Sending love or risking trouble: Exploring sexting behaviors among university students.

doi:10.21203/rs.3.rs-2623504/v1

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Research Article

Sending love or risking trouble: Exploring sexting behaviors among university students.

https://doi.org/10.21203/rs.3.rs-2623504/v1

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Background:

Young people involved in sexting are predisposed to risky sexual behaviours, poor psychological well-being, and cyberbullying. This study aimed to assess the prevalence of sexting and associated factors among undergraduate students in Ghana.

Method:

We conducted a cross-sectional survey among 652 undergraduate students at the University of Ghana.

Results:

The prevalence of sexting was 48% for sending, 69% for receiving and 35% for two-way sexting. Participants aged 20–24 years (AOR = 0.58; 95% CI: 0.35–0.95) had a lower likelihood of sending sexually suggestive pictures compared with those aged 17–19 years. Females (AOR = 0.47; 95% CI: 0.32–0.70) were 52% less likely to send sexually suggestive pictures compared with males. Also, second year (Level 200) students (AOR = 0.48; 95% CI: 0.25–0.94) had lower odds of sending sexually suggestive pictures compared with first year (Level 100) students.

Conclusion:

Therefore, effective interventions are crucial to help promote the sexual health and well-being of undergraduate students.

sexting

undergraduate students

prevalence

determinants

young people

Ghana

Sexting is an emerging risk behaviour among young people that poses a global public health concern. Sexting is the exchange of sexually suggestive pictures or messages, including nude or semi-nude photographs, through mobile phones or other social networking sites[1]. Thus, it comprises sending, receiving or both (two-way sexting) sexually eliciting text, photos and videos using electronic devices such as computers and cellular phones. The use and ownership of smartphones and personal computers among university students predisposes them to sexting behaviours [2, 3]. The prevalence of sexting varies by type, across age groups and geographical settings. For instance, the prevalence of receiving sexually suggestive text and photos is higher than the prevalence of sending [4]. One in seven young people sends sexually suggestive photos, while one in four receives sexually suggestive photos [5]. Also, the prevalence among high school students ranges between 15 and 28% across regions. It is less common among adolescents but increasing rapidly among university students [6]. A study among undergraduate students in the United States of America reported that 61% of the students were involved in sexting behaviours [7]. A similar study among university students in Kenya reported a prevalence of 57% and 48% for one-way and two-way sexting respectively [8].

Young people who involve in sexting behaviours are predisposed to risky sexual behaviours, and poor psychological well-being [7]. Evidence shows that sexting among university students is positively associated with higher levels of stress, depression, anxiety, low self-control and internet addiction [6]. Sexting is a risk factor for involving in offline sexual activities, high-risk sexual behaviours, and sexual coercion [9–12]. Evidence shows that living with parents, internet use and gender are associated with sexting behaviours [5]. Females are less likely to sext compared with males [6]. Students who involve in health risk behaviours, including alcohol use, sexual intercourse and tobacco use, are more likely to sext [13]. It is also common among young people in romantic relationships and young adults [10] but has no association with socioeconomic status [13].

Ghana has a youthful population, with more than half of its population below 25 years [14]. Mobile phone penetration among university students is extremely high. A study revealed that 99% of students in Ghana’s premier and largest university own mobile phones, with 58% owning smartphones [15]. It is common knowledge that most university students have joined social media platforms, including WhatsApp, Facebook, Twitter, Instagram, Snapchat and TikTok, where they exchange text, video, and photos. Sexting is an emerging concept in Africa and has a high potential of endangering the healthy behaviour of adolescents and young people, but has received limited attention from researchers and policymakers [10]. Little is known about the scope, prevalence, and correlates of sexting behaviours among university students in Ghana. A search of the literature revealed that only one peer-reviewed article has been published on the subject matter in Ghana, which focused on adolescents in high schools [16]. To the best of the authors’ knowledge, this is the maiden study to investigate sexting behaviours and associated factors among university students in Ghana. Findings from this study would help stakeholders to understand the scope of the problem and the risk factors, which are crucial for designing public health policies and programmes. This study aimed to assess the prevalence of sexting and its determinants among undergraduate students at the University of Ghana, the premier university.

