Center on Media and Child Health

World AIDS Day 2011: Studies on Media and HIV/AIDS

According to United Nations Programme on HIV/AIDS (Unaids) there are now 34 million people living with HIV, including 3.4 million children. To celebrate World AIDS Day 2011, we selected a list of studies which evaluate the impact of sexual, HIV and AIDS media messages on children and teens’ health:

Lemal, M. & Van den Bulck, J. (2009). Exposure to semi-explicit sexual television content is related to adolescents' reduced fear of AIDS. Eur J Contracept Reprod Health Care, 14(6), 406-409.

• This study investigates the relationship between adolescents' frequency of watching semi-explicit sexual television content and their fear of getting AIDS.

Horner, J. R. et al. (2008). Using culture-centered qualitative formative research to design broadcast messages for HIV prevention for African American adolescents." J Health Commun, 13(4), 309-25.

• This article describes a culture-centered approach for developing messages to promote sexual risk reduction in urban African American adolescents.

Ito, K. E. et al. (2008). Let's Talk About Sex: Pilot study of an interactive CD-ROM to prevent HIV/STIS in female adolescents." AIDS Educ Prev, 20(1), 78-89.

• This study explores the effectiveness of an interactive CD-ROM developed by researchers to teach adolescent females about Sexually Transmitted Infections (STIs).

Geary, C. W. et al. (2006).  Does MTV reach an appropriate audience for HIV prevention messages? Evidence from MTV viewership data in Nepal and Brazil. J Health Commun, 11(7), 665-81.

• This study examines the audience of MTV and the concurrent teaching capabilities of MTV in relation to HIV/AIDS awareness.

Escobar-Chaves, S.L., Tortolero, S.R., Markham, C.M., Low, B.J., Eitel, P.,Thickstun, P.(2005). Impact of the media on adolescent sexual attitudes and behaviors. Pediatrics, 116(1), 303-26.

• This study explores the effects of mass media on adolescent sexual attitudes and behaviors.

Collins, R. L. et al. (2004). Watching sex on television predicts adolescent initiation of sexual behavior.Pediatrics, 114(3), e280-e289.

• This study explores the relationship between exposure to sex on television and adolescent sexual behavior.

 Segal, L., et al. (2002). Developing an HIV/AIDS education curriculum for "Takalani Sesame," South Africa's "Sesame Street." Early Education & Development, 13(4), 363-78.

• This study describes the process of developing an HIV/AIDS education curriculum for "Takalani Sesame," an educational media project for young South African children.

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Use the free CMCH Database of Research to find other studies on children, media, and health.

Q: What do you get when you cross a Hollywood filmmaker with a pediatrician?

A: The Mediatrician^SM

Q:  How do I deal with inappropriate commercials during sports TV?

Q:  My 2 year old was scared by a movie, what do I do?

Q:  How much TV is too much TV?

From cyberbullying and violent video games to social networking and sexting, parents are overwhelmed by the new media environment and how it affects their children. To help parents navigate this new and changing landscape, CMCH is excited to announce the launch of Ask the Mediatrician ^SM.

Pediatrician, former Hollywood producer, parent, and CMCH founder Dr. Michael Rich
turns research-based recommendations into action steps parents can take in order to make media a positive and healthful encounter for their families.   

Also, check out our new and improved homepage!

Using Cell Phones to Learn about Sex

A new text service offers teens a way to ask questions about sex that they otherwise might feel too embarrassed to ask. The Birds & Bees Text Line, based out of the Adolescent Pregnancy Campaign of North Carolina, does not offer medical advice but does answer questions like, "What are the symptoms of gonorrhea?" or "Where can I get condoms?"

Although it can only accept texts from phones within the state, this service is one of many currently experimenting with using text messages to communicate health information to youth. Another is SEXINFO in San Francisco, whose work is similar to that of The Birds & Bees.

For those living outside of North Carolina, other private, teen-friendly resources for questions about sex include the Center for Young Women's Health, Scarleteen and Go Ask Alice.

Preventing Teen Pregnancy

Wednesday May 6 is this year's National Day to Prevent Teen Pregnancy, sponsored by the National Campaign to Prevent Teen and Unplanned Pregnancy. The goal of this day is to "help teens think carefully about sex and contraception, the possibility of pregnancy, and the lifelong challenges of being a parent,” both through events held around the country and through an online quiz that teens can take throughout the month of May.

In the past few years, research has found that youth who experience "high levels of exposure to television programs that contain sexual content are twice as likely to be involved in a pregnancy" as their peers who are exposed to low levels. Teen pregnancies are also becoming increasingly visible in media--often without any reference to the decisions that came before or the consequences that come after.

For information that adults can use to address this issue, see Managing the Media Monster. For pregnancy-prevention information geared toward teens, visit It's Your Sex Life. It offers information on topics like types of contraception that do and don't work, information about using condoms correctly, and prevention of unintended pregnancy.

Perspective on Sexting: Part III - Reactions and Responses

This is the third installment of an examination of the phenomenon of sexting by guest blogger Dr. Richard Chalfen.  

