Measuring the Effects of Sexual Content in the Media: A Report to the Kaiser Family Foundation

This Report is available in Adobe Acrobat Format

Author: Drs. Aletha C. Huston, Ellen Wartella, and Edward Donnerstein

Executive Summary

The Kaiser Family Foundation has an ongoing interest in sexual health among young people and the potential contributions of mass media to sexual behavior. This report was prepared at the request of the Foundation to examine the methodological options for investigating the effects of sexual content in the media on children and adolescents. In preparing the report, we convened a Forum of twenty scholars with expertise in sexuality, sexual development, media analysis, and media effects to discuss these issues.

The purposes of this report are to review what we know about the relations of entertainment media to sexual development during childhood and adolescence, to consider methodological issues and challenges in studying this topic, and to propose some fruitful directions for future research.

There are many opinions about the effects of sexual content in the mass media, and they are often couched in political or religious overtones. This report is not intended to debate these opinions, rather, it is a review and discussion of social scientific methods which provide publicly shared, objective, empirical, and replicable information that can be used to build a cumulative body of knowledge of this area.

Although the effects of sexual content have received relatively little attention from researchers, there have been content analytic studies of the portrayals of sexuality in television and movies and there is evidence that sexual messages in entertainment media have been increasing.

Studies of sexual messages in movies and on television (prime-time, soaps, and music videos have been studied most heavily) have found that over the past twenty years, there has been an overall increase in the number of portrayals and the amount of talk about sex in these media and an increase in the explicitness of these portrayals. Furthermore, the television research shows a fairly consistent sexual message across TV genres: most portrayals of sex depict or imply heterosexual intercourse between unmarried adults, with little reference to STDs/AIDS, pregnancy, or use of contraception.

There are sound theoretical reasons to believe that television and other media can play an important role in educating children and adolescents about sexuality. Media portrayals surround children and adolescents, and young people are intensely interested in sexuality, romance, and relationships.

Yet, there are very, very few studies of the effects of sexual messages in the media on child and adolescent viewers. The few experimental studies show that television has the potential to change viewers’ attitudes and knowledge. Correlational designs provide weak evidence that television viewing is linked with sexual behavior and beliefs, but the measures of viewing are crude at best. There also is some evidence that such personal factors as interest in sexual content, level of understanding, perceived reality, and parental mediation modify the influence of sexual messages. Much more empirical work is needed to substantiate the claim that naturally occurring sexual content in the media actually does cause changes in attitudes, beliefs, and behaviors. Such changes need to be examined as a function of what individuals are watching, the messages they are receiving, how they are interpreting them, and other factors that influence a young person’s sexual personae.

Two approaches to sexual development are reviewed in this report. Healthy sex, or the role of sex in individual mental health and in healthy relationships, focuses on enabling people of all ages to develop the attitudes, values, and behaviors that promote healthy sexual functioning. In this approach, sex is considered good and essential to human functioning. The second orientation, sexual health, has a narrower focus based in public health concerns about the physical disease, mental health, and social problems that can arise from sexual behavior. The majority of the literature in this area is concerned with STDs, including HIV, and unwanted, early, or out-of-wedlock pregnancy, but sexual violence and coercion, including rape, and mental health problems (e.g., depression, low self-esteem, distorted body image) also are considered. The sexual health literature tends to focus on prevention through encouraging young people to abstain from or postpone sexual intercourse, especially with multiple partners, and by encouraging them to use “safer sex” practices when they do have intercourse.

Research designed to understand the influence of mass media on sexual health must be informed by an understanding of the developmental changes in sexuality during childhood and adolescence, as well as socioeconomic, cultural, family, and peer influences. At the very least many of these influences must be controlled in studying media effects. Perhaps more important, it is likely that the processes involved and outcomes of interest will differ for different groups of young people. If we are to completely understand the effects of sexual content in the media we need to consider a range of outcomes — cognitive, emotional, attitudinal, behavioral — either separately or in combination with one other. In addition, we need to be cognizant of vast individual differences in how viewers respond to sexual depictions.

There are several inherent ethical and practical problems in doing research on children’s and adolescents’ sexual knowledge, attitudes, and behavior. The broad outline of these issues can be subsumed under several general principles regarding the protection of human subjects, which have been articulated by the federal research directors. Specific concerns regarding how various institutional research boards (IRBs) interpret these general guidelines, and gaining parental consent when children and adolescents are the subjects in a study also pose barriers to research.