Study design and setting

A cross-sectional design was employed to assess sexting behaviours among university students in Ghana, a country in West Africa that shares boundaries with Togo to the east, Cote d'Ivoire to the west, Burkina Faso to the north and the Gulf of Guinea to the south. According to the 2021 Population and Housing Census, the country has a total population of about 30.8 million. We conducted this study among undergraduate students at the University of Ghana, the premier and the largest university in Ghana, founded in 1948. The university is in Accra, Ghana’s capital city. It has four colleges and runs undergraduate and graduate programmes Currently, it has a student population of about 61,000, of which about 83% are undergraduate students. The total population comprises students enrolled in regular, sandwich and weekend distance education programmes, as well as students from affiliate institutions; and enrolment by sex is approximately 51% males and 49% females. For this study, we limited the sample to regular students.

Population and sample size

The target population for this study was all undergraduate students at the University of Ghana, but the accessible population was all regular undergraduate students residing in the halls of residence. Students who were married were excluded from this study. In addition, students offering a regular programme, but outside the university’s main campus were excluded. Also, graduate students and students above age 24 were excluded. A sample size of 384 was estimated using Cochran’s formula. To adjust for the clustering effect and to improve precision, the sample size was multiplied by a design effect of 1.5 [17]. To adjust for non-response, 25% of the sample size was added, resulting in a total sample size of 720. Data collection yielded 670 completed questionnaires, resulting in a response rate of 93%. However, for this study, 18 respondents aged 25 years and above were dropped, resulting in a final sample of 652 students.

Sampling

A multistage cluster sampling technique with probability proportional to size was employed to select participants. The measure of size was the number of students in each hall of residence. In the first stage, five (5) out of eleven (11) mixed-sex students' halls of residence were randomly selected by lottery. The second stage involved a systematic selection of rooms within the halls. A list of room numbers (for each hall) obtained from the respective hall administrators served as the sampling frame. Respective sampling intervals were computed for each hall, which was applied to select every n^th room. In the third stage, one student was randomly from the selected rooms. In cases where an eligible student in a selected room refused participation or did not meet the eligibility criteria, we moved to the next room.

Data collection

A structured questionnaire was designed in the English language through a literature review. The questionnaire was pre-tested among 25 students in a different university in Accra, after which it was refined and finalized. The self-administered questionnaires method was employed to collect data. Trained research assistants who received one-day intensive training in survey techniques comprising questionnaire administration, informed consent and sampling procedures distributed the questionnaires to the selected students for completion. The research assistants followed up later at an agreed date to collect the completed questionnaires.

Measures

The main outcome variable was sexting behaviours, defined as two-way sexting, which was measured using two items. The first item measured sending sexually suggestive pictures/text (Have you ever sent any sexually suggestive picture or text to anyone?) coded as Yes = 1 and No = 0. The second item measured receiving sexually suggestive pictures/text (Have you ever received any sexually suggestive text messages or pictures?) coded as Yes = 1 and No = 0. Thus, two-way sexting was generated as the intersection of those who had ever sent and received sexting messages. The independent variables were measured as direct questions, and these included socio-demographic characteristics such as age, sex, ethnicity, religion and family arrangement. Age was a continuous variable and was recoded as a dichotomous variable as 17–19 years = 1, and 20–24 years = 2. Sex was coded as ‘male’ = 1 and ‘female’ = 2. Religion was coded as ‘Christian’ = 1, ‘Muslim’ = 2 and ‘Traditionalist’ = 3. Ethnicity was coded as Akan = 1, Ga = 2, Ewe = 3, Northerner = 4 and other = 5. Again, Year (Level) of study was coded as ‘Year 1 (Level 100) = 1, Year 2 (Level 200) = 2, Year 3 (Level 300) = 3 and Year 4 (Level 400) = 4. We also assessed ownership of smartphones, laptops, digital cameras, tablets, and access to 24-hour internet, which were all coded as ‘Yes’ = 1 and ‘No’ = 2. Other independent variables include frequency of sexting, asked to sext, attitude, receivers and senders of sexually suggestive text/pictures.

