Original studiesAdolescent sexuality and the internet: the good, the bad, and the URL☆
Introduction
The Internet is clearly a powerful tool that has become incorporated into many aspects of our daily lives. This is especially true among adolescents, most who have grown up with this technology readily available (Table 1). Its popularity leads one to ask what adolescents are doing on the Internet. Nearly all “online youth” are using it to send e-mail or instant messages. Other popular uses reported among those surveyed include school-related research, obtaining news information, getting information about movies, music, and television, and looking up health information.
Among the many needs that the Internet has served, providing health information is a particularly important niche. Before the Internet became so user friendly, one's only true method of finding health information was through magazine articles, library books, or a visit to the doctor. Aside from these limited resources, there were no readily available places to search for such information in lay terms. Now, with the Internet providing hands on information essentially for free, it is easy to see why many people have opted to use this way of obtaining numerous opinions with just the click of a button.
It has been estimated that 75% of today's youth have, at some point, used the Internet to look up health information and 24% of people 15–24 years old have reported using it “a lot” for this purpose. Additionally, 44% of online youth have used it specifically for sexual health information (second only to searches regarding such diseases as cancer and diabetes).1 According to another survey of 412 socioeconomically and ethnically diverse suburban New York tenth graders, the top three most frequently researched topics on the Internet were sexual health (e.g. sexual activities, contraception, and pregnancy), fitness and exercise, and sexually transmitted diseases (Fig. 2).2
While the specific breakdown of health topics accessed through the Internet may change somewhat among various groups sampled, it is clear that sexual health is among the most popular areas of interest to adolescents. Consequently, teenagers as a group spend more time researching sexuality topics on the Internet as compared to other issues. This is illustrated by the questions asked at one popular adolescent health website, TeenHealthFX.com (Figure 1).
Section snippets
The Good
There are a number of reasons that the Internet has become such a popular medium by which to obtain health information. According to the Kaiser Family Foundation survey, the issues regarded as most important in the search for health information include confidentiality, the ability to ask questions, knowing who produced the information, the ability to obtain data portraying different sides of an issue, finding information easily, a convenient time and place to obtain the information, the ability
The Bad
As technological advances increase the ease with which we carry on our daily routines, it is easy to allow their drawbacks to be blinded by their advantages. The myriad advantages have been of tremendous help to many young people feeling their way through the mysteries of adolescence. These same benefits often become part of a “double-edged sword” making entry into dangerous territory all too easy. For instance, the Internet has provided adolescents with the ability to ask sexual health
The Pornography Issue
Numerous surveys have been conducted in recent years to discern exactly what kids are doing on the Internet. In a Kaiser Family Foundation survey (a random sample telephone survey of 1209 young people ages 15–24) examining how young people use the Internet for health information, it was reported that 70% of young people 15–17 years old had unintentionally been exposed to pornographic websites.1 It becomes clear why such accidental exposures are so common when one takes the example of //www.whitehouse.gov
Facilitation of Physical Harm
Besides viewing developmentally inappropriate sexual content, the Internet has created a new vehicle for sexual exploration. The ease of instant communication through such mediums as chat rooms, instant messenger services, and e-mail has increased the likelihood of similar types of people finding each other and meeting anonymously for sexual purposes. Through its relative privacy the Internet can provide a unique environment that is quite different from that of traditional meeting places such
Potential for Exploitation
A particularly offensive problem that arises from the anonymous nature of the Internet is that of child exploitation. The privacy allotted by the Internet allows users to represent themselves in any way they please. Such misrepresentation has led to many documented cases of the victimization of children through child pornography and seduction. There are many cases in which people have been able to use the Internet to traffic child pornography and communicate with other pedophiles in addition to
Other Concerns
An area of health closely tied with sexuality is the important concept of developing confidence about self-image. The distortion of body image is a key element found in teenagers (and adults) with eating disorders. Thus, the “Pro-anorexia” sites found on the Internet have the potential to impact young people with eating disorders who are often confused or have distortions about the physical and emotional aspects of sexuality. A www.google.com search for “anorexia tips” yielded links to
Information Overload
Beyond problematic exposure to physically or psychologically harmful material, the Internet has the additional problem of presenting an overabundance of information with no method of screening for accuracy. A search in www.yahoo.com for “teen sexual health” yielded a list of 555,000 websites. Clearly, this is an enormous amount of information for anyone to comb through. It is not always easy to discern which of these sites may be providing reliable information and which may provide misleading
The URL: Weighing the Pros and Cons in Practice
While it has been a relatively short time since the Internet has become an integral part of most people's lives, the ramifications of internet access are many. The ease with which it provides a vast amount of information has enabled people to be better informed about their medical concerns than ever before. The anonymity and confidentiality provided by this interface has afforded more exploration into issues that may have otherwise gone without adequate discussion. This is particularly true for
Acknowledgements
The authors wish to acknowledge Dina Borzekowski, Ed.D. for her helpful feedback and critical review of the manuscript.
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Synopsis: The positive and negative impact of the Internet on adolescent sexual health is examined with guidance provided for clinicians.