Exposure to sexual content and problematic sexual behaviors in children and adolescents: A systematic review and meta-analysis

Abstract

BackgroundExposure to sexual content, such as online pornography or live sexual content, has been posited in the literature as a risk factor for problematic sexual behaviors (PSBs) in children and adolescents, and has been identified as an important avenue for research and intervention, particularly given the ubiquitous access to technology among children. ObjectiveTo examine the association between live/violent and non-violent sexual content exposure and PSB among children and adolescents. Objectives also include informing future research on sexual content exposure as a risk factor for PSB, and providing clinical recommendations related to prevention and intervention. Participants and settingResults are based on 16,200 participants (28.65 % female; Mage = 14.26; range = 4.74–17.92) and 27 studies conducted in North America, Europe, Asia, and Africa. MethodsA systematic review was conducted of available literature published up to September 2021. Abstract and full-text review were conducted to assess whether studies met inclusion criteria. Random-effects meta-analyses were conducted on included studies. ResultsSignificant associations were found between exposure to non-violent sexual content and likelihood of engaging in PSB (OR = 1.82; p < .001; 95 % CI: 1.50–2.21), and between exposure to violent/live sexual content and PSB (OR = 2.52; p < .001; 95 % CI: 1.75–3.61). Sex emerged as a moderator of the association between exposure to non-violent sexual content and PSB, such that the association was stronger in studies with a greater proportion of females. ConclusionsResults support the need for future research on risk factors and mechanisms implicated in PSB. Prevention and intervention programs for children with PSB and their families could benefit from incorporating education on sexual content exposure.