Statistical analysis

Before the analysis, the questionnaires were cross-checked for completeness and consistency. The data were cleaned and then entered in Statistical Package for Social Sciences (SPSS), version 23. Data were then cross-checked, and the necessary corrections were made to improve the accuracy of the data. The final data was then exported into Stata/SE (Stata Corp LLC, College Station, TX, USA), version 16 for analysis. The data were analysed at the univariate, bivariate and multivariable levels. At the univariate level, descriptive statistics, frequencies and percentages were computed. We used the Chi-square test to assess bivariate associations between the dependent variable and the independent variables. At the multivariable, binary logistic regression was constructed to identify the predictors of sexting. The odds ratio and their 95% confidence intervals were used to assess the strength of association. In all analyses, a p-value less than 0.05 was used to determine the statistical significance.

Participant characteristics

The results showed that of the 652 students, the majority (76%) were aged 20-24 years, Akan (51%), stayed with both parents (67%) and professed Christianity (92%). Exactly 36% of the students were in Level 300 and 13% were in Level 100. Three-quarters (75%) of the students had access to 24-hour internet connectivity, 95% owned a smartphone with internet while 81% had a laptop with internet facility.

Regarding sexting behaviours, the prevalence of sending and receiving sexually suggestive pictures was 38% and 69% respectively. Among the participants who had ever sent a sexually suggestive picture, 37% sent it to their friends, while 22% sent it to their boyfriend/girlfriend/lover. On the other hand, among those who had ever received a sexually suggestive picture, 47% received it from a friend, while 14% received it from a boyfriend/girlfriend/lover. The prevalence of two-way sexting (sending and receiving) was 35%. Four in ten participants had ever been asked by someone to sext, 8% of them sext often, while 44% had never engaged in sexting. Concerning gender and sexting, a majority (51%) of the participants believed that males sext more than females, while 30% felt that females sext more than males. (Table 1)

Table 1: Sociodemographic and sexting characteristics of students (n = 652)

Characteristic

Frequency

Percentage

Age

17-19 years

20-24 years

154

498

Sex

Male

Female

270

382

Religion

Christian

Muslim

Traditionalist

597

Ethnicity

Akan

Ewe

Northerner

Others

334

107

122

Level of study

100

200

300

400

217

238

115

Stays with

Both parents

Mother only

Father only

Alone

Other relatives

433

113

Smartphone with internet

Yes

620

Laptop with internet

Yes

529

123

Tablet with internet

Yes

250

402

Digital camera with internet

Yes

105

547

Access to 24 h internet

Yes

492

160

Frequency of sexting

Rarely

Often

Never

310

287

Ever asked to sext

Yes

No idea

270

369

Perception of who sexts more.

Males

Females

No idea

334

194

124

Ever sent any sexually suggestive picture.

Yes

246

406

If yes, who was the receiver.

Boy/girlfriend.

Colleague

Friend

Elderly person

Casual friend

Ever received any sexually suggestive picture.

Yes

450

202

If yes, who was the sender.

Boy/girlfriend.

Colleague

Friend

Elderly person

Casual friend

212

Two-way sexting

Yes

228

424

Association between student characteristics and sexting behaviours

The results showed that sending sexually suggestive pictures was significantly associated with the sex of the student, religion, access to 24-hour internet, frequency of sexting and having been asked to sext. For example, a higher proportion of males (46%) sent sexually suggestive pictures than females (32%). A majority of the respondents who professed traditional religion (86%) have ever sent a sexually suggestive picture. In addition, receiving sexually suggestive pictures was significantly associated with religion, family arrangement, frequency of sexting and having been asked to sext. For instance, almost all the respondents (91%) who stayed alone have received a sexually suggestive photo compared with those who stayed with both parents (68%). Eight in ten respondents who were asked to sext have ever received a sexually suggestive picture. All the respondents who professed traditional religion had ever received a sexually suggestive picture. Further, two-way sexting was significantly associated with the sex of the respondent, religion frequency of sexting and having been asked to sext. Exactly 43% of male respondents were involved in two-way sexting compared with 29% of the females. Also, a majority (86%) of the respondents who professed traditional religion were involved in two-way sexting compared with 35% of those who professed Christianity. Half of the respondents who were asked to sext engaged in two-way sexting. (Table 2)

