From a health viewpoint, early sexual activity among US adolescents is a potential problem because of the risk of pregnancy and sexually transmitted infections. New evidence points to the media adolescents use frequently (television, music, movies, magazines, and the Internet) as important factors in the initiation of sexual intercourse. There is a major disconnect between what mainstream media portray-casual sex and sexuality with no consequences-and what children and teenagers need-straightforward information about human sexuality and the need for contraception when having sex. Television, film, music, and the Internet are all becoming increasingly sexually explicit, yet information on abstinence, sexual responsibility, and birth control remains rare. It is unwise to promote "abstinence-only" sex education when it has been shown to be ineffective and when the media have become such an important source of information about "nonabstinence." Recommendations are presented to help pediatricians address this important issue. Pediatrics 2010;126:576-582
INTRODUCTIONEarly sexual activity among teenagers can be problematic. According to the 2009 Youth Risk Behavior Survey, 46% of all high school seniors have had sexual intercourse, and 14% have had 4 partners or more. 1 Although pregnancy rates have generally been decreasing since 1991, the United States still has the highest teen pregnancy rate in the Western world, 2 and for the first time in 15 years, the birth rate increased 3% from 2005 to 2006. 3 Early intercourse also increases the risk of contracting a sexually transmitted infection (STI), including HIV, and adolescents have one of the highest STI rates of any age group. 4 Although 15-to 24-year-olds account for only one-quarter of the sexually active population in the United States, they contract nearly half of all new STIs every year. 4 A recent study by the Centers for Disease Control and Prevention revealed that 1 in 4 teenagers has had an STI. 5 Ten percent of young women who had first had sex in their teenage years reported that their first time was involuntary, and the younger they were, the more likely that was the case. 6
WHAT CHILDREN AND TEENAGERS LEARN FROM THE MEDIAAmerican children and teenagers spend more than 7 hours/day with a variety of different media. 7 Those media are filled with sexual messages and images, many of which are unrealistic. 2 On television (TV), which remains the predominant medium in terms of time spent for all young people, more than 75% of prime-time programs contain sexual THE COUNCIL ON COMMUNICATIONS AND MEDIA