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. Author manuscript; available in PMC: 2010 Dec 22.
Published in final edited form as: Am J Prev Med. 2009 Apr;36(4):317–323. doi: 10.1016/j.amepre.2008.11.011

Exposure to Sexual Lyrics and Sexual Experience Among Urban Adolescents

Brian A Primack 1, Erika L Douglas 1, Michael J Fine 1, Madeline A Dalton 1
PMCID: PMC3008595  NIHMSID: NIHMS256342  PMID: 19285196

Abstract

Background

Two thirds of all sexual references in music are degrading in nature, yet it remains uncertain whether these references promote earlier sexual activity. The purpose of this study was to determine if exposure to lyrics describing degrading sex in popular music is independently associated with sexual behavior in a cohort of urban adolescents.

Methods

All ninth-grade health students at three large urban high schools completed in-school surveys in 2006 and 2007. Participants’ exposure to lyrics describing degrading sex was computed with overall music exposure and content analyses of their favorite artists’ songs. Outcomes included sexual intercourse and progression along a noncoital sexual continuum. Multivariable regression was used to assess independent associations between exposure to lyrics describing degrading sex and outcomes.

Results

The 711 participants were exposed to 14.7 hours each week of songs with lyrics describing degrading sex (SD=17.0). Almost one third of participants (n=216) had previously been sexually active. Compared to those with the least exposure to lyrics describing degrading sex, those with the most exposure were more than twice as likely to have had sexual intercourse (OR=2.07; 95% CI=1.26, 3.41), even after adjusting for all covariates. Similarly, among those who had not had sexual intercourse, those in the highest tertile of exposure to lyrics describing degrading sex were nearly twice as likely to have progressed along a noncoital sexual continuum (OR=1.88; 95% CI=1.23, 2.88) compared to those in the lowest tertile. Finally, the relationships between exposure to lyrics describing nondegrading sex and sexual outcomes were not significant.

Conclusions

This study supports an association between exposure to lyrics describing degrading sex in popular music and early sexual experience among adolescents.

Introduction

Early sexual intercourse and the early progression of other sexual behaviors are of concern because of their direct relationship to sexually transmitted infections1–4 and costly, unwanted teenage pregnancies.4–6 Recent data indicate that one fourth of all female adolescents in the U.S.—and one half of African-American female adolescents—have sexually transmitted infections.7 More than 750,000 American teenagers become pregnant each year,8 giving the U.S. one of the highest rates of teenage pregnancy in the developed world.9

During the crucial adolescent years, young people in the U.S. are exposed to 2.4 hours of music per day, or >16 hours per week.10 There are few limits to this access to music; 98% of children and adolescents live in homes with both radios and CD/MP3 players, and 86% of those aged 8–18 years have CD/MP3 players in their bedrooms.10 These figures have increased substantially over the past decade.10,11

More than one third of popular songs contain explicit or strongly implied references to sexual activity,12 and there is strong theoretical and initial empirical support that exposure to such media may lead to early sexual activity.13,14 According to the social cognitive theory,15 people learn not only by direct experience but also by exposure to modeled and rewarded behavior, such as that represented in popular music.15–17 Music is well known to connect deeply with adolescents and to influence identity development, perhaps more so than any other entertainment medium.13,18–20

References to sexual intercourse in popular music lyrics are generally either degrading or nondegrading (Table 1). Degrading sex is defined as sex that (1) is based only on physical characteristics and (2) contains a power differential instead of being mutually consensual.12,21,22 Degrading references constitute two thirds of all sexual references in popular music,12 and in particular may promote early sexual activity. This is because they may encourage youth to play out the described roles (sex-driven male partner and acquiescent female partner) rather than resolving their true desires and anxieties surrounding sexual activity.14,21

Table 1.