Table 2: Bivariate association between student characteristics and sexting behaviours (n = 652)

Sent

Received

Two-way sexting

Characteristic

No n (%)

Yes n (%)

No n (%)

Yes n (%)

No n (%)

Yes n (%)

Age

17-19 years

20-24 years

86(56)

320(64)

68(44)

178(36)

41(27)

161(32)

113(73)

337(68)

91(59)

333(67)

63(41)

165(33)

Sex

Male

Female

145(54)

261(68)

125(46)*

121(32)

75(28)

127(33)

195(72)

255(67)

153(57)

271(71)

117(43)*

111(29)

Religion

Christian

Muslim

Traditionalist

374(63)

31(65)

1(14)

223(37)

17(35)

6(86) *

181(30)

21(44)

0(0)

416(70)

27(56)

7(100) *

390(65)

33(69)

1(14)

207(35)

15(31)

6(86) *

Ethnicity

Akan

Ewe

Northerner

Others

210(63)

66(62)

67(55)

53(75)

10(56)

124(37)

41(38)

55(45)

18(25)

8(44)

91(27)

42(39)

40(33)

26(37)

3(31)

243(73)

65(61)

82(67)

45(63)

15(83)

222(66)

68(64)

71(58)

53(75)

10(56)

112(34)

39(36)

51(42)

18(25)

8(44)

Level of study

100

200

300

400

48(58)

137(63)

143(60)

78(68)

34(42)

80(37)

95(40)

37(32)

27(33)

58(27)

75(32)

42(37)

55(67)

159(73)

163(68)

73(63)

50(61)

142(65)

148(62)

84(73)

32(39)

75(35)

90(38)

31(27)

Stays with

Both parents

Mother only

Father only

Alone

Other relatives

271(63)

69(61)

23(55)

7(58)

36(69)

162(37)

44(39)

19(45)

5(42)

16(31)

137(32)

30(27)

20(48)

1(8)

14(27)

296(68)

83(73)

22(52)

11(91) *

38(73)

285(66)

71(63)

25(60)

7(58)

36(69)

148(34)

42(37)

17(40)

5(42)

16(31)

Smartphone with internet

Yes

382(62)

24(75)

238(38)

8(25)

193(31)

9(28)

427(69)

23(72)

400(65)

24(75)

220(35)

8(25)

Laptop with internet

Yes

327(62)

79(64)

202(38)

44(36)

156(29)

46(37)

373(71)

77(63)

341(64)

83(67)

188(36)

40(33)

Tablet with internet

Yes

150(60)

256(64)

100(40)

146(36)

71(28)

131(33)

179(72)

271(67)

158(63)

266(66)

92(34)

136(34)

Digital camera with internet

Yes

69(66)

337(62)

36(34)

210(38)

26(25)

176(32)

79(75)

371(68)

74(70)

350(64)

31(30)

197(36)

Access to 24 h internet

Yes

294(60)

112(70)

198(40)*

48(30)

149(30)

53(33)

343(70)

107(67)

310(63)

114(71)

182(37)

46(29)

How often do you sext?

Rarely

Often

Never

142(46)

19(35)

245(85)

168(54)

36(65) *

42(15)

6(2)

1(2)

195(68)

304(98)

54(98) *

92(32)

147(47)

19(35)

258(90)

163(53)

36(65) *

29(10)

Have you been asked to sext?

