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Journal of Sex Research

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A Pilot Evaluation of Older Adolescents' Sexual Reference Displays on Facebook

Megan A. Moreno , Libby N. Brockman , Judith N. Wasserheit & Dimitri A. Christakis
a b c d a b c b d

Department of Pediatrics, University of WisconsinMadison Seattle Children's Research Institute Department of Global Health, University of Washington Department of Pediatrics, University of Washington

Available online: 12 Jan 2012

To cite this article: Megan A. Moreno, Libby N. Brockman, Judith N. Wasserheit & Dimitri A. Christakis (2012): A Pilot Evaluation of Older Adolescents' Sexual Reference Displays on Facebook, Journal of Sex Research, DOI:10.1080/00224499.2011.642903 To link to this article: http://dx.doi.org/10.1080/00224499.2011.642903

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JOURNAL OF SEX RESEARCH, 0(0), 110, 2011 Copyright # The Society for the Scientic Study of Sexuality ISSN: 0022-4499 print=1559-8519 online DOI: 10.1080/00224499.2011.642903

A Pilot Evaluation of Older Adolescents Sexual Reference Displays on Facebook1

Megan A. Moreno
Department of Pediatrics, University of WisconsinMadison

Libby N. Brockman
Seattle Childrens Research Institute

Judith N. Wasserheit
Department of Global Health, University of Washington

Dimitri A. Christakis
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Seattle Childrens Research Institute; and Department of Pediatrics, University of Washington Many older adolescents display sexual references on their social networking site proles; this study investigated whether these references were associated with self-reported sexual intention, sexual experience, or risky sexual behavior. Public Facebook1 proles of undergraduate freshmen were identied within 1 large U.S. university Facebook network. Prole owners who displayed sexual references (Displayers) and did not display references (Non-Displayers) were invited to complete surveys. Surveys measured sexual intention, using the Postponing Sexual Intercourse (PSI) scale, and sexual experiences. A higher PSI score was inversely related to intention to initiate sexual intercourse. Of the 118 proles that met inclusion criteria, 85 prole owners completed surveys. Prole owners were mostly female (56.5%) and Caucasian (67.1%). The mean PSI score for Displayers was 6.5 1.6, and the mean PSI score for Non-Displayers was 10.2 0.6 (p .02). There were no differences between Displayers and Non-Displayers regarding lifetime prevalence of sexual behavior, number of sexual partners, or frequency of condom use. Display of sexual references on college freshmens Facebook proles was positively associated with reporting intention to initiate sexual intercourse. Facebook proles may present an innovative cultural venue to identify adolescents who are considering sexual activity and may benet from targeted educational messages.

Social networking (Web) sites (SNSs) are immensely popular among adolescents and young adults; the vast majority have Internet access, and most report daily use (Lenhart, Purcell, Smith, & Zickuhr, 2010). Over 90% of U.S. college students use the SNS Facebook1

Support for this project was provided by an Emerging Opportunity Grant from the Center for AIDS Research at the University of Washington (AI 27757), as well as by award K12HD055894 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. We acknowledge the contributions of Fred Rivara, King Holmes, Elizabeth Cox, and Henry Young to this project. Correspondence should be addressed to Megan A. Moreno, Department of Pediatrics, University of WisconsinMadison, 2870 University Ave, Ste. 200, Madison, WI 53705. E-mail: mamoreno@ pediatrics.wisc.edu

(Ellison, Steineld, & Lampe, 2007; Ross, Orr, Arseneault, Simmering, & Orr, 2009). Sexual content is part of many adolescents SNS proles; approximately one-fourth of older adolescents display sexual references on these publicly available proles (Moreno, Parks, Zimmerman, Brito, & Christakis, 2009). Examples of sexual references include personally written texts describing sexual experiences, such as Mark got laid last night, or revealing photographs of the prole owner, such as in lingerie. SNSs may represent a new venue in which adolescent sexual behavior is explored and displayed. The meaning of these displayed sexual references, possibly as an indicator of the prole owners sexual intentions or behaviors, is not well understood.