>>See part I: Teen Culture
>>See part II: Photo-sharing Behavior

After examining the historical precedents for sexting in the past two entries, I have come to the conclusion that as trite and reductive as it might sound, sexting seems to me to be a modern and slightly subversive example of teens-being-teens in the context of modern technological opportunity.  In my opinion, legal sanctions have no place here; I am not sure how the incarceration of young people and/or attaching permanent labels to their life records, is in their best interests.  

Regardless, whether legal action continues or not, there are serious consequences to the act of distributing sexual pictures and parents should be encouraged to use the current news coverage as a teachable moment.  Circumstances are just right for some effective counseling in a situation where a young person opens the door to new information and potential learning.  

In the case of media-related issues like this one, you often hear people say “Parents just need to talk to their kids!”  But few bother to suggest what should actually be said and how to open conversations up when teenagers are quick to shut them down.  Clearly there is no one successful way to respond, but you might try to emphasize that sexting makes people vulnerable to several kinds of consequences:

• Legal Consequences:  Teenagers who engaged in sexting have been charged with crimes of creating and distributing child pornography and finding themselves in varying degrees of legal turmoil. 
• Physical Consequences:  Sending sexual images to phones and social networking sites allows them to be distributed via the internet, which, in turn, facilitates their use by commercial pornographers, pedophiles or others who might want to harm or exploit young people appearing in the photographs.  
• Emotional Consequences:  Sexting can have ongoing consequences for the victim.  As one educator noted "You're going to be humiliated hundreds of thousands of times. It's totally devastating."  

Parents should also be aware that they may face difficulties as they present their criticisms and warnings, facing a minimum of three notions difficult for teenagers to grasp:

• The Future:  Parents want their kids to consider troubles they will have “later on,” “when you’re older,” “when you grow up,” or “when you’re our age.”
• Forever:  Images released into cyberspace are permanent, and can be retrieved and referenced in years to come.  
• Anonymity:  The internet is not anonymous, even though it appears to be.  People cannot hide behind a screenname or avatar. 

It is my hope that parents can use the ideas mentioned here to think more deeply about the contexts in which young people live and how this leads them to experience today’s technology-rich and image-abundant world.  

Perspective on Sexting: Part II - Photo Sharing Behavior

This is the second installment of an examination of the phenomenon of sexting by guest blogger Dr. Richard Chalfen. 

>>See part I: Teen Culture
>>See part III: Reactions and Responses

How and when did young people give pictures to one another in the past?  We know that historically young couples swapped pictures of themselves by exchanging them in person or sending them through the mail.  Though school portraits were often traded, shots of girlfriends in skimpy swim suits were often preferred.  For the past few years, the internet has become a major medium of photo exchange, through family-created websites, photo-sharing websites such as Flickr and Picassa, and now through social networking sites such as MySpace and Facebook.  Very personal pictures, including moment-of-birth shots and sexually revealing shots, are often shared very publicly over the internet.

Additional structural complexity appears when we acknowledge a series of related photographic activities:

1. Hearing daily reports of adults misusing cell phone cameras for “up-skirting” on escalators, and of cameras being placed in such public locations as department store changing rooms, locker rooms, and even bathrooms.
2. Learning that large sums of money are earned from taking and selling the “right” picture of certain people in private acts.  This occurs in situations from ordinary people using their camera phones to become citizen photo journalists, to actual photo journalists catching images of politicians taking bribe money or celebrities engaged in salacious acts.
3. Acknowledging that photo journalists, street photographers and others have struggled with differences of taking photographs and publishing photographs as two domains of activity, each with different rules, rewards and consequences.  This has resonated with ordinary people because individuals engage in two different processes when they first take a cell phone picture and then second, decide to “publish” it by sending it on to someone else.
4. Redefining the Public and the Private and the subsequent emergence of two overlapping domains.  This relationship is constantly in flux, though we could claim a considerable acceleration of movement from the private into the public. This trend is certainly not new and mass media has perhaps led the way in offering examples.  Consider very personal information about private body acts that were revealed and discussed on popular shows such as the Newlywed Game, as well as the more recent Jerry Springer models of personal revelation.  This private to public phenomenon extends to our personal pictures.  The new aspect is that once you put photos in cyberspace, they can go anywhere and will exist forever.  

Combine all of the above factors with adolescent culture and you can see an expected emergence and popularity of sexting for which relevant codes of laws, rules and standards have yet to be established and formalized.

Parents need to exert caution and care when trying to protect their children from being a participant (willing or unwilling) in sexting.  Because many parents rely on their children having cell phones to keep in touch about locations, plans, and needs, it may be far more troublesome to ban cell phones than to keep an open dialogue about concerns. 

So how can you talk to your kids about your concerns?  Tune in for tomorrow's installment of this post, which will offer some concrete ideas.

Perspective on Sexting: Part I - Teen Culture

A few weeks ago, we blogged about "sexting", which is the new term for when people send sexual text and picture messages to others.  This has been sweeping the news, especially since some teens have been hit with child pornography charges.