Examples of popular music lyrics describing degrading and nondegrading sex

Type of sex Lyrics
Degrading Get on top then get to bouncing round like a low rider
I’m a seasoned vet when it come to this shit
After you work up a sweat you can play with the stick
I’m tryin to explain baby the best way I can
I melt in your mouth girl, not in your hands
Ay bitch! Wait ’til you see my dick
Wait ’til you see my dick
Ay bitch! Wait ’til you see my dick
I’m gonna beat that pussy up
Nondegrading Come a little closer baby, I feel like strippin’ it down
Back to the basics of you and me
And what makes the world go round
Every inch of you across my skin
I wanna be stronger than we’ve ever been
I’m here to cater to you
Any thing that you want me to do I’ll do it
Cause I’ll be your lover
I’ll be your lover
I’ll be your best friend
Tell me what I gotta do
Tell me what I gotta do and I’ll do it
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Initial reports suggest that those exposed to more-degrading sexual references in popular music lyrics have greater odds of initiating sexual experimentation at a younger age,21 but there is a need for replication of these results using varied methodologies and populations. In particular, these findings should be confirmed among African-American and socioeconomically disadvantaged populations. Although these individuals are at greatest risk for the undesirable sequelae of early intercourse,7 prior work in this area has not focused on these more at-risk populations.21 Additionally, the measurement of exposure to sexually oriented lyrics presents an important challenge for researchers. Whereas prior work has measured exposure to sexual lyrics with Likert-type checklists,21 it may be valuable to confirm those findings when using more-intensive information—generated directly by students—that is related to music exposure.

The purpose of this study was to determine if exposure to lyrics describing degrading sex is independently associated with sexual behavior in an urban, socioeconomically disadvantaged cohort of adolescents, even when using an intensively generated assessment of exposure to sexually descriptive lyrics. It was hypothesized that, for both young men and women, exposure to lyrics describing degrading sex in popular music would be independently associated with early sexual experience. It also was hypothesized that exposure to lyrics describing nondegrading sex would not be significantly linked to prior sexual experience.

Methods

Design, Setting, and Participants

This cross-sectional analysis used baseline data from a randomized trial comparing two different antismoking programs. For this study, all students enrolled in ninth-grade health classes at three large high schools located in urban, low-income areas of Pittsburgh PA completed a survey in 2006 and 2007 (n=857). Overall, approximately 50% of students at these schools are African American; more than half of students receive free or reduced-cost school lunches, and the student body is equally divided by gender.

Sample

Of the 894 students who were eligible during the first 2 years of data collection (i.e., they were ninth-grade health students in one of the three target schools during that time), 857 (96%) completed the survey. Of those, 711 had complete exposure data (i.e., at least one of their three favorite artists performed one of Billboard magazine’s top songs during the years 2005–2006). This represented 80% of those eligible. The final sample contained 54% female students and 56% African-American students. The average age was 15.0 years (SD=0.8; range: 13–18; Table 2).

Table 2.

Sample characteristics by ever having had intercourse

n=711 Has had intercourse n=216 (%) p
Exposure to lyrics describing degrading sex <0.001
 Lowest tertile (0–2.7) 231 20.6
 Middle tertile (2.8–17.5) 234 30.3
 Highest tertile (17.6–70) 231 44.6
Exposure to lyrics describing nondegrading sex 0.67
 No 576 32.6
 Yes 135 30.7
Age (years) <0.001
 ≤15 439 26.4
 >15 272 41.6
Gender <0.001
 Male 328 42.7
 Female 383 23.3
Race
 White 281 25.7 0.003
 Black 395 39.5 <0.001
 Other 103 25.0 0.11
Maternal education 0.11
 Did not graduate high school 110 40.8
 Graduated high school but not college 268 32.1
 ≥College degree 333 29.6
Grades <0.001
 A’s and B’s 382 19.6
 <B’s 323 47.1
Demanding parenting 0.07
 Lowest tertile (0–2) 362 36.1
 Middle tertile (2.1–2.3) 124 30.4
 Highest tertile (2.4–3) 218 26.8
Responsive parenting 0.07
 Lowest tertile (0–1.7) 286 36.9
 Middle tertile (1.8–2.3) 271 27.5
 Highest tertile (2.4–3) 148 32.2
Sensation seeking 0.01
 Lowest tertile (0–1.5) 296 28.1
 Middle tertile (1.6–2) 253 30.9
 Highest tertile (2.1–3) 156 43.5
Rebelliousness <0.001
 Lowest tertile (0–1.3) 317 21.4
 Middle tertile (1.4–1.7) 157 36.7
 Highest tertile (1.8–3) 232 44.3
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Note: Figures do not always sum to total sample size because of missing data.

