if others (e.g. parents) should see the material.

… (If you see sexual content on social media), You scroll past and look at other stuff. You don’t think about it.’ (Boy – Grade 9)

Yeah and then you’re just like where’s this come from ….it’s like an awkward situation….’ (Girl – Grade 11)

I have to keep a locked door now because if my Mum walks in and I’m just scrolling [through Facebook] it’s all just there.’ (Girl – Grade 9)

Popular social media sites such as Facebook and Instagram have content regulations in place and are known to regulate advertising content; there is less control over user-generated content, which is crowd-regulated or influenced by algorithms that choose content based on a user’s engagement and interest. Content may be reported to a social media site by its users and it is up to that site to decide if the content violates its published community standards (which all registered users agree to) and is removed. This process is not immediate, and in this time, the content remains seen and can be shared.

The option of deleting, unfollowing or blocking a friend/follower on social media who posts undesirable content is available to users. Some participants reported being aware of this option, but few reported that they had done this in response to seeing sexual content.

Na, I know I should but again I just can’t be bothered.’ (Boy – Grade 10)

When I was in year 8, I got Facebook and accepted everyone even randoms as friends then got all these weird guys messaging me and asking for nudes and I blocked them.’ (Girl – Grade 9)

Gender differences in exposure and content

 

While both girls and boys reported seeing user-generated sexual content across social media sites, there were some differences in the explicitness of the content described. Girls most commonly described photos of women in sexual, provocative or suggestive poses rather than more explicit content involving full nudity.

…I have never seen it [full nudity] on an Instagram; I’ve seen [girls] ridiculously push up their boobs.’ (Girl – Grade 11)

While boys also described seeing suggestive sexual images, much more of the content described was sexually explicit and involving full nudity.

…there was a page [on Facebook] for my school, specifically of naked girls….’ (Boy – Grade 9)

I notice on Twitter, still, naked photos of chicks and on Tumblr there is as well….’ (Boy – Grade 12)

The reasons for boys seeing more sexually explicit content was unclear, but it may be due to boys sharing content one-on-one or in group sharing. Boys in the focus groups, particularly older boys, described sexual photos being ‘shared’ by opening a social media page on one smartphone and passing it around so a particular image could be seen, sending it in a text or posting it on social media. It is interesting to note that these descriptions of sharing sexual content by boys was reported as being carried out by ‘others’ and not by the participants themselves.

I know like a lot of guys if they got [nude] pictures [of a girl] they wouldn’t send them to their friends but they would show their friends and sometimes it is their friends who are the irresponsible ones who go on their phone and send them to their phone and sometimes it is not even the friend and it is just the friend being cool to say he has photos.’ (Boy – Grade 12)

This weekend I went back home and had my friend showing me all of these videos he took of him and random chicks.’ (Boy – Grade 12)

There is like private groups on Facebook ….there’s a group of about 30 kids from our school and all sorts of sexual stuff gets on there.’ (Boy – Grade 12)

Girls were far less likely than the boys to report this kind of sharing of sexual images among girls. While some described being ambivalent about the sexual content they saw, others felt it was unacceptable and described disengaging from it. Indeed, one girl was explicitly condemning of a male friend sharing sexual images of his ex-girlfriend.

Well someone posts it [sexual content] but my friends would never pass that stuff around and I would totally just ignore it. You just totally scroll through.’ (Girl – Grade 10)

When Facebook and those naked selfies pages come out no one cares anymore. They [Facebook] either shut it down or people come to the conclusion that it is a wider society and it’s disgusting and not acceptable.’ (Girl – Grade 11)

I have a friend who recently broke up with his girlfriend and during their relationship to express their love they would send those types of photos and he saved those photos and was like ‘look at this stupid bitch’ and sent me the photos…it was gross.’ (Girl – Grade 10)

One area of striking gender difference was in the reported demand for sexual content. Snapchat is a social networking site that participants described as ‘made for nudes’; users send a photo or video that is automatically deleted several seconds after being viewed. As with other sites, users receive friend requests, which they accept or decline before being able to view or share content with that person, but during focus group discussions, some girls described scenarios where they had been asked or knew someone who had been asked to share sexual photos of themselves through Snapchat. In many of these scenarios, the people asking for the sexual photos were described as unknown to the participant.

…and say maybe on Snapchat…people, random people that you are not sure of will ask you for sexual photos.’ (Girl – Grade 8)

I personally know lots of girls who have been asked to send nudes on Snapchat. It’s kinda made for that – if you’re on it you either see it or some random guy is asking you for it.’ (Girl – Grade 11)

Intentionally seeking sexual content

 

Intentionally seeking out sexual content in social media was rarely reported during focus group discussions; although participants may not have felt comfortable disclosing this in a group environment. However, boys in the older age groups were candid about actively searching sexual content, specifically pornography, and reported that social media was not their preferred medium to view pornography.

