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Using Media to Maintain Sexual Health: A Focus on Adolescent Girls 

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Using Media to Maintain Sexual Health: A Focus on Adolescent Girls 
Using Media to Maintain
Sexual Health:
A Focus on Adolescent Girls
Jane D. Brown, PhD
Sarah N. Keller, MS
School of Journalism & Mass Communication, UNC-Chapel Hill
Overview
Adolescents
 Sexual
health
 Special risk for teen girls
Media
 Sexual
content
 Effects on sexual identity & behavior
 Potential to promote sexual health
Lessons learned: How to use media to
promote sexual health?
Defining the problem:
Adolescent sexual health
73% of boys and 56% girls have sexual
intercourse by age 18
 Estimated 4 in 10 get pregnant by age 20
 2/3 all STD cases acquired by age 25
 75% teen pregnancies unintended

AGI, 1994. McCauley A,. Meeting the needs of young people. Popul Rpts 1995;
series J, no.41. Eng TR, Butler WT. Institute of Medicine. The Hidden Epidemic:
Confronting Sexually Transmitted Diseases. Washington: National Academy Press, 1996.
Use of contraceptives
72% sexually active girls ages 15-17 use
contraception
 Fewer than half (44%) of girls who use
contraception use condoms
 Girls, on average, delay 1 year after first sex
before contracepting
 Estimated four in 10 get pregnant by age 20

AGI, 1994. McCauley A,. Meeting the needs of young people. Popul Rpts 1995;
series J, no.41.
STD rates
Youth under 25 have one-half world’s HIV
infections
 12 million STD cases a year in U.S.
 3 million in teens
 Girls age 15-19 have highest rates of
gonorrhea in U.S.; chlamydia rates growing

Eng TR, Butler WT. Institute of Medicine. The Hidden Epidemic: Confronting
Sexually Transmitted Diseases. Washington: National Academy Press, 1996.
STD knowledge
42% U.S. teenagers can’t name an STD
other than HIV
 Only 3% know of chlamydia -- the fastest
growing STD in U.S.
 Fewer than half (44%) of sexually active
women talk to partners about HIV-- only
27% discuss other STDs

American Social Health Association. Gallup Study: Teenagers Know More than
Adults about STDs. Research Triangle Park, NC: 1996. Glamour, et al. Survey of
Women about their Knowledge, Attitudes, and Practices Regarding their Reproductive
Health. Menlo Park, CA: Kaiser Family Foundation, 1997.
Media’s potential as an educator
Media can be powerful
 Media are not being used to their full
potential

 In
Western Europe, 3/4 of population learns
about STDs from TV, books or magazines
 In U.S., 1/4 learn about STDs from media
ASHA, 1996.
TV videos in Nigeria related to
increased family planning
30
25
20
15
%using
family
planning
10
5
0
TV/radio
Contraceptive use by
Nigerian women in
1993 who had seen
music videos and TV
dramas to promote
family planning in
1989-92
none

Westoff C, Rodriguez G, Bankole A. Family Planning and Mass Media Effects.
Chapel Hill: The Evaluation Project, 1996.
PSAs promote condoms in
Portland, Oregon 1992-94
Teens who used condoms in last month
increased from 32% to 40%
 Teens who used condoms with casual
partners rose from 72% to 90%
 Teens who planned to discuss condoms with
next partners rose from 53% to 80%

Blair J. PSI/Project ACTION: Improving Teen Risk Reduction. Washington:
Population Services International, 1995.
Define Target Audience,
Focus Message & Choose Media
Start with audience
 Define who they are:

 media
use
 personal identity - what they care about
 risk level
Gear message to fit
 Choose appropriate media

Selecting target audience:
Teen girls
Girls twice as likely as boys to get STDs.
 Asymptomatic infections harder to diagnose
 Long-term complications more serious
 Young women have special risk:

 thinner
cervical mucus
 multiple partners

Less negotiating power in relationships
CDC. HIV/AIDS Surveillance Report 1994; 5:1-36. Germain A, Wasserheit J, eds.
Reproductive Tract Infections: Global Impact and Priorities for Women’s Reproductive
Health. New York: Plenum Press, 1992.
Formative research: Media use
TV: 2 hours, 43 minutes per day
 Music: 3 - 4 hours per day
 Movies: First R-rated film at age 12.5
 Magazines: Girls ages 11-13 start with
Seventeen, move to Glamour
 Internet: Girls constitute 40% of CD-Rom
Myst users

American Psychological Association, 1993.
Media diets vary by race &
gender
Not all teenagers tune into the same kind of
media
 Girls prefer softer music and soap operas
 Boys prefer action flicks and harder, louder
music
 African-Americans and children from
single-parent households watch more TV