MORENO, BROCKMAN, WASSERHEIT, AND CHRISTAKIS

SNSs in the Lives of Adolescents and Young Adults When exploring the meaning of displayed sexual references on SNSs, we must rst consider the functions that SNSs serve for adolescents and young adults. SNSs combine multiple tools into one Web site; thus, they may serve multiple functions in an adolescents life. The rst tool is the capacity to build an online social network via friending. When two prole owners accept each other as online friends, the two proles become linked, and content is mutually accessible. These online social networks may include peers, acquaintances, family, coworkers, or even college professors. SNSs are also a venue in which users may initiate and maintain romantic relationships (boyd, 2007; Ellison et al., 2007; Pujazon-Zazik & Park, 2010). A second tool provided by SNSs is access to three distinct methods of communication. These include prole-to-prole messages that are sent privately, similar to e-mail. Instant messaging, or chatting, can be used if two proles are linked as friends and both prole owners are logged onto the site at the same time. Adolescents may also display comments on their friends proles, thus allowing a public form of feedback from peers to be displayed on proles. Finally, a major developmental task in the transition between adolescent and adult lives is the development of ones identity. As adolescents navigate this developmental process, SNSs provide a technological tool and cultural venue for adolescents and emergent adults to express their identities. SNSs allow users to create a personal Web prole that may contain audio, images (e.g., downloaded images and icons, personal photographs, and video), and text (e.g., blogs and personal descriptions). Adolescents often use online tools to express their identity, as has been supported by previous studies examining adolescents use of blogs (Mazur & Kozarian, 2010). A widely used feature of some SNSs, such as Facebook, is called status updates, which allow a user to share a short text description of ones current location, emotion, or activity. SNSs also allow prole owners to create online photo albums and to share photographs with other prole owners. Proles can be updated or changed at any time. Through developing and modifying a SNS prole, users choose what pieces of their identity to publicly display at a given moment. The identity that is displayed on SNS proles is, thus, a public online identity. SNSs present opportunities for adolescents and young adults to decide how much of their identities to reveal publicly. At the time of the data collection in this study, proles were either publicly available to the Facebook network at large or privately available only to other friends whose proles were linked. Facebook has undergone numerous privacy setting changes over the past few years. Currently, privacy 2

settings include options to set pieces of the prole to public or private audiences. Just as privacy settings for the Web site itself may change, privacy settings for individual prole owners are not static; they are uid over time, and can be changed at any point. For example, a prole owner may choose to change his or her prole security from privately accessible to publicly available after a romantic relationship ends to allow access by new potential suitors. Thus, prole security settings are best viewed as a dynamic process, rather than a permanent state.

Displayed Sexual Content on SNS Proles Adolescence is frequently a time of behavioral experimentation concomitant with identity development (Neinstein & Anderson, 2002). This experimentation may also become part of the displayed identity that is presented on SNS proles. A previous study found that approximately 41% of adolescents proles displayed references to substance use, and 24% displayed references to sex (Moreno, Parks, et al., 2009). Online sexual references may include personally written descriptions of sexual behaviors or perceived sexual identity in that moment; examples may include status updates, such as Erika is goin whoring or Mary is ready to go out and get naked. Sexual references may also include intimate personal photographs, such as a picture of the prole owner posed provocatively. References to sex that are displayed in a public online venue may raise concern. Previous work among younger adolescents has shown that increased amounts of personal or sexual information increases risk for unwanted sexual solicitation or cyberbullying (Lenhart, 2007; Mitchell, Finkelhor, & Wolak, 2007; Ybarra, Espelage, & Mitchell, 2007). These references may also lead to negative consequences by sending unintended messages to potential romantic partners. A recent study investigated male college students views of displayed sexual references by females on SNS proles (Moreno, Swanson, Royer, & Roberts, 2010). Males who viewed displayed sexual references on a womans SNS prole felt a heightened expectation for sexual activity from these women, but stated they were less interested in pursuing a romantic relationship. It is unclear whether women who display sexual content are impacted by these heightened sexual expectations in positive or negative ways. In examining these online sexual displays on SNS proles, two points are worthy of consideration. First, these sexual displays may inuence other peers or romantic partners who view the SNS proles. Second, the validity of the sexual reference presented by the prole owner remains unknown.

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SEXUAL REFERENCE DISPLAYS ON FACEBOOK1

Sexual Reference Displays on SNSs: Impact on Viewers In considering the potential impact of sexual reference displays on viewers, it is helpful to consider other sources of sexual information that an adolescent typically encounters. Two important inuences on adolescent and young adult sexual attitudes and behaviors are peers and the media (Onyeonoro et al., 2011). Adolescents perceptions that peers are sexually active has been shown to inuence adolescents intentions to initiate sexual intercourse (Kinsman, Romer, Furstenberg, & Schwarz, 1998). Intention to initiate intercourse is one of the strongest predictors of initiating sexual intercourse (Gray et al., 2008). In one study, adolescents who reported intention to become sexually active in the next six months were signicantly more likely to do so, compared to peers who were uncertain or did not intend to initiate intercourse (Stanton et al., 1996). Numerous studies have illustrated the powerful role of perceived peer norms in shaping attitudes toward sexual behavior among adolescents (Lim, Aitken, Hocking, & Hellard, 2009; Skinner, Smith, Fenwick, Fyfe, & Hendriks, 2008; Wetherill, Neal, & Fromme, 2009). Social learning theory predicts that teens who see characters displaying references to behaviors, such as risky sex without experiencing negative consequences, will be more likely to adopt the behaviors portrayed (Bandura, 1977, 1986). It has further been argued that a key element of effective sexual education for adolescents is addressing social inuences in adolescents sexual decision-making (Peters, Kok, Ten Dam, Buijs, & Paulussen, 2009). Although among older adolescents these associations have been understudied, it is likely that peer inuence remains inuential as adolescents get older and become more independent from family and more immersed in peer networks. Another source of inuence on adolescents intention to initiate intercourse is the media. The most studied media in the area of sexual behavior is television (Collins et al., 2004; Kunkel, Eyal, & Donnerstein, 2007). Findings from one study support a model in which the relationship between exposure to televisions sexual content and intercourse initiation is mediated by safe sex self-efcacy among African American and White adolescents (Martino, Collins, Kanouse, Elliott, & Berry, 2005). Another study examining television viewing and adolescent sexual initiation found that among young adolescents who reported strong parental disapproval of sex, watching television for two or more hours each day and a lack of parental regulation of television programming were each associated with increased risk of initiating sexual intercourse within one year (Ashby, Arcari, & Edmonson, 2006). It has been hypothesized, on the basis of Social-Cognitive Theory, that exposure to televised sexual content could inuence adolescents safe-sex self-efcacy, sex-related outcome expectancies,

