Relationship Between Self-Esteem and Risky Sexual Behavior among Adolescents and Young Adults: A Systematic Review

Abstract

This systematic review aimed to understand the effects of self-esteem on risky sexual behavior (RSB) among adolescents and young adults. We followed the procedures outlined in the Cooper’s five-step approach, and used the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 reporting requirements. Published studies were identified using nine electronic databases. Studies were included based on (a) a focus on populations aged between 10 and 25 years; (b) an examination of the association between self-esteem-related factors, in line with RSB outcomes among adolescents and young adults; and (c) early sexual debut before 16 years, having multiple sex partners, and unprotected sex. In total, 11,216 studies were identified, of which nine studies met the inclusion criteria. All articles received high quality ratings. Despite methodological limitations, results showed that early sexual debut positively associated with self-esteem among female participants; condom use showed a negative association with lower self-esteem among female participants, while condom use decreased with decreasing self-esteem. Several sexual partners were found not to be associated with self-esteem. Intervention programs to increase the self-esteem of adolescents are recommended by educators to reduce risky sexual behavior among adolescents and young adults. Moreover, subsequent studies should develop instruments that assess self-esteem using subscales and educational programs that enhance healthy self-esteem development and correct sexual norms in peer groups and local communities.

KEY MESSAGE

• Early sexual debut was positively associated with self-esteem, and condom use negatively associated with self-esteem among adolescents.

• Intervention programs are recommended to establish healthy self-esteem and reduce risky sexual behavior among adolescents and young adults.

• Future research should consider self-esteem as a pertinent aspect of sexual behaviors (e.g., physical pride, romantic capacity, and sexual autonomy).

Keywords:

• Adolescents
• self-esteem
• risky sexual behavior
• systematic review

Disclosure statement

No potential conflict of interest was reported by the author(s). The findings and conclusions of this review are those of the authors and do not represent the official position of Jeonbuk National University or other institutions to which the authors are affiliated.

Provenance and peer review

Not commissioned; externally peer-reviewed.

Data availability statement

The datasets used in the current study are available from the corresponding author upon reasonable request.

Additional information

Funding

This study was supported by the Ministry of Education of the Republic of Korea and National Research Foundation of Korea [NRF-2020S1A5A2A03047080].