Yes

No idea

130(48)

266(72)

10(77)

140(52)*

103(28)

3(23)

52(19)

145(39)

5(38)

218(81)*

224(61)

8(62)

136(50)

278(75)

10(77)

134(50)*

91(25)

3(23)

Note: *p-value < 0.05

Determinants of sexting behaviours among undergraduate students

The results showed that sending of sexually suggestive pictures/text was predicted by age of respondent, sex, ethnicity, level of study, 24-hour internet access, frequency of sexting and having been asked to sext. For instance, respondents aged 20-24 years (AOR = 0.58; 95% CI: 0.35-0.95) had a lower likelihood of sending sexually suggestive pictures compared with those aged 17-19 years. Females (AOR = 0.47; 95% CI: 0.32-0.70) were 52% less likely to send sexually suggestive pictures compared with males. Also, Level 200 students (AOR = 0.48; 95% CI: 0.25-0.94) had lesser odds of sending sexually suggestive pictures compared with Level 100 students. Respondents who had 24-hour internet access (reference group) were more likely to send sexually suggestive pictures compared with their counterparts (AOR = 0.63; 95% CI: 0.40-1.00).

Regarding receiving sexually suggestive pictures, respondents aged 20-24 years (AOR = 0.46; 95% CI: 0.23-0.90) were 54% less likely to receive sexually suggestive pictures compared with those aged 17-19 years. Also, respondents who stayed with only their father (AOR = 0.16; 95% CI: 0.04-0.57) had lesser odds of receiving sexually suggestive pictures compared with those who stayed with both parents. Respondents who did not have a digital camera (AOR = 0.50; 95% CI: 0.25-0.98) had a lesser likelihood of receiving sexually suggestive pictures compared with their counterparts. Moreover, respondents who were not asked to sext (AOR = 0.43; 95% CI: 0.24-0.76) had a lesser likelihood of receiving sexually suggestive pictures compared with those asked to sext.

Concerning two-way sexting, females (AOR = 0.46; 95% CI: 0.31-0.70) were less likely to sext compared to males. Respondents who belonged to the Ewe ethnic group (AOR = 1.98; 95% CI: 1.14-3.41) had a higher likelihood of engaging in two-way sexting compared to those belonging to the Akan ethnic group. Also, Level 200 students (AOR = 0.46; 95% CI: 0.23-0.92) were less likely to sext compared to Level 100 students. Respondents who had never been asked to sext (AOR = 0.38; 95% CI: 0.25-0.57) were less likely to engage in two-way sexting compared to those who had ever been asked to sext. (Table 3)

Table 3: Binary Logistic Regression analysis of determinants of sexting behaviours among undergraduate students (n = 652)

Covariates

Sending

AOR (95%CI)

Receiving

AOR (95% CI)

Two-way sexting

AOR (95%CI)

Age

17-19 years

20-24 years

1(ref)

0.58(0.35-0.95) *

1(ref)

0.46(0.23-0.90) *

1(ref)

0.61(0.36-1.02)

Sex

Male

Female

1(ref)

0.47(0.32-0.70) *

1(ref)

0.76(0.44-1.32)

1(ref)

0.46(0.31-0.70) *

Religion

Traditionalist

Christian

Muslim

1(ref)

0.21(0.02-2.00)

0.40(0.03-4.29)

1(ref)

1.64(0.55-4.85)

1(ref)

0.21(0.02-2.01)

0.33(0.03-3.59)

Ethnicity

Akan

Ewe

Northerner

Others

1(ref)

1.13(0.65-1.95)

1.78(1.06-2.98) *

0.50(0.24-1.03)

1.48(0.48-4.50)

1(ref)

0.57(0.27-1.21)

0.63(0.30-1.32)

0.57(0.22-1.50)

4.30(0.84-21.84)

1(ref)

1.37(0.77-2.45)

1.98(1.14-3.41) *

0.70(0.33-1.46)

1.97(0.63-6.21)

Level of study

100

200

300

400

1(ref)

0.48(0.25-0.94) *

0.95(0.48-1.87)