and perceived peer norms regarding sex, and that each of these could inuence intercourse initiation (Escobar-Chaves et al., 2005). Overall trends indicate that media exposure is linked to sexual outcomes, especially for women (Ward, 2003). Exposure to sexual media content likely increases adolescent sexual behavior by increasing their perceptions of social pressure to have sex (Bleakley, Hennessy, Fishbein, & Jordan, 2011). More specically, exposure to sex content leads to increased beliefs that people like them, including their friends and peers their age, are having sex. Because perceived normative pressure is not the primary determinant of ones intention to engage in sex, these changes likely produce only relatively small increments in intention and behavior. Further, it could be argued that no single medium can have enormous impact given the range of media outlets accessible to todays youth. Although many studies in this eld focus on the amount of media exposure, several gaps in the literature exist. First, few studies have focused on older adolescent populations, although previous work suggests that rst-year college students grapple with the role of media inuence in their expectations for sexual behavior (Siebold, 2011). Second, as much of the early media inuence literature has focused on venues such as television, music, and movies, less is known about newer venues such as the Internet and Facebook. One study found that among African American adolescents, greater frequency of Internet use was associated with a history of oral, vaginal, or anal sex, as well as sexual sensation-seeking (Onyeonoro et al., 2011). Finally, fewer studies have addressed aspects of viewer involvement, such as identication and perceived realism, which may be more inuential compared to absolute viewer exposure. These are salient considerations in considering the potential of Facebook inuence, as one may consider that perceived realism and identication may be more profound in this media outlet, given that most content is created by an adolescents peers. These Web sites may function as a media superpeer, promoting and establishing norms of behavior among other adolescents (Strasburger & Wilson, 2002). A previous study found that adolescents viewed displayed alcohol references on SNS proles as accurate and inuential representations of alcohol use (Moreno, Briner, Williams, Walker, & Christakis, 2009). Displayed health risk behaviors, such as sexual references, may have inuence on the attitudes, intentions, and potential behaviors of adolescents who view them. It has been argued that Facebook may have greater inuence than traditional media, as Facebook combines the power of interpersonal persuasion with the reach of mass media (Fogg, 2008). The power of interpersonal persuasion cannot be underestimated among adolescents, for whom peers are such an important source of inuence (Neinstein & Anderson, 2002; Sacerdote, 3

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MORENO, BROCKMAN, WASSERHEIT, AND CHRISTAKIS

2001). Facebook has been described as the most signicant advance in persuasion since the radio was invented in the 1890s, and initiated a new form of persuasion labeled mass interpersonal persuasion (Fogg, 2008, p. 23).

Sexual Reference Displays on SNSs: Validity of Displays SNS data is both created and consumed by adolescents, and has the reach of mass media. Thus, it may combine elements from both peer and media inuence. As displayed sexual references on SNSs have the potential to inuence their viewers, we now consider what these displays mean to the adolescents who choose to display them. Prior studies suggest that SNS displays are likely to represent the beliefs, attitudes, or actions of the prole owners (Back et al., 2011). Thus, there are several hypothesized explanations for the meanings behind displayed sexual references on Facebook. First, sexual references may represent intention to become sexually active. It is possible that the display of sexual references on Facebook is a developmental marker of the emergence of the older adolescent as a sexual person. Facebook may be a venue in which adolescents who intend to become sexually active may present this message to others. This hypothesis is supported by the Media Practice Model, which states that adolescents choose and interact with media based on who they are, or who they want to be, at the moment (Brown, 2000). Facebook may represent a new tool by which adolescents experiment with and develop their sexual identities. A second hypothesis is that sexual references may represent current sexual behaviors. These references may reect sexual expression or pleasure related to sexual behaviors. Prior studies have shown that computer use encourages high levels of self-disclosure and uninhibited personal expression, thus supporting the validity of Internet self-reporting (Fleming, 1990; Wallace, Linke, Murray, McCambridge, & Thompson, 2006; Walther & Parks, 2002). A recent study of college students found that students reported disclosing more information about themselves on Facebook than in their day-to-day, ofine life (Christodes, Muise, & Desmarais, 2009). Further, patterns of display on SNSs may also give clues to the validity of the displayed information. References to health risk behaviors are often displayed in patterns consistent with those seen in self-report studies (Moreno, Parks, et al., 2009). For example, proles that display references to one risk behavior, such as substance use, are more likely to display references to other risk behaviors, such as sex. Further, references to health risk behaviors are displayed in similar patterns among adolescents online friend groups (Moreno, Brockman, Rogers, & Christakis, 2010). 4