If going looking for it [sexual content on social media] all you would be looking for is hot chicks and not naked chicks. If someone wanted to look for porn it wouldn’t be through social media. There are other places.’ (Boy – Grade 12)

Several young people, mostly girls, across focus groups, described knowing about or viewing the hashtag #aftersexselfie on Instagram where people uploaded (supposedly) post-sex photos or comments. Some of those who actively sought out the hashtag reported that they did so because they were curious after hearing about it from friends. There is little sense here of seeking content for titillation or pleasure, and the reports were often accompanied by a judgement of the person who originally generated the material.

Everyone was talking about it [#aftersexselfie] so I wanted to take a look. I know it’s bad but it was kinda funny, stupid but funny. I mean who would do that?’ (Girl – Grade 11)

I saw these posts the other day and ‘I just had sex with my boyfriend blah blah’ and all in year 7 and 8 ……they just want to come across as mature but seriously why would you share that?’ (Girl – Grade 10)

 

 

Discussion

 

This study investigated young people’s experience of sexual content in social media; exposure occurred through paid advertising via the website/application they were using and user-generated content through their social network. To our knowledge, this present study is the first qualitative study to describe the pathways through which young people aged under 18 years are exposed to unintended sexual content specifically through social media.

A key finding is that most of the sexual content young people encountered was unintended. The more friends/followers a young person has, the more opportunity they have for social interactions. If online social networks comprise even a few friends/followers who are interested and share sexual content among their network, then young people may be exposed to this content more often.

We solicited information about how young people felt when they saw sexual content and also what they did when they encountered it. In line with findings from Wolak et al. 2007,5 many of our participants described this sexual content exposure as unintended, and it made them feel irritated, uncomfortable and awkward. Our young participants described scrolling past content on their timelines, ignoring it, and managing their physical environment so no-one else (e.g. a parent) would see it. Although participants reported they were aware they could report sexual content to the social media site where they viewed it, few young people told us they did this; that is, young people’s response to sexual content they did not want to see was to try to ignore it. Reporting sexual content, on Facebook for example, is done using a ‘Report link’ that appears near the content itself and the details of the person reporting is kept completely confidential. This raises a valuable question about why young people may not choose to report sexual content. Further research to explain what would empower young people to act rather than ignore this content would be valuable.

Another option for young people upset by a sexual image or post on social media, which was shared by a friend or follower, would have been to unfollow or delete that person from their social media site. Although we did not ask specifically if they had ever done this, only a few participants spontaneously described deleting friends. Perceived pressure to keep a high number of friends or avoid hurt feelings may explain this apparent reticence to act. Another interpretation comes from the study by Marwick and Boyd (Mitchell) on young people and privacy in social media, which found that while young people have control over what they post on social media, they have little control over what friends post or share.19 It may be that young people see themselves as having little influence over certain types of social media interactions or with certain social media connections. Further research into how young people perceive their role (if any) in managing friends’ social media content would be valuable.

An interesting insight produced through this study is that few young people described sharing (or liking) sexual content; it was something other people did. This may be a simple social desirability effect, and we may have heard more such reports if we had conducted one-on-one interviews or anonymous surveys. These findings may also reflect previous work that describes a usually careful and deliberate decision-making process around what young people post and share online.19,20 Older boys in our study did report sharing and younger participants and girls generally did not; the careful curation of their social media feeds may be strongly connected to social norms.

This study represents a sample of young people across cultural and socioeconomically diverse areas of Sydney, but was limited to those attending schools in a large urban centre and therefore may limit generalisability to young people in other areas of Australia. We did ask young people to describe the nature of the sexual content they saw on social media, but we did not explore a definition of the term specifically, due to ethical constraints on questions/prompts. Young people may have had differing interpretations of the sexual nature of content they viewed or shared. The dynamic of focus group discussions may also have inhibited participants from revealing experiences with sexual content that differed from their peers. Even though we were limited in the directness of our questioning, a key strength of this study was participation of young people aged ≥14 years. Including young adolescents in a study on such a sensitive topic is an important factor in capturing the range of experiences of young people, some of whom were presumably not yet sexually active.13

Finally, our study examined social media broadly. It was beyond the scope of the study to explore young people’s social media interactions as a set of diverse practices across diverse platforms/tools. For example, social media sites vary in how they regulate content, how friends or followers connect with each other and how content is viewed and shared. It would be valuable for future studies to explore these nuances – recognising that social media websites/applications are also a dynamic field.

 

 

Conclusion

 

Our findings raise awareness of young people’s high levels of engagement with social media and the ubiquitous nature of sexual content. They allow for a more informed understanding of how young people’s social media engagement leads to their interactions with sexual content, even while it is not directly sought out. This is important information for those who support young people: parents, policymakers, educators and clinicians who can utilise this to educate and communicate with young people in an environment that does not judge or shame young people.

Harm-minimisation communication and education approaches that acknowledge that exposure to sexual content is inevitable and do not try to prohibit social media use or seek to prevent exposure could be more helpful for young people. Understanding that social media is important to young people and yet exposure to sexual content will happen may lead to more realistic and engaged education and awareness programs. Young people should feel safe to ask questions, share their experiences and discuss strategies to manage exposure with informed educators and parents.

 

 

Conflicts of interest

 

No potential conflicts of interest are reported by the authors.

