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PEDIATRICS Vol. 107 No. 1 January 2001, pp. 191-194
AMERICAN ACADEMY OF PEDIATRICS:
Sexuality, Contraception, and the Media
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ABSTRACT |
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Early sexual intercourse among American adolescents represents a major public health problem. Although early sexual activity may be caused by a variety of factors, the media are believed to play a significant role. In film, television, and music, sexual messages are becoming more explicit in dialogue, lyrics, and behavior. In addition, these messages contain unrealistic, inaccurate, and misleading information that young people accept as fact. Teens rank the media second only to school sex education programs as a leading source of information about sex. Recommendations are presented to help pediatricians address the effects of the media on sexual attitudes, beliefs, and behaviors of their patients.
Early sexual intercourse among American adolescents
represents a major public health problem. According to the most recent data, 61% of all high school seniors have had sexual intercourse, about half are currently sexually active, and 21% have had 4 or more
partners.1 Although other developed countries have similar
rates of early sexual intercourse, the United States has one of the
highest teenage pregnancy rates in the world.2 In addition
to pregnancy, early sexual intercourse carries the risk of contracting
a sexually transmitted disease (STD), including human immunodeficiency
virus (HIV). Adolescents have the highest STD rates.3
Approximately one fourth of sexually active adolescents become infected
with an STD each year, accounting for 3 million cases,4,5
and people under the age of 25 account for two thirds of all STDs in
the United States.6
One study found that the younger a girl is at first sexual intercourse,
the greater the chance that she has had involuntary or forced
sex.7 In another study, 74% of female adolescents who had
sex before age 14 reported that it was involuntary.4 In
another high school sample, 10% of adolescents reported a sexual
experience in which they did not give consent.8 Sexual
assault is one of the fastest growing crimes in the United States, with
an annual incidence of 80 per 100 000 women and a peak incidence among
16- to 19-year-olds.9,10 Acquaintance rape and date rape
account for 70% to 80% of rape crisis center contacts.11
Although early sexual activity may be caused by a variety of
factors,12,13 the media are believed to play a significant
role. The media also represent the most easily remediable influence on
young people and their sexual attitudes and behaviors.14
A recent study found that American children spend more than 38 h/wk using media (television, videos, music, computers, and video
games).15 Adolescents view television for an average of
nearly 17 h/wk16 and listen to music for several hours per
day (usually as background music).17 On average, children
between 9 and 17 years old use the Internet 4 d/wk and spend almost 2 hours online at a time.18 By the time adolescents graduate
from high school, they will have spent 15 000 hours watching
television, compared with 12 000 hours spent in the
classroom.19
In contrast to the large number of studies relating media violence to
real-life behavior, only 4 studies have explored a possible relationship between sexual content in the media and adolescents' behavior.20-23 However, there are numerous studies that
illustrate television's powerful influence on adolescents' sexual
attitudes, values, and beliefs.14,24-26 In film,
television, and music, sexual messages are becoming more explicit in
dialogue, lyrics, and behavior. Too often, these messages contain
unrealistic, inaccurate, and misleading information that young people
accept as fact. Adolescents have ranked the media second only to school
sex education programs as a leading source of information about
sex.27
American media are thought to be the most sexually suggestive in the
Western Hemisphere.28 The average American adolescent will
view nearly 14 000 sexual references per year, yet only 165 of these
references deal with birth control, self-control, abstinence, or the
risk of pregnancy or STDs.29,30 In a recent content
analysis, 56% of all programs on American television were found to
contain sexual content.31 The so-called "family hour"
of prime-time television (8:00 to 9:00 PM) contains on
average more than 8 sexual incidents, which is more than 4 times what
it contained in 1976.32 Nearly one third of family-hour
shows contain sexual references, and the incidence of vulgar language
is also increasing.33
Soap operas, which are extremely popular with adolescents and
preadolescents, might be one ideal venue for responsible sexual portrayals, yet a recent study of 50 hours of daytime dramas found 156 acts of sexual intercourse with only 5 references to contraception or
safe sex.34 Unmarried partners outnumbered married
partners by 3 to 1.34 On talk shows, sexual themes are
common, including unusual sexual habits.35
Music Television (MTV) and other sources of music videos often display
suggestive sexual imagery. In one content analysis, 75% of concept
videos (videos that tell a story) involved sexual imagery, and more
than half involved violence, usually against women.36
Although a recent content analysis found less eroticism in violent videos,37 experimental studies have found that viewing