Third, display of sexual references may represent risky sexual behavior. We would not expect all sexually active adolescents to display sexual information on a public Web site. However, given that over 60% of adolescents are sexually active by the end of high school and only 25% of 18-year-olds display sexual references on SNS proles, the population of adolescents who display such information online may represent a higher risk population that is willing to showcase sexual behaviors in a public venue (Eaton et al., 2008; Moreno, Parks, et al., 2009). Fourth, these displays may represent experimentation with identity based on curiosity or other motivations. These displays may represent a public self and public performance that may be wholly different from their private self. However, it is worth considering that Facebook is a publicly constructed identity in which peers also provide commentary and support to the constructed identity. It is likely that a prole owner cannot stray too far from their identity without being called out by friends. The validity of these displayed sexual references remains unknown, and ndings could enhance our understanding of sexual behaviors among adolescents. The transition to college is frequently a time of sexual initiation among adolescents; however, very few college students report seeking contraception counseling or a medical visit prior to sexual initiation (American College Health Association, 2009). As intention to initiate sex is among the strongest predictors of sexual initiation, a better understanding of predictors to identify young college students who are intending to become sexually active would be useful, as it would allow an opportunity to provide anticipatory guidance prior to sexual initiation (Kinsman et al., 1998; Stanton et al., 1996). Although sexual initiation among college students is considered far less concerning or risky compared to younger adolescents, sexual behavior during the college years is often marked by patterns of sexual behavior, such as frequent casual partners or hooking up, as well as with inconsistent rates of condom use and low levels of knowledge about sexual health resources available to them (Miller, 2011; Owen, Fincham, & Moore, 2011). This older adolescent population could benet from information and resources to assist them in maintaining healthy sexual practices that avoid negative health outcomes. A better understanding of predictors of sexual activity, particularly risky sexual behavior, among college students would also have value, as it may ensure that clinicians conduct appropriate, routine sexually transmitted infection (STI) testing. The purpose of this study was to evaluate whether sexual reference display by older adolescents on a SNS was associated with sexual intention, sexual experience, or risky sexual behavior. For this study, we focused on publicly available proles to understand what these references may mean when they are purposely displayed to a global online audience.

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SEXUAL REFERENCE DISPLAYS ON FACEBOOK1

Method Study Setting and Participants This study was conducted between November 1, 2008 and January 15, 2011 and received institutional review board approval from the University of Wisconsin and the University of Washington. The study was conducted using the SNS Facebook (www.Facebook.com). This SNS was selected for several reasons. First, Facebook is the most popular SNS among our target population of college freshmen (Ellison et al., 2007; Ross et al., 2009). Second, Facebook proles are identied by the prole owners full name, leading to the expectation that the prole represents an individual (Ortutay, 2009). Third, at the time of this study, Facebook was organized into networks, which typically represent a city or university. Prole owners could join up to six networks, and viewers could access individuals proles within ones network, as well as any prole linked as an online friend. We investigated publicly available Facebook proles of freshmen undergraduate students within a large state university Facebook network. We selected college freshmen as our target population because the transition to college and associated independence can lead to increased likelihood of sexual initiation, as well as risks of negative sexual consequences, such as STIs (Fromme, Corbin, & Kruse, 2008; McGuire, Shega, Nicholls, Deese, & Landefeld, 1992). Proles were eligible for inclusion in this study if the following criteria were met: (a) the prole was publicly available, (b) the prole owner self-reported residence in the United States, (c) the prole owner indicated their age as 18 or 19 years old, and (d) the prole had been in the past 30 days. We only analyzed proles for which we could conrm the prole owners identity by calling a personal cell phone listed on the university directory or the Facebook page. Measurements and Procedures Denition of a sexual behavior reference. To dene a sexual reference, we used criteria established by the Kaiser Family Foundation (Kunkel, Eyal, Finnerty, Biely, & Donnerstein, 2005). These criteria include any depiction of sexual activity or sexually suggestive behavior. Examples of sexual references in Kaiser criteria could include discussion of personal sexual experiences or images suggesting sexual acts. Kaiser criteria also consider any talk about sexuality as a sexual reference. Because Facebook provides a specic text eld to describe the prole owners sexual orientation, and many adolescents provide this information, such responses were not included as sexual references. Coder training. Facebook proles were evaluated by one trained investigator (Libby N. Brockman).