0.73(0.34-1.56)

1(ref)

1.03(0.41-2.54)

1.69(0.68-4.19)

0.86(0.30-2.44)

1(ref)

0.46(0.23-0.92) *

0.96(0.47-1.95)

0.59(0.26-1.30)

Stays with

Both parents

Mother only

Father only

Alone

Other relatives

1(ref)

1.02(0.62-1.70)

1.54(0.72-3.27)

0.44(0.11-1.74)

0.67(0.31-1.42)

1(ref)

1.04(0.49-2.20)

0.16(0.04-0.57) *

4.98(0.37-6.24)

2.12(0.86-5.23)

1(ref)

1.13(0.67-1.92)

1.47(0.66-3.25)

0.49(0.12-1.97)

0.84(0.38-1.83)

Smart phone with internet

Yes

1(ref)

0.39(0.14-1.04)

1(ref)

1.14(0.32-4.06)

1(ref)

0.45(0.16-1.25)

Laptop with internet

Yes

1(ref)

1.31(0.79-2.20)

1(ref)

0.70(0.34-1.40)

1(ref)

1.20(0.70-2.06)

Tablet with internet

Yes

1(ref)

0.98(0.65-1.48)

1(ref)

1.49(0.83-2.68)

1(ref)

1.04(0.68-1.60)

Digital camera with internet

Yes

1(ref)

1.38(0.80-2.38)

1(ref)

0.50(0.25-0.98) *

1(ref)

1.65(0.93-2.93)

Access to 24 h internet

Yes

1(ref)

0.63(0.40-1.00) *

1(ref)

0.93(0.50-1.73)

1(ref)

0.69(0.43-1.12)

Frequency of sexting

Rarely

Often

Never

1(ref)

1.21(0.62-2.35)

0.12(0.08-0.19) *

1(ref)

1.32(0.14-11.84)

0.01(0.00-0.01) *

1(ref)

1.30(0.66-2.55)

0.08(0.05-0.13) *

Ever asked to sext

Yes

No idea

1(ref)

0.42(0.28-0.62) *

0.51(0.11-2.25)

1(ref)

0.43(0.24-0.76) *

0.80(0.17-3.76)

1(ref)

0.38(0.25-0.57) *

0.59(0.12-2.78)

Note: * p-value < 0.05

Sexting behaviour is an emerging research area in Ghana. This study sought to assess the prevalence of sexting and associated factors among university students. The findings revealed that about four in ten (38%) respondents sent sexually suggestive pictures, about seven in ten (69%) of the respondents received sexually suggestive pictures and 35% of the respondents sent and received sexually suggestive pictures (two-way sexting). Prior studies have shown that sexting is prevalent among university students [8, 18]. However, a previous study in Kenya found a higher prevalence of sexting (57% for sending and 48% for two-way sexting) among university students [8]. The differences in findings may be due to variations in contextual factors and target populations.

Sexting behaviours were influenced by age. Thus, students aged 20–24 years were less likely to involve in sexting compared to those aged 17–19 years [8]. This finding has been confirmed by a previous study in Ghana. Adolescents aged 16 years or more had a higher likelihood of sexting [16]. Evidence shows that adolescents (17–19 years) are mostly in sentimental relationships [19], hence may see sexting as a way of expressing affection to the opposite sex. Further, adolescents use sexting as a form of interaction in romantic relationships to express affection and trust [20]. In addition, adolescents (17–19 years) are less mature and inexperienced compared to young adults (20–24 years). Therefore, they may not be able to make informed decisions regarding the consequences of sexting.