Procedures

The study was approved by the University of Pittsburgh IRB. Students provided assent on computer terminals, and parents were informed about the survey and were offered the opportunity to refuse participation. Students entered all information directly onto computer terminals in school computer laboratories. In the few instances when there were not sufficient computer terminals, students used paper copies of the survey. They did not enter their names or any other unique identifiers.

Measures

Independent variables: exposure to lyrics describing degrading and nondegrading sex

Students reported (1) the number of hours per day that they listen to music and (2) their favorite musical artists. Students were asked to estimate separately their exposure to popular music on weekdays, Saturdays, and Sundays, because prior research demonstrates that these exposures can be very different from one another.10,11 Through a detailed content analysis,12,23 the percentage was calculated of each artist’s most popular songs that contain lyrics describing degrading sex. An exposure score for lyrics describing degrading sex was then computed by multiplying each student’s hours of music exposure by the percentage of his or her favorite artist’s songs that contain lyrics describing degrading sex. Finally, that score was divided into tertiles: low exposure, medium exposure, and high exposure. Students reported in order their three favorite artists, whose names they typed in blank spaces (i.e., they did not select from a list). If a first-choice favorite artist was not represented in the database of top popular artists, then the second- or third-choice favorite was used as necessary.

A similar algorithm was used to estimate exposure to lyrics describing nondegrading sex. However, such exposure could not be divided into tertiles, because only 20% of the sample chose favorite artists who sang about nondegrading sex. This was expected for two reasons: these artists are less popular among young people, and, compared with songs portraying degrading sex, far fewer songs are produced that portray nondegrading sex.12 Thus, to estimate exposure to lyrics describing nondegrading sex, a dichotomous variable was developed to distinguish those songs with lyrics describing nondegrading sex and those without.

Methods for the content analysis have been previously described in detail.12,23 In brief, two coders independently analyzed for sexual material the top 535 songs from 2005 and 2006 according to Billboard magazine’s year-end charts. If there were multiple song versions (e.g., edited or explicit), the version that Billboard magazine reported had the greatest exposure was the one coded. First, the coders used a dichotomous variable to indicate if sexual intercourse—defined for this analysis as penile–vaginal sex, penile–anal sex, or oral sex—was either explicit or implicit. Then, a separate variable was used by each coder to classify songs with sexual activity as either degrading or nondegrading. Table 1 contains examples of degrading and nondegrading sexual references. According to the Landis and Koch framework24 for κ values, initial coders had moderate agreement on sexual intercourse (κ=0.46) and substantial agreement on degrading versus nondegrading sexual intercourse scores (κ= 0.71).24 After an iterative process of adjudication, additional training, and codebook clarification, coders agreed on all final codes.

Dependent variables: sexual behavior

Sexual behavior was measured in two ways. First, a dichotomous measure indicated whether the participant had ever had sexual intercourse (yes versus no). For the survey, sexual intercourse was defined as when a boy puts his penis in a girl’s vagina. A validated scale was also used to measure an adolescent’s progression along a noncoital sexual continuum.25 The adolescent received a score of 0 if he or she had never kissed; 1 if he or she had kissed only; 2 if he or she had “made out” (defined for the participant in parentheses as kissed for a long time); 3 if the respondent had touched breasts or had breasts touched; 4 if he or she had touched genitals or had genitals touched; and 5 if he or she had given or received oral sex.25

Covariates

Data were collected on a number of sociodemographic characteristics that have been related to sexual intercourse in prior studies. These included age, gender, race, maternal education, and grades. Items were also included from validated scales measuring two dimensions of authoritative parenting,26 sensation seeking,27 and rebelliousness.28 All covariates are listed in Tables 2 and 3.

Table 3.