Training included reviews of sexual reference criteria from Kaiser Family Foundation and evaluations of a separate set of approximately 100 proles. All sexual references coded in this practice dataset were then discussed with another investigator (Megan A. Moreno) to determine consensus in coding based on Kaiser criteria (Kunkel et al., 2007; Kunkel et al., 2005). After training was completed, the investigator began evaluating proles used in this study. Data collection. For this study, we calculated a sample size requirement of approximately 70 participants, given our previous data on prevalence of displayed sexual behavior on SNSs and recent data regarding rates of college student sexual behavior (Eaton et al., 2008; Moreno, Parks, et al., 2009). We used the Facebook search engine to search for proles within our selected university network that displayed a college graduation year of 2012 and a high school graduation year of 2008. This search yielded 330 proles, all of which we assessed for eligibility. The majority of excluded proles did not provide a working cell phone number on Facebook or within the online university directory for us, which was required to both conrm prole owner identity and recruit participants to the online survey (n 147). The investigators viewed all publicly accessible elements of the Facebook prole to determine if sexual references were present, including status updates, information sections, photographs, prole pictures, and bumper stickers. Each prole that displayed one or more sexual references was then labeled as a Displayer. Proles without sexual references were labeled as Non-Displayers. Survey Recruitment to online survey. For proles that met inclusion criteria (N 118), prole owners were called on their cell phones. After verifying identities, one investigator (Libby N. Brockman) briey explained the study, and requested permission to send an e-mail with further information and a link to the online survey. If the participant expressed interest in the study, an e-mail that provided detailed information about the study and a link to the online survey was sent to the prole owners university e-mail account. We used two different links to identical surveys so as to obtain aggregate results without requiring personal identiers. Participants in the Displayer group were e-mailed a link to one survey; participants in the Non-Displayer group were e-mailed a link to a separate, but identical, survey. Survey measures. The survey was administered online via a Catalyst WebQ online survey engine (Seattle: University of Washington). Our survey evaluated sexual 5

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MORENO, BROCKMAN, WASSERHEIT, AND CHRISTAKIS

intention, sexual experience, and risky sexual behavior. First, for survey respondents who reported no lifetime sexual intercourse experience, we assessed sexual intention using the Postponing Sexual Intercourse (PSI) scale. The PSI is a 12-item scale based on Social-Cognitive Theory and the Theory of Planned Behavior, which was developed to assess intention to initiate sexual intercourse (Baranowski & Parcel, 2002; Gray et al., 2008; Kahn et al., 2004; Montano, 2002). The PSI has been shown to have reliability and construct validity among adolescents who have not yet initiated sexual intercourse (Gray et al., 2008; Kahn et al., 2004). Only participants who indicated that they had never engaged in sexual intercourse were asked to respond to the following item: Many teenagers have decided not to have sexual intercourse yet. Please read the following list of reasons why teenagers have not had sexual intercourse, and rate how important each is for you. The 12 reasons listed were each scored on a three-point scale ranging from 0 (not important=does not apply), 1 (somewhat important), to 2 (very important). PSI scores theoretically range from 0 to 24; a lower PSI score is associated with greater intention to initiate sexual intercourse. Second, survey questions assessed sexual experience, including three yes=no questions about lifetime experience of oral, vaginal, and anal sex. Third, for survey respondents who answered yes to one or more questions regarding these three sexual experiences, we assessed risky sexual behavior by asking about lifetime number of sexual partners and frequency of condom use (responses included always, usually, sometimes, occasionally, or, never). These measures were individually obtained for each type of sex in which a participant reported a previous experience. The survey asked participants for demographic information including age, gender, and ethnic identity. Survey questions also included an assessment of current relationship status (e.g., single or in a relationship), sexual orientation, and a 13-item scale measuring social desirability bias using the MarloweCrowne Social Desirability Scale (Crowne & Marlowe, 1960; Robinette, 1991). For participants who completed the survey, we provided a $15 iTunes gift card as compensation. Analysis All statistical analyses were conducted using STATA Version 9.0 (Statacorp, College Station, TX). First, to evaluate whether displayed sexual references were associated with increased likelihood of initiating sexual activity, we used students t tests to evaluate differences in mean PSI scores between Displayers and NonDisplayers. We then regressed the PSI score with Displayer versus Non-Displayer status. This model included our a priori variables of interest: Displayer versus Non-Displayer, relationship status, sexual orientation, and, adjusted for gender, ethnicity and social 6