Our findings also revealed that male students had a higher chance of sexting than female respondents [6, 8, 21, 22]. Previous studies have corroborated this finding in Ghana [16]. The sex differences in sexting may be linked to cultural norms surrounding masculinity and femininity [23]. Sexually active young men perceive sexting as a way of expressing their masculinity [11]. The high prevalence of sexting among males has been attributed to the desire to attain higher status and recognition among peers [24]. Moreover, males may send sexually suggestive photos to lure females into romantic relationships [25]. In some societies, sexting among girls is more likely to be disapproved due to cultural norms regarding female behaviours in society [26, 27]. In many countries, it is culturally unacceptable for a female to initiate sex. However, sexual initiation is considered a traditional role of the male [25]. Like previous studies, our findings showed that sexting was influenced by the level of study. First-year students were more likely to sext compared to second-year students. This finding is not surprising because first-year students are more likely to be adolescents (17–19 years) compared to second-year students. As stated above, adolescents have a higher likelihood of sexting than young adults.

Moreover, students with 24-hour internet access showed higher odds of being involved in sexting behaviours compared with their counterparts. This finding has been confirmed by a prior study in Spain [6]. This finding is expected because smartphones and personal computers mostly need an internet connection to be able to send and receive pictures. Therefore, students who do not have access to the internet would be unable to get involved in sexting. The study area (the university) provides free internet services (Wi-Fi) to students which can be accessed anywhere on campus, including lecture halls, library, and hall of residence. This is a plausible explanation for the high prevalence of sexting among undergraduate students.

Implications and recommendations

These findings imply that undergraduate students are at a higher risk of involving in sexual risk behaviours with their attendant consequences [11], cyberbullying and internet addiction. For instance, studies have revealed that sexting among university students was positively associated with internet addiction, low self-esteem, depression, anxiety and stress [6]. There is also evidence to show that sexting has a positive relationship with engaging in early sexual initiation, unprotected sexual intercourse and watching pornography [7]. Moreover, sexting has the potential of affecting students’ academic performance poorly, mental health and well-being. It is therefore recommended that stakeholders, including the university authority, should sensitize and raise awareness about the ripple effects of sexting among university students. Also, sexting behaviours should be included in sex education and online safety programmes. The sensitization programme should prioritize male students, first-year students and adolescents. In addition, the university authority should implement measures to ensure that students cannot share nude or sexually suggestive pictures via the university’s internet service as well as restrict access to sexting websites.

Strengths and limitations

This study provides relevant information for policy and programming. It is the maiden study to be conducted among university students in Ghana. In addition, this study highlights the scope of sexting and risk factors which can help stakeholders to appreciate the magnitude of the problem. Consequently, stakeholders can implement public health and behavioural change interventions to reduce sexting and associated negative health outcomes. However, this study is not devoid of limitations. This study is subject to recall and social desirability biases since participants had to recall their past sexting behaviours. Further, this study was conducted in a single university, hence the findings must be interpreted with caution. The cross-sectional nature of this study makes it impossible to establish a causal relationship. This study focused on students in a public university, hence future studies should explore sexting behaviours among private university students as well as the non-student population. Further studies regarding the relationship between sexting and sexual behaviours among Ghanaian youth are crucial.

This study has demonstrated that sexting is common among undergraduate students in Ghana. Sexting behaviours were influenced by sex, ethnicity, year/level of study, sexting on demand, and access to 24-hour internet. Going forward, stakeholders should implement programmes and strategies to help reduce the burden of sexting and associated negative health outcomes. This is the maiden study among university students in Ghana and one of the few studies in Africa.

Acknowledgement

The authors would like to thank all the participants of this study.

Author contributions

Conceptualization, AM, DEA; methodology, AM, DEA; writing—original draft preparation, AM, EAA; writing—review and editing: AM, EAA. All authors have read and agreed to the published version of the manuscript.

Funding

The authors received no financial support for the research, authorship and/or publication of this article.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ethics approval and consent to participate.

In the case of this research, before completing the questionnaires, free and informed consent was obtained from the participants as well as from the participating schools. Ethical approval was sought from the Ghana Health Service Ethical Review Committee (ID NO: GHS- ERC 89/12/15). The authors confirm that all experiments were performed in accordance with relevant guidelines and regulations (such as the Declaration of Helsinki).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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No competing interests reported.

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Sending love or risking trouble: Exploring sexting behaviors among university students.

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