Acknowledgements

 

The authors would like to acknowledge the NSW Department of Education and each school that took part in this research. We would especially like to thank the young people who thoughtfully and candidly shared their world of social media with us and the financial support of Australian Rotary Health and Rotary District 9690.

 

References

 

[1]  O’Keeffe GS, Clarke-Pearson K. Pediatrics 2011; 127 800–4.
CrossRef |

 

[2]  Rideout VJ. Social media, social life: how teens view their digital lives. Common Sense Media; 2012. Available from at https://www.commonsensemedia.org/research/social-media-social-life-how-teens-view-their-digital-lives [verified 19 July 2017]

 

[3]  Bober M, Livingstone S. UK children go online: final report of key project findings. London: EU Kids Online; 2005.

 

[4]  Steinberg L. Cognitive and affective development in adolescence. Trends Cogn Sci 2005; 9 69–74.
Cognitive and affective development in adolescence.CrossRef |

 

[5]  Wolak J, Mitchell K, Finkelhor D. Unwanted and wanted exposure to online pornography in a national sample of youth Internet users. Pediatrics 2007; 119 247–57.
Unwanted and wanted exposure to online pornography in a national sample of youth Internet users.CrossRef |

 

[6]  Australian Communications and Media Authority. Like, post, share: young Australian’s experience of social media. Pyrmont, NSW: Australian Communications and Media Authority, Commonwealth of Australia; 2011.

 

[7]  Green L, Brady D, Olafsson K, Hartley J, Lumby C. Risks and safety for Australian children on the Internet: full findings from the AU Kids Online Survey of 9-16-year-olds and their parents. Sydney: ARC Centre of Excellence for Creative Industries and Innovation; 2011.

 

[8]  Livingstone S, Haddon L, Görzig A, Ólafsson K. Risks and safety on the internet: the perspective of European children: full findings and policy implications from the EU Kids Online survey of 9–16 year olds and their parents in 25 countries. London: EU Kids Online; 2011.

 

[9]  Prichard J, Spiranovic C, Watters P, Lueg C. Young people, child pornography, and subcultural norms on the Internet. J Am Soc Inf Sci Technol 2013; 64 992–1000.
Young people, child pornography, and subcultural norms on the Internet.CrossRef |

 

[10]  Livingstone S, Kirwil L, Ponte C, Staksrud E. In their own words: what bothers children online? Eur J Commun 2014; 29 271–88.
In their own words: what bothers children online?CrossRef |

 

[11]  Livingstone S, Smith PK. Annual research review: harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age. J Child Psychol Psychiatry 2014; 55 635–54.
Annual research review: harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age.CrossRef |

 

[12]  Jones LM, Mitchell KJ, Finkelhor D. Trends in youth internet victimization: findings from three youth internet safety surveys 2000–2010. J Adolesc Health 2012; 50 179–86.
Trends in youth internet victimization: findings from three youth internet safety surveys 2000–2010.CrossRef |

 

[13]  Rissel C, Richters J, Grulich A, de Visser R, Smith A. Sex in Australia: first experiences of vaginal intercourse and oral sex among a representative sample of adults. Aust N Z J Public Health 2003; 27 131–7.
Sex in Australia: first experiences of vaginal intercourse and oral sex among a representative sample of adults.CrossRef |

 

[14]  Holloway IW, Dunlap S, Del Pino HE, Hermanstyne K, Pulsipher C, Landovitz RJ. Online social networking, sexual risk and protective behaviors: considerations for clinicians and researchers. Curr Addict Rep 2014; 1 220–8.
Online social networking, sexual risk and protective behaviors: considerations for clinicians and researchers.CrossRef |

 

[15]  Brown JD, L’Engle KL. X-rated sexual attitudes and behaviors associated with US early adolescents’ exposure to sexually explicit media. Communic Res 2009; 36 129–51.
X-rated sexual attitudes and behaviors associated with US early adolescents’ exposure to sexually explicit media.CrossRef |

 

[16]  Smith LW, Liu B, Degenhardt L, Richters J, Patton G, Wand H, Cross D, Hocking JS, Skinner SR, Cooper S. Is sexual content in new media linked to sexual risk behaviour in young people? A systematic review and meta-analysis. Sex Health 2016; 13 501–15.

 

[17]  Marston C, Lewis R. Anal heterosex among young people and implications for health promotion: a qualitative study in the UK. BMJ Open 2014; 4
Anal heterosex among young people and implications for health promotion: a qualitative study in the UK.CrossRef |

 

[18]  Charmaz K. The search for meanings – Grounded theory. In Smith JA, Harre R, & Van Lengenhove L, editors. Rethinking methods in Psychology. London: Sage Publications; 1996. pp. 27–49.

 

[19]  Marwick AE, Boyd D. Networked privacy: how teenagers negotiate context in social media. New Media Soc 2014; 16 1051–67.
Networked privacy: how teenagers negotiate context in social media.CrossRef |

 

[20]  Byron P, Albury K, Evers C. “It would be weird to have that on Facebook”: young people’s use of social media and the risk of sharing sexual health information. Reprod Health Matters 2013; 21 35–44.
“It would be weird to have that on Facebook”: young people’s use of social media and the risk of sharing sexual health information.CrossRef |