desirability bias using the MarloweCrowne Social Desirability Scale (Crowne & Marlowe, 1960). These analyses included participants who reported no lifetime vaginal sex experience, regardless of reported oral or anal sex experience, consistent with the PSI scale design. Second, to investigate associations between Displayers and Non-Displayers lifetime sexual experiences (oral, vaginal, or anal sex) we used chi-square tests. Third, to assess whether sexual display was associated with risky sexual behavior, we used students t tests to compare the mean reported number of sexual partners between Displayers and Non-Displayers. We then used chi-square tests to compare the proportion of participants who reported that they always or usually used condoms between Displayers and Non-Displayers. These nal analyses were limited to those who reported oral, vaginal, or anal sex.

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Results Sample Population All 118 eligible prole owners were contacted via cell phone, and 85 (72%) of these college freshmen completed the survey. Of participants who did not complete the survey, 11 stated they were not interested, and 22 agreed to participate but failed to complete the survey. Survey respondents were mostly female (56.5%), Caucasian (67.1%), single (60%), and heterosexual (91.7%; see Table 1). There were no differences in Facebook data regarding reported age, gender, race, or Displayer= Non-Displayer status between those who responded to the survey and those who did not.

Table 1.
Variable

Descriptive Characteristics of Survey Respondents

Number (%)

Social networking site group Displayer Non-Displayer Gender Female Male Race=ethnicity Caucasian Asian=Pacic Islander Other Hispanic=Latino African American Current relationship status Single In a relationship Unsure Sexual orientation Heterosexual Homosexual Bisexual Note. N 85.

18 (21.2) 67 (78.8) 48 (56.5) 37 (43.5) 57 15 7 4 2 (67.1) (17.6) (8.2) (4.7) (2.4)

51 (60) 29 (34.1) 5 (5.9) 77 (91.7) 2 (2.4) 5 (5.59)

SEXUAL REFERENCE DISPLAYS ON FACEBOOK1

Of the 85 included proles, 18 (21.2%) displayed sexual references and were considered Displayers. The 67 (78.8%) proles that did not display such references were considered Non-Displayers. Of the 18 Displayers, there were more males (66.7%) than females (33.3%; p .03). There were no signicant differences between Displayers and Non-Displayers regarding age, ethnicity, current relationship status, or sexual orientation. There was no difference in mean score on the MarloweCrowne Social Desirability Bias Scale between Displayers and Non-Displayers. Table 1 illustrates these data. Intention to Initiate Vaginal Sex Forty of the 85 respondents (47.1%) reported no vaginal sex experience, and completed the PSI scale. Displayers demonstrated greater intention to initiate sexual intercourse, with a mean PSI score of 6.5 (SD 1.6) compared to Non-Displayers, whose mean PSI score was 10.2 (SD 0.6; p .02). Table 2 illustrates these data. In multivariate analysis, a lower PSI score (increased intention to initiate sexual intercourse) was associated with Displayer status (b 5.20; p < .001). There were no differences in PSI scores by gender, age, current relationship status, or sexual orientation. Sexual Experience Almost 70% of our survey respondents reported having had oral, vaginal, or anal sex. Most reported oral
Table 2. Self-Reported Sexual Intention by College Freshmen Who Have Not Initiated Vaginal Intercourse
Variable Number (%) PSI Scale Score: M (SD)a 6.5 (4.4) 10.2 (3.5)

sex experience (63.5%), approximately one-half reported vaginal sex experience (52.9%), and a minority reported anal sex experience (16.5%). Table 3 illustrates these data. There were no differences between Displayer or Non-Displayer statuses for any of these reported sexual experiences. We noted a trend that Displayers were approximately twice as likely to report oral sex experience (odds ratio 2.2; 95% condence interval 0.66 7.48; p .19). Risky Sexual Behavior The average number of sexual partners for oral sex was 2.5 (SD 2.2), vaginal sex was 2.4 (SD 1.9), and anal sex was 1.1 (SD 0.5). Few participants reported that they always or usually used a condom for oral sex (11.1%), whereas most reported that they always or usually used a condom for vaginal sex (68.8%), and many reported that they always or usually used a condom for anal sex (42.8%). Table 4 illustrates these data. There were no statistically signicant differences in sexual risk between sexually experienced Displayers and Non-Displayers.

