JMIR Publications

ABSTRACT

Formative experiences in adolescence lay the foundation for healthy and pleasurable romantic and sexual relationships throughout life. Exposure to pornography may impact these experiences. We aimed to synthesize evidence published in the past decade for relationships between exposure to pornography and sexual behavior (earlier age of first sex (<16), condomless sex, past-year multiple partners (>1), lifetime multiple partners (>1), group sex, sexual aggression including forced sex, paid sex, teenage pregnancy, and history of sexually transmitted infection) in adolescents aged 10-19. Searching Medline, PsycInfo, Cochrane, CINAHL, Embase, and Web of Science from January 2010 to March 2022, we identified nineteen eligible studies. Four out of six studies of earlier age of first sex, including one longitudinal study, found a significant association with exposure to pornography. Given most studies were cross-sectional or had substantial limitations, a causal inference could not be made. Evidence was conflicting or insufficient to make any conclusions for other outcomes. Exposure to pornography was not measured consistently. More quantitative research is needed to elucidate the association between pornography exposure and sexual behavior, and sex education should adopt evidence-based approaches to minimize potential harms of pornography.