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How We Communicate Behavior Matters: Adolescent Sexual Behavior in the Era of Streaming Television
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2025-05
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Public Health
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https://doi.org/10.34944/knqk-6e96
Abstract
Sexually transmitted infections (STIs) in the United States continue to be a threat to the country’s public health and prove to be an enduring public health challenge. Although most STIs are treatable, if left untreated they can result in a range of mild to severe physical symptoms. Adolescents are a particularly at-risk population, so understanding why STI rates continue to rise in this despite public health efforts to decrease them is crucial. Research has consistently found that media has a strong impact on the performance of unsafe sexual behaviors, particularly among adolescents. However, the role of new media and streaming television has not yet been explored, even though it is currently the dominant medium to distribute television content and often has sexually explicit content. The Theory of Planned Behavior (TPB) may help to predict and understand the motivational influences of new media use on sexual behavior, specifically those that are not attributed to an individual’s volitional control. Additionally, the Extended Parallel Process Model (EPPM) can help identify whether adolescents perceive STIs to be a threat and can help inform how to promote healthy sexual behaviors. In the context of media, we can use the EPPM to better analyze how media portrays the threat of STIs and unsafe sexual behaviors that the media has popularized. Using constructs from the TPB and the EPPM, this study developed an interview guide and survey with a sample of college students from a United States university (for interviews n=20, for surveys n=190). For the interviews, applied Thematic Analysis using a phenomenological underpinning informed the extrapolation of meaningful patterns across the collected data to identify themes and broaden the transferability of findings. For the survey, Spearman’s test and the Mann Whitney U test were used to understand how new media use correlates with theoretical constructs. Mediation and moderation tests were also conducted. Results of the interviews indicate that sexually explicit media in streaming television has a positive association with the performance of unsafe sexual behaviors among adolescents. Quantitative results reveal there are also theory and research informed item constructs (such as normative beliefs and substance use) that may impact unsafe sexual behaviors among adolescents. This study provides foundational research on this topic that can be built upon by future studies and interventions aimed at decreasing the rates of STIs among the adolescent population (and in the United States at large).
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