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Discussion Our ndings suggest that sexual references displayed on Facebook proles of college freshmen were associated with intention to become sexually active. We did not nd a signicant association between the online display of sexual references and either sexual experience or risky sexual
Table 3. Self-Reported Sexual Experience by College Freshmen
Number (%) Reporting Lifetime Experience Variable 9.6 (3.8) 9.2 (4.3) 9.1 (4.3) 9.6 (3.9) 9.9 (3.8) 9.3 (4.7) 7.3 (1.3) 9.9 (3.9) 8.4 (4.3) 8.0 (1.4) Total for all participants Social networking site groupa,b Displayer (n 18) Non-Displayer (n 67) Gendera,b Female (n 48) Male (n 37) Sexual orientationb,c,d Heterosexual (n 77) Homosexual (n 2) Bisexual (n 5) Current relationship statusb,c Single (n 51) In a relationship (n 29) Unsure (n 5) Oral Sex 54 (63.5%) 14 (77.8%) 40 (59.7%) 29 (60.4%) 25 (67.5%) 50 (64.9%) 0 (0.0%) 4 (80.0%) 29 (56.9%) 22 (75.9%) 3 (60.0%) Vaginal Sex 45 (52.9%) 10 (55.6%) 35 (52.2%) 25 (52.1%) 20 (54.1%) 41 (53.3%) 1 (50.0%) 2 (40.0%) 23 (45.1%) 19 (65.5%) 3 (60.0%) Anal Sex 14 (16.5%) 3 (16.7%) 11 (16.4%) 7 (14.6%) 7 (18.9%) 13 (16.9%) 0 (0.0%) 1 (20.0%) 6 (11.8%) 6 (20.7%) 2 (40.0%)

Social networking site groupb,c Displayer 8 (20.0) Non-Displayer 32 (80.0) Genderb,c Female 23 (57.5) Male 17 (42.5) Ageb,c 18 13 (32.5) 19 27 (67.5) Sexual orientationc,d Heterosexual 37 (97.4) Homosexual 1 (2.6) Bisexual 2 (5.0) Current relationship statusc,d Single 28 (70.0) In a relationship 10 (25.0) Unsure 2 (5.0)

Note. N 40. Total Postponing Sexual Intercourse (PSI) scale score: M 9.5 (SD 3.9). a The PSI scale was administered to those who reported no vaginal intercourse experience regardless of oral sex or anal sex experience. b Mean comparison using students t tests. c Proportion comparison using chi-square. d Mean comparison using analyses of variance. p .02.

Note. N 85. a Mean comparison using students t tests. b Proportion comparison using chi-square. c Mean comparison using analyses of variance. d One participant did not complete this question.

MORENO, BROCKMAN, WASSERHEIT, AND CHRISTAKIS

Table 4.

Self-Reported Sexual Risk among College Freshmen

M (SD) Reported Number of Sexual Partners Oral Sex (n 54) 2.5 (2.2) 3.1 (2.8) 2.4 (1.9) 2.8 (2.4) 2.2 (1.9) 3.0 (2.4) 2.2 (2.1) 2.6 (2.3) 0.0 (0.0) 1.8 (0.9) 2.6 (2.4) 2.1 (1.3) 5.3 (4.2) Vaginal Sex (n 45) 2.4 (1.9) 2.9 (2.9) 2.3 (1.5) 2.3 (1.6) 2.6 (2.2) 2.7 (1.7) 2.3 (2.0) 2.0 (1.9) 1.0 (0.0) 1.0 (0.0) 2.4 (1.8) 2.0 (1.4) 5.3 (3.2) Anal Sex (n 14) 1.1 (0.5) 1.7 (1.2) 1.0 (0.0) 1.0 (0.0) 1.3 (0.8) 1.0 (0.0) 1.4 (0.9) 1.2 (0.6) 0.0 (0.0) 1.0 (0.0) 1.0 (0.0) 1.0 (0.0) 2.0 (1.4) Number (%) Reporting Always or Usually Use Condoms Oral Sex (n 54) 6 (11.1%) 1 (7.1%) 5 (12.5%) 4 (13.8%) 2 (8.0%) 1 (4.8%) 5 (15.2%) 5 (10.0%) 0 (0.0%) 1 (25.0%) 2 (6.9%) 3 (13.6%) 1 (33.3%) Vaginal Sex (n 45) 31 (68.8%) 8 (80.0%) 23 (65.7%) 15 (60.0%) 16 (80.0%) 11 (61.1%) 20 (74.1%) 29 (70.7%) 1 (100.0%) 2 (100.0%) 17 (73.9%) 11 (57.9%) 3 (100.0%) Anal Sex (n 14) 6 (42.8%) 2 (66.7%) 4 (36.4%) 3 (42.9%) 3 (42.9%) 2 (22.2%) 4 (80.0%) 6 (46.2%) 0 (0.0%) 1 (100.0%) 1 (16.7%) 3 (50.0%) 2 (100.0%)

Variable Total for all participantsa,b Social networking site groupa,b Displayer Non-Displayer Gendera,b Female Male Agea,b 18 19 Sexual orientationb,c,c Heterosexual Homosexual Bisexual Current relationship statusb,c Single In a relationship Unsure
a