The report suggests that researchers can design and conduct important research within these national and local guidelines. We recommend research based on the following premises:

1. Research in this area should be conducted by interdisciplinary teams of investigators, with expertise in the area of sexual development and others with expertise in media research.
2. There is need for an accumulated body of systematic studies using a variety of methods with a variety of populations. Given the paucity of available studies and the need to develop a systematic research base, no one grand study will provide definitive answers.
3. Research on the effects of sexual media content should in general begin with small-scale studies and move to larger field and longitudinal studies. Small-scale studies (laboratory, survey, observational) can permit refinement of questions, measures and methods in a relatively low-cost and efficient way.
4. Research must take into account developmental, gender and ethnic differences. The functions and effects of sexual media content in sexual development may vary substantially for boys and girls, for different ethnic groups, and across different age groups.
5. There is a need for the development of valid and reliable measures of the use of media sexual content and of outcome measures of sexual knowledge, attitudes, and behaviors. One cannot generalize the validity or reliability of measures used with adult populations to children and adolescents particularly in this research domain.

In addition to the premises laid out above, the report provides some more specific recommendations about what kinds of studies should be conducted. We encourage researchers to think creatively about additional research design options.

There is little existing research literature that addresses the issue of children’s media use patterns. Any attempt to understand the influence of media on young people should begin with an assessment of both the amount and patterns of media use among children. Given the recent explosion in new media choices such as the Internet, computer games, and niche cable channels, it is imperative that we have an understanding of what media kids are using, and how and why they are using them.

Though many studies have looked at the amount and nature of sexual depictions on television, future content analyses should be more theoretically guided and contextually situated. Future research should include in its framework theories about sexuality, sexual development, and media effects. In addition, most content analyses have been limited to certain genres of television programming. Future content analyses should include cable programming, advertising, news, talk shows and new media.

In studying the effects of sexual media content on viewers, it is important to consider the various types of outcomes, including cognitive, emotional, attitudinal, and behavioral. In the early stages of conducting research on this topic, small experimental studies are likely to be more useful than correlational studies. Some of the proposed experimental techniques include manipulating outcomes of sexual media messages to measure immediate effects on children’s knowledge, schemas, attitudes and even behaviors.

A second phase of research could employ the field experiment technique, best used in cooperation with the media industry. The body of the report identifies two successful examples of field experiments, and recommendations for future field experiments on sexual content.

Once preliminary research is conducted on the effects of sexual content, an accelerated longitudinal design with overlapping cohorts would be the next recommended approach. This design would maximize the information obtainable in a five-year period, and would allow for follow-up in later years, were funding available.

Our final recommendation concerns the process for bootstrapping research in this entire area. As we have previously noted there is little systematic knowledge about the effects of sexual content. We certainly encourage research across many disciplines and funding agencies (both federal and private), but a central guiding framework is needed. We believe that an initiative akin to the Surgeon General’s 1970 study of Television and Social Behavior would be useful. A collaborative effort by the Kaiser Family Foundation, working with other foundations, could produce a coordinated research base collected in a major report that would provide a solid foundation for understanding the effects of sexual media content and could serve as a basis for future funding and research.

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Measuring the Effects of Sexual Content in the MediaReport

Two New Studies On Latinos And AIDS In America:

• Survey Of Latinos Finds Widespread Concern About HIV/AIDS; Impact Of Disease Felt “Close To Home”
• Report Documents Impact Of AIDS/HIV On Hispanics And Offers Guidance For Community Health Providers

Embargoed For Release Until:9:30 am, ET, Friday, May 1, 1998

For Further Information Contact: Tina Hoff or Matt James/KFF(650) 854-9400

Xiomara Sosa/COSSMHO(202) 797-4335

Washington, DC — Next week Latino leaders will gather at Harvard University for the first ever Latino “Leading for Life/Unidos Para la Vida” conference to discuss how to address the growing problem of HIV/AIDS among Latinos. As Latino leaders mobilize to address the problem of HIV/AIDS, most Latinos living in the U.S. today say they are extremely concerned about the impact of this deadly disease on their communities, families and themselves, according to a new national survey released today by the Kaiser Family Foundation, along with the National Coalition of Hispanic Health and Human Services Organizations (COSSMHO).