ORs for sexual experience based on exposure to lyrics describing degrading sex

Has had intercourse (dichotomous) n=216
OR (95% CI) unadjusted AORa (95% CI)
Exposure to lyrics describing degrading sex
 Lowest tertile (0–2.7) 1.0 (ref) 1.0 (ref)
 Middle tertile (2.8–17.5) 1.67 (1.08, 2.58)** 1.41 (0.85, 2.33)
 Highest tertile (17.6–70) 3.10 (2.04, 4.72)* 2.07 (1.26, 3.41)**
Age (years)
 ≤15 1.0 (ref) 1.0 (ref)
 >15 1.99 (1.43, 2.77)* 1.97 (1.34, 2.91)**
Gender
 Male 1.0 (ref) 1.0 (ref)
 Female 0.41 (0.29, 0.57)* 0.36 (0.25, 0.53)*
Race
 White 0.60 (0.43, 0.84)** 1.46 (0.70, 3.02)
 Black 2.18 (1.55, 3.06)* 2.48 (1.22, 5.04)**
 Other 0.66 (0.40, 1.10) 0.94 (0.49, 1.80)
Maternal education
 Did not graduate high school 1.0 (ref) 1.0 (ref)
 Graduated high school but not college 0.69 (0.43, 1.11) 0.73 (0.42, 1.28)
 ≥College degree 0.61 (0.38, 0.97)** 0.55 (0.32, 0.94)**
Grades
 A’s and B’s 1.0 (ref) 1.0 (ref)
 <B’s 3.66 (2.59, 5.16)* 2.47 (1.67, 3.65)*
Demanding parenting
 Lowest tertile (0–2) 1.0 (ref) 1.0 (ref)
 Middle tertile (2.1–2.3) 0.78 (0.49, 1.22) 0.69 (0.41, 1.18)
 Highest tertile (2.4–3) 0.65 (0.45, 0.95)** 0.73 (0.46, 1.19)
Responsive parenting
 Lowest tertile (0–1.7) 1.0 (ref) 1.0 (ref)
 Middle tertile (1.8–2.3) 0.65 (0.45, 0.94)** 0.73 (0.47, 1.12)
 Highest tertile (2.4–3) 0.81 (0.53, 1.25) 1.09 (0.62, 1.89)
Sensation seeking
 Lowest tertile (0–1.5) 1.0 (ref) 1.0 (ref)
 Middle tertile (1.6–2) 1.14 (0.78, 1.67) 1.08 (0.69, 1.68)
 Highest tertile (2.1–3) 1.97 (1.29, 2.99)** 1.75 (1.05, 2.93)**
Rebelliousness
 Lowest tertile (0–1.3) 1.0 (ref) 1.0 (ref)
 Middle tertile (1.4–1.7) 2.13 (1.38, 3.29)** 1.70 (1.02, 2.83)**
 Highest tertile (1.8–3) 2.93 (2.00, 4.31)* 2.00 (1.25, 3.21)**
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a

Adjusted for all variables in the table

*

p<0.001;

**

p<0.05

Analysis

Descriptive analyses were used to summarize sample characteristics across sexual outcomes. Multivariable analyses were used to assess associations between independent variables (exposure to lyrics describing degrading and nondegrading sex) and sexual behavior (intercourse and, for those who had not had intercourse, progression along a noncoital sexual continuum). Logistic regression was used for the dichotomous variable (intercourse), and ordered logistic regression was used for the ordered categorical outcome (noncoital sexual continuum). By definition, analyses related to the noncoital sexual continuum involved only participants who did not report prior sexual intercourse (n=475). The primary multivariable models controlled for all covariates that had bivariate relationships with the outcome at or below the threshold of p<0.15. Additionally, to determine the robustness of results, all logistic regression analyses were conducted using stepwise backward regression, and all analyses were conducted using the independent variable (exposure to lyrics describing degrading sex) as continuous rather than categorical. For the analyses involving the ordered categorical outcome (noncoital sexual continuum), the proportional odds assumption was tested, and it was not violated.29

In multivariable analyses, possible interactions between exposure to lyrics describing degrading sex and age, gender, and race were tested. Participants with missing data were not included in the analysis. For all analyses, a two-tailed α of 0.05 was used to define significance. Analyses were conducted in 2008.

