A study of students at seven public high schools in Texas suggests that "sexting" was prevalent and may be linked to teens' sexual behaviors, according to a report published Online First by Archives of Pediatrics & Adolescent Medicine, a JAMA Network publication.

Sexting (a combination of the words sex and texting) is the practice of electronically sending sexually explicit images or messages from one person to another. The study background suggests pediatricians, policy makers, schools and parents have insufficient information about the nature and importance of teen sexting because there is not enough empirical data.

Jeff. R.Temple, Ph.D., of UTMB (University of Texas Medical Branch) Health, Galveston, and colleagues sought to identify the prevalence and nature of sexting, and to examine the association between sexting and sexual behaviors. The data were from part of a longitudinal study and 948 students (55.9 percent female) participated.

Teens, who ranged in age from 14 to 19 years old, self-reported their history of dating, sexual behaviors and sexting. Researchers assessed teen sexting with four questions: have they ever sent naked pictures of themselves through text or email, have they ever asked someone to send them a naked picture, have they been asked to send naked pictures of themselves to someone, and, if so, how bothered were they by it.

"Specifically, more than 1 in 4 adolescents have sent a nude picture of themselves through electronic means, about half have been asked to send a nude picture, and about a third have asked for a nude picture to be sent to them. Boys were more likely to ask and girls more likely to have been asked for a sext," the authors note.

White/non-Hispanic and African American teens were more likely than the other racial/ethnic groups to have both been asked and to have sent a sext, according to the study.

The study also suggests that for both boys and girls, teens who sexted were more likely to have begun dating and to have had sex than those who did not sext.

"Given its prevalence and link to sexual behavior, pediatricians and other tween-focused and teen-focused health care providers may consider screening for sexting behaviors. Asking about sexting could provide insight into whether a teen is likely engaging in other sexual behaviors (for boys and girls) or risky sexual behaviors (for girls)," the authors comment.

Editorial: A Closer Look at New Media

In an editorial, Megan A. Moreno, M.D., M.S.Ed., M.P.H., of the University of Wisconsin-Madison, and Jennifer M. Whitehill, Ph.D., of the Harborview Injury Prevention & Research Center, University of Washington, Seattle, write: "In summary, pediatricians should view social media as part of the integrated self of the adolescent patient. Pediatricians have new opportunities to ask their patients about social media, including questions about how time is spent in this environment."

"Discussing social media with patients may provide new ways to identify intentions or engagement in risky health behaviors," they continue.

"Health care providers and researchers may also consider building education or prevention efforts within social media, as previous work illustrates that teens may be willing to investigate topics such as sexual behavior in a social media setting," they conclude.