music videos may, in fact, influence adolescents' attitudes concerning
early or risky sexual activity.38 Greater sexual content
is also found in videos that depict alcohol use.39 Music
lyrics have become increasingly sexually explicit as
well,40 and at least 2 studies have shown a correlation
between risky adolescent behaviors and a preference for heavy metal
music.17,41
Advertising also contains a significant amount of sexual imagery,
including the inappropriate use of children in provocative poses.42 Sex is used to sell most common products from
shampoo to hotel rooms, yet when children and adolescents respond to
the cues and become sexually active too young, society seems to blame
young people, not the advertisers.14 Research also shows
that heavy exposure to media sex is associated with an increased
perception of the frequency of sexual activity in the real
world.43 As a result, television may function as a kind of
"super-peer," normalizing these behaviors and, thus, encouraging
them among teenagers.14,43
The Internet offers unparalleled access to hard-core pornography with
just a few keystrokes.44-46 One recent study found that a
child exploring the Internet may be trapped in an adult site by a new
marketing technique that disables options such as the "back,"
"exit," or "close" navigation buttons.46
Despite American adults' willingness to have birth control
information discussed and advertised on television, the networks continue to resist.47 In a poll by the Centers for Disease
Control and Prevention, 86% of adults surveyed supported airing of
information about HIV and acquired immunodeficiency syndrome (AIDS)
prevention and 73% favored condoms being discussed on
television.48
There is no evidence that increased sexual knowledge or increased
access to birth control affects the likelihood of adolescents having
sexual intercourse at a younger age. Four recent studies have found
that allowing access to condoms in school-based clinics did not affect
rates of sexual activity but did increase use of condoms with
intercourse.49-52
Teaching that adolescents should not have intercourse at a young age
but, if they do, they should use contraception is a double message. But
it is a double message that every teenager in America can understand
and benefit from, and it is consistent with normal adolescent
psychology, because it acknowledges that adolescents do not always
listen to their elders.28
Television has been effective in promoting the use of
family-planning clinics in selected American
communities.53 Trial advertising of barrier-contraceptive
methods for women on local radio, local television, and national cable
television has elicited few viewer complaints and many positive
comments.53 Such advertising has been carefully developed,
is generally considered to be in good taste, and focuses on adult women
who choose to delay childbearing until a more appropriate time in their
lives.
In the absence of effective, comprehensive sex education at home or in
the schools, television and other media have become the leading sex
educators of children and adolescents today.28 With a
large number of sexual messages found in television programming and
contained in music and music videos, it seems incongruous for national
networks to avoid or censor any reference to responsible sexual behavior. Broadcast media should provide messages that support
and encourage the delay of first coitus. Media also should present
information on the use of methods to avoid unintended pregnancies and
STDs and their consequences. A few prime-time programs have done this.
Promoting responsible and healthy sexual behavior by adults and
adolescents may result in a greater percentage of wanted and
well-spaced pregnancies, with improvement in the health and well-being
of many children and their families.
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THE MEDIA AND SEXUAL LEARNING
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CONTRACEPTIVE ADVERTISING
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EVIDENCE FOR MEDIA'S POSITIVE INFLUENCE
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RECOMMENDATIONS
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Abstract
Recommendation
References
Committee on Public Education, 2000-2001
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Miriam E. Bar-on, MD, Chairperson
Daniel D. Broughton, MD
Susan Buttross, MD
Suzanne Corrigan, MD
Alberto Gedissman, MD
M. Rosario González de Rivas, MD
Michael Rich, MD, MPH
Donald L. Shifrin, MD
Liaisons
Michael Brody, MD
American Academy of Child and Adolescent Psychiatry
Brian L. Wilcox, PhD
American Psychological Association
Consultants
Marjorie Hogan, MD
H. James Holroyd, MD
Victor C. Strasburger, MD
S. Norman Sherry, MD
Staff
Jennifer Stone
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FOOTNOTES |
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The recommendations in this statement do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.
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ABBREVIATIONS |
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STD, sexually transmitted disease; HIV, human immunodeficiency virus; MTV, Music Television; AIDS, acquired immunodeficiency syndrome.
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REFERENCES |
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Pediatrics (ISSN 0031 4005). Copyright ©2001 by the American Academy of Pediatrics
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