Results

Participants were exposed to an average of 31.0 hours of popular music per week (SD=21.1) and an estimated 14.7 hours each week of songs with lyrics describing degrading sex (SD=17.0). Thirty percent (n=216) of the 711 participants had previously had sexual intercourse. Higher exposure to lyrics describing degrading sex, older age, male gender, African-American race, lower grades, higher sensation seeking, and higher rebelliousness were all associated with having had sexual intercourse (Table 2). However, higher exposure to lyrics describing nondegrading sex was not associated with intercourse (p=0.67). The 475 participants who had not had sexual intercourse reported a range of behaviors, with most at the stage in which they had touched breasts or had breasts touched. Higher exposure to lyrics describing degrading sex was associated with progression along the noncoital sexual continuum (p=0.01). However, exposure to lyrics describing nondegrading sex was not associated with progression along the noncoital sexual continuum (p=0.76).

In analyses that controlled for all covariates that had bivariate relationships with the outcome at or below the threshold of p<0.15, exposure to lyrics describing degrading sex was independently associated with both sexual outcomes (Table 3). Compared to those in the lowest tertile, those with the most exposure to lyrics describing degrading sex had greater odds for having had sexual intercourse (OR=2.07; 95% CI=1.26, 3.41). Likewise, compared to those in the lowest tertile, those with the most exposure to lyrics describing degrading sex had greater odds for having progressed further down the noncoital sexual continuum (OR=1.88; 95% CI=1.23, 2.88).

However, exposure to lyrics describing nondegrading sex was not significantly related to either sexual outcome. Those with exposure to such lyrics did not have significantly higher adjusted odds of having been sexually active (OR=1.15; 95% CI=0.70, 1.89) or having progressed along the noncoital sexual continuum (OR=1.44; 95% CI=0.94, 2.22).

In the models presented in Table 3, other factors independently associated with intercourse included older age, male gender, African-American race, lower maternal education, lower grades, higher sensation seeking, and higher rebelliousness. Only male gender, sensation seeking, and rebelliousness were independently associated with progression along the noncoital sexual continuum in these multivariable analyses.

There were no significant interactions between exposure to degrading sexual lyrics and age, gender, or race in any of the multivariable models. All results were similar when analyses were conducted with stepwise backward logistic regression and when exposure to lyrics describing degrading sex and exposure to lyrics describing nondegrading sex was modeled as a continuous variable.

Discussion

This study demonstrates that, among this sample of young adolescents, high exposure to lyrics describing degrading sex in popular music was independently associated with higher levels of sexual behavior. In fact, exposure to lyrics describing degrading sex was one of the strongest associations with sexual activity in these models. In contrast, exposure to lyrics describing non-degrading sex in popular music was not associated with greater risk of sexual activity in any of the models.

These findings build on those of previous studies13,30 suggesting that exposure to sex in media messages may be a risk factor for early sexual progression. Specifically, these results support previous findings21 that exposure to lyrics describing degrading sex in particular may be a stronger risk factor for early sexual progression than exposure to lyrics describing nondegrading sex. It is instructive that this study’s results were similar to those in the other studies,13,21,30 despite this sample’s having a greater percentage of African-American and socioeconomically disadvantaged participants and its using a more-intensive algorithm to estimate exposure to lyrics describing degrading and nondegrading sex.

Although music lacks the visual elements of film and television, there are reasons why references in popular music may be as potent in relationship to sexual behavior. First, exposure to popular music is rapidly increasing, whereas exposure to films is much lower, and exposure to television is decreasing.10 Also, music is known to be highly related to personal identity, and young people often model themselves after musical figures in terms of dress, behavior, and identity.20,31,32 Further studies with rigorous methodology will be necessary to more carefully determine the relative potency of exposure to lyrics describing sex (both degrading and nondegrading) in music.