Highlights from the Kaiser Family Foundation National Survey of Latinos on HIV/AIDS:

• One in two Latinos (50%) rate AIDS as the nation’s most urgent health problem, and nine in ten (91%) say it is a major threat to public health in this country;
• Half of all Latinos (52%) say AIDS is a more urgent problem today for their local community than it was a few years ago and one in five (20%) say their community is losing ground on AIDS;
• Two thirds of Latinos (67%) say AIDS is a very serious problem for people they know and a third (35%) say they personally know someone who has HIV or AIDS or who died from AIDS;
• 46% of Latinos say they are very worried about becoming infected with HIV, a level of worry which far exceeds that among a national sample of all Americans (24%), and 41 percent say their personal worry has grown in recent years.

Responding to the concerns and information needs of Hispanics about HIV/AIDS at the community level, COSSMHO also released today HIV/AIDS: The Impact on Hispanics. This report, which contains the most current data on the AIDS epidemic among Hispanics, including national trends as well as variations by region, supports the need to intensify community-based prevention and education efforts. Produced for community-based organizations, health and human services professionals, and others, it offers information for accessing Hispanics’ response to HIV/AIDS and suggestions for a course of action.

“At a time when public perception moves in the direction of viewing HIV/AIDS as a manageable disease, Hispanic communities continue to be devastated by this epidemic,” said Jane L. Delgado, Ph.D., President and Chief Executive Officer of the National Coalition of Hispanic Health and Human Services Organizations (COSSMHO).

COSSMHO recommends that every comprehensive community-based HIV/AIDS program should have the following:

• Access to culturally and linguistically appropriate, voluntary and anonymous testing, and appropriate medical care for early diagnosis and treatment of HIV infection;
• AIDS education curricula (that include information about HIV/AIDS, skill building on condom use, the interpersonal challenges of negotiating safer sex, and avoiding drug use) to be used in junior- and senior-high school settings, and targeted settings for out-of-school youth;
• Outreach, education, and prevention — including the provision of prevention tools such as sterile injection equipment — to persons who are injecting drugs.

THE FACTS from HIV/AIDS: The Impact on Hispanics:

As of June 1997, a total of 109,252 Hispanic AIDS cases had been reported in the U.S. While Hispanics make up 12 percent of the U.S. population (including Puerto Rico), they account for 18 percent of all AIDS cases in this country. This represents a continued upward trend: in 1995, Hispanics accounted for 15 percent of all AIDS cases. While AIDS mortality declined by 32 percent in 1996 for non-Hispanic whites, Hispanics experienced a 20 percent decline and non-Hispanic blacks a 13 percent decline.

There is significant variation in the regional distribution of Hispanic AIDS cases by exposure category. In the Eastern part of the U.S. and Puerto Rico, injection drug use (IDU) constitutes the most significant exposure category for Hispanic AIDS cases (MA, NJ, NY). For the other states studied in this report (AZ, CA, CO, FL, IL, NM, TX), men who have sex with men represent the most significant exposure category.

The Role of Information in Fighting HIV/AIDS

According to the Kaiser Family Foundation survey, almost all Latinos know that HIV is sexually transmitted (98%) and that a pregnant woman with HIV can pass it to her baby (92%). Slightly fewer, though still the majority, know there is no cure for AIDS (77%) and that no vaccine against HIV is available (68%).

“Even those who are most knowledgeable about AIDS say there is more information they want, especially about the most practical aspects of HIV prevention: how to talk with children and partners, and where to go for testing and treatment,” said Sophia Chang, MD, Director of HIV Programs, Kaiser Family Foundation.

While Latinos know the basic facts about HIV/AIDS, most say there are areas they want to know more about, such as how to talk with children (70%) and partners (51%) about this disease and where to go if exposed to HIV for testing (58%) and treatment (63%). Many (41%) also say that to help guard against the spread of HIV they want more information about how to properly use condoms. Importantly, respondents interviewed in Spanish (50% of the sample) cited an even greater desire for information in all areas, highlighting the importance of making education and prevention materials available in both English and Spanish.