CMCH Senior Scientist Dr. Richard Chalfen has been investigating the use of cell phones for a few years and took an interest in this issue.  Here, he joins us as a guest blogger for a 3 part post.

>>See part II: Photo-sharing Behavior
>>See part III: Reactions and Responses

As a practicing visual anthropologist very concerned with young people, health and media culture, I have found it very helpful to adopt a structural perspective when examining an image-related or even image-centric situation.  This applies to current problems surrounding the emergence of "sexting" – the sending of sexually oriented photos of oneself on cell phones (see an introductory overview).

Many of us see this activity as something brand new -- an unfortunate, and indeed dangerous, surprise.  However, if we look deeper, social precedents have been in place for some time.  I often find that taking a historical and structural look at a “new” phenomenon often proves helpful to gain a sense of what’s going on as well as where and how to intervene if and when it is deemed necessary.

Looking at the social world that young people live within, there are at least 4 kinds of sub-cultures crucial to understanding the “sexting” phenomena.  In addition to their home, school and sometimes work cultures, they face:

1. Media Culture – Teens live in a world of mediated life where images are ubiquitous, including an increase in public and private camera surveillance.  Public imagery is more sexually explicit than ever, from television shows to magazines ads.  With the advent of YouTube, Young people are also drawn to the creation of media, not just the consumption of it.
2. Digital Culture –Teens today have grown up as "digital natives" -- they are used to being plugged-in at all times.  Camera-phones are not only embedded in everyday life, they are a part of teen identity.
3. Intense Visual Culture – Young people value personal appearance, and are cognizant of how imagery rules when it comes to entertainment and advertising.  Also important is that kids have been playing with cameras, as well as looking at TV, all their lives, even from infancy in many cases.
4. Adolescent Culture – Adolescence is a period of raging hormones, rebelliousness, competition, identity-seeking and -construction, pushing normative boundaries, seeking privacy and intimacy, living in a world where only the present matters and the future is hard to envision.

In the next installment of this post, Dr. Chalfen will examine how photo-sharing behavior in the past is connected to that of the present.

Sexting = Sexual Texting

A new trend of sending sexual texts and pictures via cell phone has lead to a number of teens being charged with child pornography.  In addition to the legal questions here, there are several sexual and emotional health concerns.

A survey from the National Campaign to Prevent Teen and Unplanned Pregnancy shows that 20% of teens report having sent or posted nude pictures or videos of themselves. Here are some other interesting statistics:

• 21% of teen girls and 39% of teen boys say they have engaged in "sexting" with someone they wanted to date or hook up with.  
• 15% of teens who have sent or posted nude/semi-nude images of themselves say they have done so to someone they only knew online.
• 29% of teens believe those exchanging sexually suggestive content are “expected” to date or hook up.
• 51% of teen girls say pressure from a guy is a reason girls send sexy messages or images

edit: video changed 04/15/09 after previous video link was broken

Discussing Risky Behavior Online is...Well...Risky

This month's issue of Archives of Pediatric & Adolescent Medicine includes two related studies about teens' online discussion of their own risk behaviors, whether real or invented, in the real world. Researchers at Seattle Children's Research Institute conducted both studies.

One study found that most teens do discuss sex, substance use, or violence on social networking sites. The other shows that many of these teens can be convinced to change their online behavior with relatively little prompting--in this case, a researcher emailed teens whose public profiles included risk-behavior content. The email recommended making their profiles private or taking down such content, pointing out that anyone--including potential employers--could see it. It also raised health concerns about the behaviors. Many students who received the email took some of her suggestions.

In both USA Today and White Coat Notes (Boston.com's blog about the Boston medical community), CMCH Director Michael Rich, MD, MPh, comments on the studies. The blog posting says that, according to Dr. RIch, "social networking sites [are] venues where young people channel their images and ideas, connecting with peers as they try on different identities. Where they can get into trouble is believing what they put on their profiles remains anonymous." And as this research suggests, a wake-up call might make them reconsider.

What I Learned at the CCFC Summit

On Friday, I presented at the Campaign for a Commercial Free Childhood's Annual Summit.  My talk about research on media and sex was well-attended and lead to some great discussion among participants. 

I wanted to post about a few resources I became aware of through the Summit and pass them on to CMCH blog readers, since you may also be interested:

• Sarah Grimes, a PhD candidate at Simon Fraser University, presented her work on interactive websites and Massively Multiplayer Online Games (MMOGs) for kids.  Turns out she has a blog about digital games and other technologies for children: Gamine Expedition
• In the main gathering area, there was an exhibit titled "Buy Me Something" by the talented photographer Nat Ward, who aims for these images to "challenge people to consider how toys and the mechanisms that facilitate their sale inform and reproduce a distinct set of culturally-defined values."  Click the arrow on the bottom right to see more images:  Buy Me Something
• The Media Education Foundation has a new video coming out in Fall 2008 about the commercialization of childhood.  CMCH Director Dr. Michael Rich makes an appearance around minute 3:37 in the trailer they previewed at the Summit: Consuming Kids