The relationship between exposure to lyrics describing degrading sex and sexual experience held equally for both young men and women, which is consistent with the social cognitive theory.15 Lyrics describing degrading sex tend to portray sex as expected, direct, and uncomplicated. Such descriptions may offer scripts that adolescents feel compelled to play out, whether they are cast in the role of either the female or the male partner. However, lyrics describing nondegrading sex may portray more of the complications and complexities of sexual activity, making it less likely that young people will simply and blindly imitate what they hear. Similarly, repeated exposure to lyrics describing degrading sex in music may desensitize individuals to real-life violence and power differentials related to sex. This possibility is consistent with prior studies15,33–35 showing that media messages containing sexual aggression toward women tend to desensitize both men and women to real-life sexual aggression.

These findings may have implications for sexual health education. Given that exposure is common to lyrics describing degrading sex (>14 hours each week), sexual health lessons in school and in the community are likely to be dwarfed in young people’s minds by the lessons they learn through the lyrics’ representations of sex. It may be useful for health educators, health professionals, curriculum designers, parents, and community-group leaders to become familiar with the messages that young people receive about sex in their music, so that they can more effectively counter these messages. Innovative interventions and creative techniques are needed to encourage young people to think critically about the veracity of the sex-related messages they receive in their media and to understand the consequences of early sexual behavior. One way of doing this may be to include more media literacy—whereby young people learn to analyze and evaluate media portrayals of sex—in sexual health education.36–38

It will be important to evolve research in this area to maintain pace with technologic advancement; for example, MP3 players now have video capability. This study focused only on lyrics. Although it is likely that those exposed to lyrics describing degrading sex similarly are exposed to images depicting it, there may be value for future analyses to more carefully assess the relationship between audio and visual messages.

This study was limited by its cross-sectional design. The associations found between measures of music exposure and sexual behavior do not imply causality. Although it is theoretically plausible that media exposure precedes sexual behavior, it is also possible that engagement in sexual behavior causes young people to seek out media with particular sexual messages. Thus, longitudinal research is needed to more completely explore these associations. This effort was also limited in that the estimated exposure to lyrics describing degrading sex was based on only one favorite artist. It is possible that an adolescent’s favorite artist does not represent total exposure, either because the adolescent lacks access to that artist’s music (for financial or other reasons) or because the adolescent listens to a wide variety of music. However, because adolescents generally listen to a narrow range of musical genres,10 it is likely that the content of an adolescent’s favorite artist is largely representative of his or her overall exposure. Finally, it should be noted that the coding of elements such as sexual behavior can be subjective. For this reason, this study employed a complex coding methodology and ensured that inter-rater agreement was adequate.

In summary, adolescents are heavily exposed to lyrics describing degrading sex in popular music, and this exposure is associated with early sexual experience among them in an urban population of youth at high risk for risky sexual behavior. These results provide further support for the need for additional research and educational intervention in this area.

Acknowledgments

Dr. Primack is supported in part by a Physician Faculty Scholar Award from the Robert Wood Johnson Foundation; a career development award from the National Cancer Institute (K07-CA114315); and a grant from the Maurice Falk Foundation. The authors would like to thank Steven Martino, PhD, for his editorial input and his assistance with study design. Dr. Primack had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Footnotes

No financial disclosures were reported by the authors of this paper.