The media, especially television and radio, is a leading source of information about HIV/AIDS for Latinos. Seven in ten Latinos (70%) say they heard something about HIV/AIDS in the past month on a television news program, and two in five (44%) got information from an entertainment show on television. Radio talk or call-in shows (42%) and other radio programming (34%) also figure as information sources. Beyond the media, health care providers (32%), family and friends (28%), and the church (20%) are the next most commonly named resources on HIV/AIDS. There is also some variation in information resources used by Latinos depending on the language of their interview: Latinos who were surveyed in Spanish were most likely to have gotten information about HIV/AIDS from broadcast outlets, including television news (73%) and entertainment (49%) programming and radio call-in or talk shows (48%); those who were interviewed in English also most frequently named television news programs (67%), but were more likely to turn to print media such as magazines (56%) and newspapers (50%).

Taking the Lead: Whose Responsibility?

Latinos see a variety of players in the fight against AIDS, giving slightly higher marks to community level efforts than to government. Latinos see community groups, such as local health care providers, churches, and schools, as among the most concerned and most active in reducing the impact of the epidemic. Fewer Latinos say government at any level cares or does as much in the fight against AIDS. Among all groups — community and government — Latinos leave room for more action.

In terms of what is needed to fight against the disease, Latinos strongly support more government efforts. Two in five (44%) say the government spends too little money on HIV/AIDS and the majority supports increased spending across a range of areas including education and other prevention activities (94%), expanding access to new drug therapies (94%), and research to find more effective treatments (95%) as well as a vaccine (94%).

A majority (56%) of Latinos also favor needle exchange – programs that offer clean needles to IV drug users in exchange for used ones. Opinions on this issue, however, appear to be influenced by how it is presented. When given an argument made by opponents of needle exchange – that it gives tacit approval of illegal drug use – support is lower among Latinos: 41% favor, 56% oppose.

Survey Methodology

The Kaiser Family Foundation National Survey of Latinos on HIV/AIDS is a random-sample national survey of 802 Latino adults, 18 years and older. The survey was designed by staff at the Foundation and conducted by telephone in both English and Spanish by Princeton Survey Research Associates (PSRA) between September 19 and October 26, 1997. The margin of sampling error is plus or minus 4 percent. The margin of sampling error may be higher for some of the sub-sets in this analysis.

The Kaiser Family Foundation, based in Menlo Park, California, is an independent national health care philanthropy and is not associated with Kaiser Permanente or Kaiser Industries.

The National Coalition of Hispanic Health and Human Services Organizations (COSSMHO) for 25 years has been connecting communities and creating change to improve the health and well-being of Hispanics in the United States. Headquartered in Washington, DC, COSSMHO is the sole national organization focusing on the health and human services needs of the diverse Hispanic communities. COSSMHO’s membership consists of thousands of front-line health and human services providers and organizations serving Hispanic communities in the United States and Puerto Rico.

A more detailed report on the survey findings, including analysis by age, gender, region of the country, religion, income and education, is available by calling the Kaiser Family Foundation’s publication request line at 1-800-656-4533 (Ask for 1392 in English or 1393 in Spanish).

The Southern Africa Grantmakers’ Affinity Group of the Council on Foundations and the U.S. Congressional Black Caucus cordially invite you to participate in a high-level conference under the co-chairmanship of Ambassador Andrew Young, Representative Maxine Waters, the Hon. Sir Ketumile Masire and the Hon. Nic

Health News Index March/April, 1998

The March/April 1998 edition of the Kaiser Family Foundation/Harvard Health News Index includes questions about major health issues covered in the news, including questions about Cancer and Social Security. The survey is based on a national random sample of 1,201 Americans conducted April 17-27, 1998 which measures public knowledge of health stories covered by news media during the previous month. The Health News Index is designed to help the news media and people in the health field gain a better understanding of which health stories in the news Americans are following and what they understand about those health issues. Every two months, Kaiser/Harvard issues a new index report.

• Report:

This policy brief provides an overview of the low-income, uninsured population. Based on an analysis of the March 1998 Current Population Survey, the report discusses the demographic characteristics of this vulnerable population. It also presents information detailing health insurance coverage for low-income children and adults, as well as trends in insurance coverage over the past decade. It concludes with a discussion of recent coverage expansions and policy changes that have affected low-income Americans. The policy brief also includes a set of detailed appendix tables that provide health insurance coverage information by socioeconomic characteristics.