Steele JR, Brown JD. Adolescent room culture: Studying media in the
context of everyday life. J Adolesc Hth 1995; 24(5).
Media diets vary by personal
identity, too
Even within race & class categories,
teenagers’ media use vary dramatically
 Teens define themselves by their identities
 Girls’ sense of selves may be particularly
transitory & vulnerable to media influence

Pipher M. Reviving Ophelia. New York: Ballantine Books, 1994.
Thompson S. Going All the Way. New York: Hill and Wang, 1995.
All teens get a lot of “sex”…
 TV:
8 sexual messages per hour on
prime-time
Movies: More explicit than TV
 Music: 3/4 lyrics about love and sex
 Magazines: Seventeen, Young Miss,
Glamour & Cosmopolitan
 Internet: ?

Sex on TV

TV family hour 8-9 pm:
3/4 network programming contain sexual
content
only 9% of scenes mention responsibilities,
risks, protection or consequences
Advocates for Youth. Talking with TV. Washington: Advocates for Youth, 1996.
Dale K, et al. Sexual Messages on Family Hour TV: Content and Context.
Santa Barbara: Children Now, Kaiser Family Foundation, 1996.
Sex on TV (cont’d)

Sexual interactions on family hour TV shows has
steadily increased over the past two decades
9
8
7
6
5
4
3
2
1
0
sexual
interactions
(talking or
behavior) per
hour
1976
1986
1996
Sex education on TV?

Condoms, STDs & pregnancy are mentioned in
fewer than 1 in 10 sex-related scenes on family
hour TV
9
8
7
6
% sex-related
scenes showing
risks or
responsibilities
5
4
3
2
1
0
1976
1986
1996
What effect?
Studies are few
 Sex on TV increases perception that peers
are having sex
 Teens unlikely to learn safe sex from TV
 Aggressive sex on TV increases acceptance
of rape & sexual abuse

Advocates for Youth, 1996. ASHA, 1996.
What effect? (cont’d)

TV violence studies
show that violent
programming teaches:
 behavior
modeling
(cool people are
violent)
 social norms (guns are
powerful)
 desensitization (killing
people isn’t so bad)

Same effects may
occur with sex on TV:
 behavior
modeling
(stars have risky sex)
 social norms
(premarital sex is OK)
 desensitization (violent
sex won’t really hurt)
When Oprah Winfrey
recommends a book, it sells!
Deep End of the
Ocean, Jaquelyn
Mitchard
 Song of Soloman, Toni
Morrison
 The Book of Ruth, Jane
Hamilton
Thigpen DE. Winfrey’s winners. Time
Magazine, Dec. 2, 1996
before
after
Hamilton
 The
900
800
700
600
500
400
300
200
100
0
Morrison
Thousands of books in
print before & after
selection by Oprah
Mitchard

Lessons learned


Define target audience
Find out who they are:
 Media
use
 Personal identity
 Risk level


Focus message
Choose media
 Use
media channel &
message style that
audience uses
 Speak to relationship
identity & sexual
scripts
 Gear health messages
to reach different
categories of risk
Gearing messages to fit
Speaking to teen identities may be key to
influencing behavior
 Identity -- a person’s self-perception &
tastes in fashion, music & friends -- may
determine sexual practice

Project ACTION

Social marketing to promote teenage
condom use in Portland, Oregon by
Population Services International 1992-94
 Community
mobilization
 Condom vending machines
 Peer skill-building workshops
 Motivational media campaign
 Evaluation research
Project ACTION:
Tailoring the message
Target audience: At-risk teens ages 12-21
 Focus groups subdivided into boys, girls &
African-Americans
 Different PSAs designed to match sexual
scripts of each subgroup

 PSA for
girls: romantic flowers
 PSA for boys: pretty girls
 PSA for African-Americans: passionate glance
Applying TV violence lessons to
safe sex campaigns
PSAs can be more effective
 Segment audience
 Show negative, realistic consequences
 Present alternatives to unwanted behavior
 Illustrate behaviors that lead to safe sex
 Use non-celebrity adolescent voices
 Avoid lengthy sponsor announcements

Microsoft ClipArt Gallery
UC-Santa Barbara, 1997.
Other lessons learned

Cues to action
 Give
constructive
suggestions to improve
behavior
 Link to services: Tell
where to go for
condoms, STD
counseling, treatment
or more information
Blair J, 1995.

Community
mobilization
 Use
media to set
agenda
 Involve youth &
opinion leaders
 Foster support for new
behavior
 Work with different
sectors
Active audience
Teens don’t accept media messages
wholesale
 Media use depends on identity
 Identity shaped partly by media
 Cyclical process

Brown, 1995. Pipher, 1994.
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