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Original Investigation
April 2018

Prevalence of Multiple Forms of Sexting Behavior Among Youth: A Systematic Review and Meta-analysis

Author Affiliations
  • 1Department of Psychology, University of Calgary, Calgary, Alberta, Canada
  • 2Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
  • 3Department of Communication Studies, Universiteit Antwerpen, Antwerp, Belgium
  • 4Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston
JAMA Pediatr. 2018;172(4):327-335. doi:10.1001/jamapediatrics.2017.5314
Key Points

Question  What is the prevalence of sexting behavior among youth?

Findings  Among 39 studies (with 110 380 participants) in this meta-analysis, the mean prevalences for sending and receiving sexts were 14.8% and 27.4%, respectively, with prevalence rates increasing in recent years and as youth age. The prevalences of forwarding a sext without consent and having a sext forwarded without consent were 12.0% and 8.4%, respectively.

Meaning  Sexting is becoming a more common practice among youth; therefore, age-specific information on sexting and its potential consequences should regularly be provided as a component of sex education.


Importance  The existing literature on sexting among youth shows that sexting is a predictor of sexual behavior and may be associated with other health outcomes and risky behaviors. However, there remains a lack of consensus on the prevalence of sexting, which is needed to inform future research, intervention, and policy development.

Objective  To provide a meta-analytic synthesis of studies examining the prevalence of multiple forms of sexting behavior, analyzed by age, sex, geography, and method of sexting.

Data Sources  In an academic setting, electronic searches in MEDLINE, PsycINFO, EMBASE, and Web of Science were conducted for the period January 1990 to June 2016, yielding 1147 nonduplicate records.

Study Selection  Studies were included if participants were younger than 18 years and the prevalence of sexting explicit images, videos, or messages was reported.

Data Extraction and Synthesis  Literature review and data extraction followed established PRISMA guidelines. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive the mean prevalence rates. Thirty-nine studies met final inclusion criteria.

Main Outcomes and Measures  Meta-analyses of the prevalence of sending, receiving, and forwarding without consent, as well as having one’s sext forwarded without consent.

Results  Among 39 included studies, there were 110 380 participants; the mean age was 15.16 years (age range, 11.9-17.0 years), and on average 47.2% were male. Studies were available for sending (n = 34), receiving (n = 20), forwarding without consent (n = 5), and having a sext forwarded without consent (n = 4). The mean prevalences for sending and receiving sexts were 14.8% (95% CI, 12.8%-16.8%) and 27.4% (95% CI, 23.1%-31.7%), respectively. Moderator analyses revealed that effect sizes varied as a function of child age (prevalence increased with age), year of data collection (prevalence increased over time), and sexting method (higher prevalence on mobile devices compared with computers). The prevalence of forwarding a sext without consent was 12.0% (95% CI, 8.4%-15.6%), and the prevalence of having a sext forwarded without consent was 8.4% (95% CI, 4.7%-12.0%).

Conclusions and Relevance  The prevalence of sexting has increased in recent years and increases as youth age. Further research focusing on nonconsensual sexting is necessary to appropriately target and inform intervention, education, and policy efforts.