By systematic review with a three-level, mixed-effects meta-analysis, this paper examines the prevalence of sexting experiences among youths aimed at analyzing conceptual and methodological moderators that might explain its heterogeneity. A search was conducted of five bibliographic databases and grey literature up until February 2020. The risk of bias in primary studies was assessed. A total of seventy-nine articles met the set inclusion criteria. Mean prevalences for sending, receiving and forwarding sexts were .14 (95% CI: .12, .17), .31 (95% CI: .26, .36) and .07 (95% CI: .05, .09), respectively, expressed as fractions over one. Moderator analyses showed that all sexting experiences increased with age (e.g., the mean prevalence for sending sexts at the age of 12 was .04, whereas, at the age of 16, it was .21) and year of data collection (e.g., the mean prevalence for sending sexts in studies collecting data in 2009 was .07, whereas, in studies collecting data in 2018, it was .33). Subgroup analysis revealed that studies with probabilistic samples led to significantly lower mean prevalences for the sexting experiences of sending (.08, 95% CI: .06, .11), receiving (.19, 95% CI: .15, .24) and forwarding sexts (.04, 95% CI: .03, .07). Self-reported administration procedures also led to more homogeneous prevalence estimates than interviews. Prevalence estimates also varied according to the type of media content (e.g., the mean prevalence for sending sexual text messages was .22, whereas, for sending sexual images or videos, it was .12). Overall, our meta-analysis results suggest high and increasing prevalences of sending and receiving sexts among youths.

“Sexting” is generally defined as the exchange of sexual media content via the internet. However, research on this topic has underscored the need to seek greater consensus when considering different conceptual elements that make up this definition. The aim of this study was to develop and validate an instrument for measuring sexting among adolescents, in order to cover a gap identified in the previous literature. The Adolescent Sexting Scale (A-SextS for short) was developed for validation on a sample of 579 Spanish secondary school pupils between the ages of 11 and 18. Evidence for face, content, concurrent, and criterion validity were assessed. A comprehensive set of 64 items, covering six defining characteristics of sexting (e.g., actions, recipient, media format, degree of sexual explicitness), was constructed after conducting an extensive literature review, two discussion groups, and a pilot study. Sexting prevalence rates measured by A-SextS were mostly concurrent with those found in previous studies. A-SextS subscales produced statistically significant positive associations with pornography consumption and physical sexual intercourse. The study shows that A-SextS can be an integrating instrument that facilitates a rigorous and comprehensive assessment of adolescent sexting experiences, as well as the formulation of an operationalized definition of the practice of sexting.

Drug use before or during sex is a high-risk sexual behavior associated with adverse health risks and outcomes, such as increasing the likelihood of overdoses and of acquiring sexually-transmitted diseases. This systematic review and meta-analysis of three scientific databases examined the prevalence of the use of intoxicating substances, those tending to excite or stupefy the user on a psychoactive level, before or during sex, among young adults (18–29 years old). A total of 55 unique empirical studies met the inclusion criteria (48,145 individuals; 39% males), were assessed for risk of bias using the tools of Hoy et al. (2012), and were analyzed via a generalized linear mixed-effects model. The results produced a global mean prevalence of this sexual risk behavior of 36.98% (95% CI: 28.28%, 46.63%). Nonetheless, significant differences were identified between different intoxicating substances, with the use of alcohol (35.10%; 95% CI: 27.68%, 43.31%), marijuana (27.80%; 95% CI: 18.24%, 39.92%), and ecstasy (20.90%; 95% CI: 14.34%, 29.45%) significantly more prevalent than that of cocaine (4.32%; 95% CI: 3.64%, 5.11%), heroin (.67%; 95% CI: .09%, 4.65%), methamphetamine (7.10%; 95% CI: 4.57%, 10.88%), and GHB (6.55%; 95% CI: 4.21%, 10.05%). Moderator analyses showed that the prevalence of alcohol use before or during sex differed according to geographical sample origin, and increased as the proportion of ethnic whites in samples increased. The remaining demographic (e.g., gender, age, reference population), sexual (e.g., sexual orientation, sexual activity), health (e.g., drug consumption, STI/STD status), methodological (e.g., sampling technique), and measurement (e.g., timeframe) variables that were examined did not moderate prevalence estimates. Implications for sexual development interventions were discussed.