References

  • 1.Niccolai LM, Ethier KA, Kershaw TS, Lewis JB, Meade CS, Ickovics JR. New sex partner acquisition and sexually transmitted disease risk among adolescent females. J Adolesc Health. 2004;34:216–23. doi: 10.1016/S1054-139X(03)00250-7. [DOI] [PubMed] [Google Scholar]
  • 2.Finer LB, Darroch JE, Singh S. Sexual partnership patterns as a behavioral risk factor for sexually transmitted diseases. Fam Plann Perspect. 1999;31:228–36. [PubMed] [Google Scholar]
  • 3.Kahn JA, Rosenthal SL, Succop PA, Ho GY, Burk RD. Mediators of the association between age of first sexual intercourse and subsequent human papillomavirus infection. Pediatrics. 2002;109:E5. doi: 10.1542/peds.109.1.e5. [DOI] [PubMed] [Google Scholar]
  • 4.Edgardh K. Sexual behaviour and early coitarche in a national sample of 17 year old Swedish girls. Sex Transm Infect. 2000;76:98–102. doi: 10.1136/sti.76.2.98. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Humblet O, Paul C, Dickson N. Core group evolution over time: high-risk sexual behavior in a birth cohort between sexual debut and age 26. Sex Transm Dis. 2003;30:818–24. doi: 10.1097/01.OLQ.0000097102.42149.11. [DOI] [PubMed] [Google Scholar]
  • 6.Buston K, Williamson L, Hart G. Young women under 16 years with experience of sexual intercourse: who becomes pregnant? J Epidemiol Community Health. 2007;61:221–5. doi: 10.1136/jech.2005.044107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Forhan SE, Gottlieb SL, Sternberg MR, et al. Prevalence of sexually transmitted infections and bacterial vaginosis among female adolescents in the U. S.: data from the National Health and Nutrition Examination Survey (NHANES) 2003–2004. Proceedings of the National STD Prevention Conference; 2008 Mar 10–13; Chicago IL. [Google Scholar]
  • 8.Ventura SJ, Abma JC, Mosher WD, Henshaw S. Estimated pregnancy rates for the U.S. 1990–2000: an update. Natl Vital Stat Rep. 2004;52:1–9. [PubMed] [Google Scholar]
  • 9.The Alan Guttmacher Institute. Teenagers’ sexual and reproductive health. New York: The Institute; 2002. www.guttmacher.org/pubs/fb_teens.pdf. [Google Scholar]
  • 10.Rideout V, Roberts D, Foehr U. Generation M: media in the lives of 8–18 year-olds. Menlo Park CA: Kaiser Family Foundation; 2005. [Google Scholar]
  • 11.Roberts DF, Henriksen L, Christenson PG. Substance use in popular movies and music. Washington DC: Office of National Drug Control Policy; 1999. [Google Scholar]
  • 12.Primack BA, Gold MA, Schwarz EB, Dalton MA. Degrading and non-degrading sex in popular music: a content analysis. Public Health Rep. 2008;123:593–600. doi: 10.1177/003335490812300509. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Brown JD, L’Engle KL, Pardun CJ, Guo G, Kenneavy K, Jackson C. Sexy media matter: exposure to sexual content in music, movies, television, and magazines predicts black and white adolescents’ sexual behavior. Pediatrics. 2006;117:1018–27. doi: 10.1542/peds.2005-1406. [DOI] [PubMed] [Google Scholar]
  • 14.Escobar-Chaves SL, Tortolero SR, Markham CM, Low BJ, Eitel P, Thickstun P. Impact of the media on adolescent sexual attitudes and behaviors. Pediatrics. 2005;116:303–26. [PubMed] [Google Scholar]
  • 15.Bandura A. Social cognitive theory: an agentive perspective. Annu Rev Psychol. 2001;52:1–26. doi: 10.1146/annurev.psych.52.1.1. [DOI] [PubMed] [Google Scholar]
  • 16.Glanz K, Rimer BK, Lewis FM. Health behavior and health education: theory, research and practice. San Francisco CA: Wiley & Sons; 2002. [Google Scholar]
  • 17.Miller NE, Dollard J. Social learning and imitation. New Haven CT: Yale University Press; 1941. [Google Scholar]
  • 18.Arnett JJ. Adolescents’ uses of media for self-socialization. J Youth Adolesc. 1995;24:519–33. [Google Scholar]
  • 19.Christenson PG, Roberts D. It’s not only rock & roll: popular music in the lives of adolescents. Kresskill NJ: Hampton Press; 1998. [Google Scholar]