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Note. N 59. Mean comparison using students t tests. b Proportion comparison using chi-square. c Mean comparison using analyses of variance. d One participant did not complete this question.

behavior, although we noted a trend that suggested an association between Displayer status and likelihood of having engaged in oral sex. These ndings suggest that the display of sexual references on Facebook is a developmental marker of the emergent adult as a sexual person. The Media Practice Model suggests that adolescents choose and interact with media based on who they are, or who they want to be, at the moment (Brown, 2000). Since transition to college involves signicant efforts toward identity development, Facebook may provide a novel means for developing ones sexual identity (Neinstein & Anderson, 2002). It is possible that the display of sexual references on a Facebook prole is associated with the emergence of the adolescent as a sexual person, representing consideration of sexual intercourse or precursors to vaginal sexual activity, such as oral sex. Our ndings are consistent with previous work that found that adolescents frequently use online venues to display clues about their romantic intentions and experiment with romantic communication (Smahel & Subrahmanyam, 2007; Young, Dutta, & Dommety, 2009). Just as adolescents ofine sexual development progresses through predictable stages, their online sexual development may also be marked by certain online displays (Savin-Williams & Diamond, 2000). It is possible that as adolescents mature in their sexual relationships, these displays are no longer maintained on the Facebook prole. This information may be useful to college student health providers and researchers in two important ways. First, given the rising popularity of new media among 8

adolescents, health care providers and researchers may be increasingly called on to provide interpretation or education regarding the content of SNS proles. Educators and health care providers who work with adolescents may nd an enhanced understanding of the possible meaning and impact of displayed sexual content on SNSs useful for tailoring related educational messages about contraception. Second, these ndings suggest new opportunities to promote targeted education about safe sex practices among college students. Given that Facebook advertising is triggered by keywords present on the SNS prole, it is possible that keywords related to sex could trigger targeted messages promoting campus resources for contraception or STI testing. Previous work has illustrated that college students have low levels of knowledge about availability of sexual health resources, such as emergency contraception (Miller, 2011). At present, prole owners already receive pop-up advertisements tailored to their displayed status updates, which may include advertisements for diet programs or online educational programs. The intention interval between display of sexual content on Facebook and engagement in sexual intercourse may represent a critical time period during which clinicians, health educators, or even Facebook itself could deliver targeted education or prevention messages. Some previous work has suggested that adults were receptive to public health education campaigns about safer sex practices (Evans, Davis, Umanzor, Patel, & Khan, 2011).

SEXUAL REFERENCE DISPLAYS ON FACEBOOK1

There are several potential limitations to this evaluation. We evaluated proles from only one SNS and one university, and participants were limited to those who maintain public Facebook proles and allowed their phone numbers to be listed either in the university directory or on Facebook. The extent to which ndings could be generalized to other SNSs or other adolescent populations is not known; however, our ndings parallel those of our prior study of 18-year-olds on MySpace regarding the overall presence of sexual reference display (Moreno, Parks, et al., 2009). Because we focused on 18-year-olds, generalizing results to younger adolescents may not be warranted. Our goal for this study was to illustrate associations between displayed sexual references and sexual intentions or experiences among college students during their transition to college. Further evaluation is needed among younger adolescents who are at higher risk of consequences relating to sexual initiation. It is possible that among younger adolescents, sexual reference display may be more strongly associated with sexual intention, and the consequences of early sexual initiation are often more serious (ODonnell, ODonnell, & Stueve, 2001). In addition, it could be argued that Non-Displayers may be more privacy-oriented and less likely to report sexual intention or experience. To address potential differences in social desirability bias between Displayers and Non-Displayers, we used the MarloweCrowne Social Desirability Bias scale (Crowne & Marlowe, 1960), and found no differences between these two groups. In addition, we administered the PSI scale to those who had reported no vaginal sexual experience, which is the population for which the scale was developed and evaluated. This provided us limited opportunities to evaluate adolescents regarding oral or anal sex, or to evaluate participants differences in prole displays among young men and women who are seeking=interacting with same-sex partners. Researchers could consider adapting the PSI instrument to include intentions toward sexual activity other than vaginal sex. Given our small sample size and ndings that only 20% of prole owners were in the Displayer category, future studies with larger sample sizes to further explore these ndings are warranted. Further, because this study was cross-sectional in design, we cannot infer causality or directionality in the relationship between intention to initiate intercourse and displaying sexual references on Facebook. Finally, to preserve the anonymity of our participants information, we provided links to the online survey and collected data in aggregate. Thus, we were unable to assess particular participants Facebook data and survey responses. To our knowledge, this is the rst study to demonstrate a relationship between displayed SNS sexual references and reported sexual intention. Further studies should evaluate SNS displays among younger teens, and consider how to effectively communicate with adolescents regarding health information displayed on SNSs.

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