• Policy Brief

Kaiser Family Foundation/Harvard University School of Public Health: Update on Americans’ Views and Experiences in Managed Care

The Kaiser Family Foundation/Harvard University School of Public Health: Update on Americans’ Views and Experiences in Managed Care is based on findings from the April 1998 Kaiser Harvard News Interest Index. The survey was designed and analyzed by researchers at the Kaiser Family Foundation and Harvard University. Nationwide interviews were conducted by telephone with 1,201 adults, 18 years or older, between Arpil 17-April 27, 1998.

• Topline/Survey: Kaiser Harvard News Interest Index April 1998

Leading Health Care Consumer Protection Proposals Would Result In Modest Premium Increases for HMOS

New Cost Analysis of Consumer Protections:Major Provisions of President’s Consumer Bill of Rights and PARCA Estimated to Raise Premiums by Less Than 1%

Embargoed for release until: 9:00 a.m., EDT, Wednesday, April 22, 1998

For further information contact:Chris Ferris (202) 347-5270or Matt James (650) 854-9400

Washington, DC – A new independent cost analysis finds that the premium increases likely to result from two leading health care consumer protections proposals currently before Congress are modest. The study, prepared by Coopers & Lybrand for the Kaiser Family Foundation, finds that major provisions of the Consumer Bill of Rights and Responsibilities (CBRR) endorsed by the President are estimated to result in an annual premium increase of 0.61% for a typical HMO policy, adding approximately $31 per year to the cost of an average family insurance policy.

Major provisions of a similar proposal in the Congress, the Patient Access to Responsible Care Act (PARCA), would increase HMO premiums by 0.77%, adding an extra $40 to a family policy per year. The estimated premium increases under PARCA do not include the provision in the legislation that would allow health care consumers to sue their health plan directly; the researchers were unable to attach a dollar figure to this measure because of the high level of uncertainty regarding its potential impact.

The cost of individual consumer protection provisions in both bills range from 12 cents per person per year to assure access to specialists in the CBRR to $6.96 per person per year to require a point of service option in PARCA.

The study estimated the effect of the consumer protection provisions on HMOs, which are the types of plans most likely to be affected. The study finds that other types of health insurance plans – such as Preferred Provider Organizations or Fee for Service plans – would be less affected by the consumer protection provisions, so the average premium increases across all types of health insurance would be lower than the figures found in the study.

The average cost of an HMO policy for a family is approximately $5,160 per year, according to the study. The report uses the HMO policy as the prototype for estimating the effects of the proposals on health insurance premiums. Premium costs are usually shared by employer and employee.

The report, Estimated Cost Effect of Provisions of Consumer Protection Proposals by the President’s Advisory Commission and the Patient Access to Responsible Care Act, is among the first to provide an independent analysis of PARCA. It comes on the heels of similar preliminary estimates of CBRR costs prepared by the Congressional Budget Office in March.

“This study suggests that most of the consumer protection provisions in the bills currently before Congress will have modest price tags,” said Drew Altman, President of the Kaiser Family Foundation. “There should be plenty of room to find common ground as the legislative process moves forward.”

A Comparison of the Two Proposals

Last year, the President appointed a commission – the Advisory Commission on Consumer Protection and Quality in the Health Care Industry – to make recommendations for ways to improve the quality of health care services. The commission issued its report, the Consumer Bill of Rights and Responsibilities, last November. The President endorsed its recommendations earlier this year and required through executive order the application of many of the provisions to all federal health programs.

The Patient Access to Responsible Care Act sponsored by Representative Norwood (H.R. 1415) and the companion bill sponsored by Senator D’Amato (S.644) contain many provisions similar to the CBRR.

“The consumer protection proposals that we examined largely reflect changes that are already underway in the health care market,” said Sandra Hunt of Coopers & Lybrand, the study’s lead author. “We estimate a modest change in HMO costs resulting from these proposals.”

The study sponsored by the Kaiser Family Foundation finds some variation in the costs of the specific measures included in the proposals:

• Information Disclosure: Both proposals contain provisions requiring information disclosure, which would require quality and satisfaction data to be made available to consumers. The CBRR recommends greater information reporting than PARCA. Because they are more extensive, the CBRR information disclosure requirements are estimated to cost six dollars per person per year; the PARCA provisions would cost about $1.20.
• Emergency Services Access: Both also propose specific levels of access to emergency services, requiring the use of a “prudent layperson” standard for access to these services. This standard generally means that an individual who reasonably believes that emergency treatment is necessary must be provided coverage for the initial treatment costs of emergency care. The study estimates that the emergency care provisions in each of the proposals would increase premiums by about $1.20 per person annually.
• Access to Specialists: The CBRR and PARCA include standards for access to specialist services, with the CBRR having more specific standards applying to gynecologists, certified nurse midwives and other routine and preventive services for women. In part because many health plans already allow access to specialists in a way similar to what the proposals call for, this provision would likely raise premiums nominally (by about 24 cents per person each year). Expanded access to women’s health services under CBRR, taken alone, would add about 12 cents per year.
• Third Party Appeals: The two proposals include provisions to allow health care consumers to ask for an independent third party review of health plan service requests and utilization decisions. This appeals process is designed to ensure that health plan consumers have a fair and impartial decision-making process to determine the medical necessity of covered services. The estimated cost of this provision is $1.20 per person annually under each of the proposals.
• Point of Service Option: Unlike the CBRR, PARCA would require that all network-model health maintenance organizations (HMOs) offer a Point of Service (POS) option to members. This would allow health plan members to chose health care providers that are not in the network by paying higher cost sharing for those services. This option would add an estimated $6.96 per person to annual premiums.
• Liability and Malpractice: PARCA also includes an amendment to federal law to permit patients to sue health plans in cases of personal injury or wrongful death. However, the cost implications of this provision are uncertain, and Coopers & Lybrand did not estimate the potential cost because of the high level of uncertainty regarding its potential impact.

Estimated Annual Costs Per Person and Percent Increase in Premium

Provision CBRR PARCA Per Person Percent of Premium Per Person Percent of Premium

Information Disclosure $6.00 0.40% $1.20 0.08%

Emergency Service Access $1.20 0.11% $1.20 0.11%

Access to Specialists $0.12 0.01% $0.24 0.02%

Access to Women’s Services $0.12 0.01% Not part of PARCA

Third Party Appeals $1.20 0.08% $1.20 0.08%

Point of Service Option Not part of CBRR $6.96 0.48%

Total $8.64 0.61% $10.80 0.77% Note: In some cases the figures cited here are annualized from monthly estimates included in the study.

Other Consumer Protection Proposals:

Since the Kaiser Family Foundation commissioned the report, two other consumer protection measures have been proposed on Capitol Hill, one sponsored by Representative Dingell and Senator Daschle (H.R. 3605/S. 1890), and the other by Senators Jeffords and Lieberman (S. 1712).

More information on the four consumer protection proposals can be found on the Internet:

CBRRPARCADingell/DaschleJeffords/Lieberman

Methodology

The report, Estimated Cost Effects of Provisions of Consumer Protection Proposals by the President’s Advisory Commission and the Patient and Access to Care Act, is based on a Coopers & Lybrand analysis of actuarial data, prior research, and interviews with key health plan, association, and industry leaders. Actuarial data were used in those portions of the analysis where certain practices are already in place. Information regarding the level of change in practices that would be required to comply with the proposed standards was obtained from experts in the field and from a review of literature. The estimated premium increases under PARCA do not include the provision in the legislation that would allow health care consumers to sue their health plan directly, since the researchers were unable to attach a dollar figure to this measure because of the high level of uncertainty regarding its potential impact. The estimates also do not include the effects of provisions in PARCA prohibiting health plans from discriminating against certain providers and providing health professionals with a variety of due process rights.

* * *The Kaiser Family Foundation, based in Menlo Park, California, is an independent national health care philanthropy and is not associated with Kaiser Permanente or Kaiser Industries.

Additional copies of this report are available by calling Kaiser Family Foundation’s publication request line at 1-800-656-4533 (Ask for document #1391). This press release is also available on the Kaiser Family Foundation website at http://www.kff.org.

* * *

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Leading Health Care Consumer Protection Proposals Would Result In Modest Premium Increases for HMOSPress Release

A joint Kaiser Family Foundation/YM Magazine survey of teens, ages 13-18, on what kinds of sexual situations they face today, how they “negotiate” dating, sex, and intimacy, and what kind f information teens need. The findings from this survey are also reported on in the May issue of YM in a special section of the magazine that provides teens with a guide to sexual decision-making, including whether it is the right choice, contraceptive information, and the risks and consequences of sexually transmitted diseases. The survey was conducted by Princeton Survey Research Associates.

News Release (.pdf)

Report (.pdf)

Toplines (.pdf)