  • 20.Mark A. Adolescents discuss themselves and drugs through music. J Subst Abuse Treat. 1986;3:243–9. doi: 10.1016/0740-5472(86)90035-8. [DOI] [PubMed] [Google Scholar]
  • 21.Martino SC, Collins RL, Elliott MN, Strachman A, Kanouse DE, Berry SH. Exposure to degrading versus nondegrading music lyrics and sexual behavior among youth. Pediatrics. 2006;118:e430–41. doi: 10.1542/peds.2006-0131. [DOI] [PubMed] [Google Scholar]
  • 22.Ward L. Talking about sex: common themes about sexuality in prime-time television programs children and adolescents view most. J Youth Adolesc. 1995;24:595–615. [Google Scholar]
  • 23.Primack BA, Dalton MA, Carroll MV, Agarwal AA, Fine MJ. Content analysis of tobacco, alcohol, and other drugs in popular music. Arch Pediatr Adolesc Med. 2008;162:169–75. doi: 10.1001/archpediatrics.2007.27. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74. [PubMed] [Google Scholar]
  • 25.Miller KS, Clark LF, Wendell DA, et al. Adolescent heterosexual experience: a new typology. J Adolesc Health. 1997;20:179–86. doi: 10.1016/S1054-139X(96)00182-6. [DOI] [PubMed] [Google Scholar]
  • 26.Jackson C, Henriksen L, Foshee V. The authoritative parenting index: predicting health risk behaviors among children and adolescents. Health Educ Behav. 1998;25:319–37. doi: 10.1177/109019819802500307. [DOI] [PubMed] [Google Scholar]
  • 27.Stephenson MT, Hoyle RH, Palmgreen P, Slater MD. Brief measures of sensation seeking for screening and large-scale surveys. Drug Alcohol Depend. 2003;72:279–86. doi: 10.1016/j.drugalcdep.2003.08.003. [DOI] [PubMed] [Google Scholar]
  • 28.Smith GM, Fogg CP. Psychological antecedents of teenage drug use. In: Simmons R, editor. Research in community and mental health: an annual compilation of research. Greenwich CT: JAI Press; 1979. [Google Scholar]
  • 29.Williams RA. Generalized ordered logit/partial proportional odds models for ordinal dependent variables. Stata Journal. 2006;6:58–82. [Google Scholar]
  • 30.Collins RL, Elliott MN, Berry SH, et al. Watching sex on television predicts adolescent initiation of sexual behavior. Pediatrics. 2004;114:e280–9. doi: 10.1542/peds.2003-1065-L. [DOI] [PubMed] [Google Scholar]
  • 31.Keen AW. Using music as a therapy tool to motivate troubled adolescents. Soc Work Health Care. 2004;39:361–73. doi: 10.1300/j010v39n03_09. [DOI] [PubMed] [Google Scholar]
  • 32.Took KJ, Weiss DS. The relationship between heavy metal and rap music and adolescent turmoil: real or artifact? Adolescence. 1994;29:613–21. [PubMed] [Google Scholar]
  • 33.Krafka C, Linz D, Donnerstein E, Penrod S. Women’s reactions to sexually aggressive mass media depictions. Violence Against Women. 1997;3:149–81. doi: 10.1177/1077801297003002004. [DOI] [PubMed] [Google Scholar]
  • 34.Linz DG, Donnerstein E, Penrod S. Effects of long-term exposure to violent and sexually degrading depictions of women. J Pers Soc Psychol. 1988;55:758–68. doi: 10.1037//0022-3514.55.5.758. [DOI] [PubMed] [Google Scholar]
  • 35.Mullin CR, Linz D. Desensitization and resensitization to violence against women: effects of exposure to sexually violent films on judgments of domestic violence victims. J Pers Soc Psychol. 1995;69:449–59. doi: 10.1037//0022-3514.69.3.449. [DOI] [PubMed] [Google Scholar]
  • 36.Thoman E. Skills and strategies for media education. Malibu CA: The Center for Media Literacy; 2003. [Google Scholar]
  • 37.Buckingham D. Media education: literacy, learning, and contemporary culture. Malden MA: Blackwell Publishing; 2003. [Google Scholar]
  • 38.Primack BA, Gold MA, Switzer GE, Hobbs R, Land SR, Fine MJ. Development and validation of a smoking media literacy scale. Arch Pediatr Adolesc Med. 2006;160:369–74. doi: 10.1001/archpedi.160.4.369. [DOI] [PMC free article] [PubMed] [Google Scholar]

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