Young peoples’ perceived benefits and barriers of sexual health promotion on social media - a literature review

Figures & data

Table 1. Study characteristics based on PEO.

PEO component	Characteristics
Population	Younger adults, youth, adolescents, teenager
Exposure	Sexual health promotion, sex education through the use of social media
Outcome	Benefits/potentials and barriers/risks

Table 2. Keywords for literature search.

Social media	AND	Sexual health	AND	Adolescen*
Social network		Sex education		Youth
SNS		Contracept*		Young people
Instagram		Condom		Teen*
Facebook		Sex*		Younger adult
YouTube		Protect*
Twitter		Prevent*
Snapchat		Sexual behaviour
Social network site		Sexual health communication
		STD
		STI
		Sexually transmitted
		Sexual health information
		Sexual health promotion
		Sexual health education

Note. Example of search string for PubMed: (‘Social media’ OR ‘Social network*’ OR ‘Social networking site*’ OR Instagram OR YouTube OR Facebook OR SNS OR Twitter OR Snapchat) AND (‘Sexual health’ OR ‘Sexual health promotion*’ OR Sex OR ‘Sex education’ OR ‘Sexual Health communication’ OR Condom* OR”Sexual health education” OR Protect* OR ‘Prevent* Behav*’ OR ‘STI prevent*’ OR ‘STD prevent*’ OR STI OR STD OR ‘Sexually transmitted*’ OR ‘Sexual behavior’ OR ‘Sexual behaviour’ OR ‘Sexual health information’ OR Contracept*). The terms within column are connected with an ‘OR’. In the final search process, the third column was not included due to the small number of results. Therefore, the aspect of younger participants was later assessed during the screening of articles and assessing for eligibility criteria. Abbreviations: STD = Sexually transmitted disease, SNS = Social network site.

Figure 1. PRISMA Flow Diagram – Study Selection Process.

Table 3. Study characteristics.

Author	Year	Country	Methodology	Sample	Limitations
Burns et al.	2021	United States	9 group-depth interviews	N = 41 18–21 years African American males 63,4 % not in a relationship 68,3 % having sex in the past 6 months	−small sample size −optimal time to discuss sexual health prevention may be during the preadolescence phase of development
Byron et al.	2013	Australia	2 phases of focus group discussions −1.) divided into age groups (16–17 years and 18–22 years, school vs. post-school) −2.) mixed age and sex	N = 22 16–22 years Urban and regional males and females	−not mentioned
Ewert et al.	2016	Australia	Semi-structured interviews	N = 28Males 18–25 years Australian and international students Majority identifies as heterosexual	−data analysis is subjective and thus open to researcher bias
Jones et al.	2019	United States	8 focus groups (separated by gender) Facebook intervention	N = 63 15–23 years 57% female From a midwestern university, a large inner-city high school, and a rural high school	−self reported data may negatively affect validity −social desirability bias
McKee et al.	2018	Australia	7 focus groups Intervention: iPad App 7 Funny Guys, vulgar comedy videos featuring male comedians telling jokes about sexual health topics	N = 6groups with young people 15 males, 5 females 14–20 years	−not mentioned
Pedrana et al.	2013	Australia	4 focus groups Intervention: 2010 launched ‘Queer as F**k’ (QAF), an innovative and novel sexual health promotion intervention using SNS to target gay men	N = 27 21–46 years Gay men	−small number of participants and those who chose to participate may be fans more engaged with the Intervention
Ralph et al.	2011	United States	Mixed method approach: surveys and focus groups with teens	N = 58 Youth in low income communities 14–19 years	−participants were selected with the help of program staff and thus represent a convenience sample −socioeconomic data were not collected to confirm income status -findings be considered in the context of the time period in which the data were collected (2008)
Selkie et al.	2011	United States	Mixed method: survey and 5 focus groups	N = 29 14–19 years 65.5% female 61.1% heterosexual	−small sample size and thus limited generalizability −having both genders in each group may have inhibited communication

Table

Inclusion Criteria	Exclusion Criteria
Published in English or German	Not published in English or German
Primary studies	Secondary studies (reviews or meta-analyses)
Focused on developed countries	Not focused on developed countries
Focused on young adults (10–24 years)	Not focused on young adults
Focused on Social Media or SNS	Not focused on Social Media or SNS
Referring to Benefits or Barriers of Social Media or SNS use for sexual health promotion	No references to Benefits or Barriers of Social Media or SNS use for sexual health promotion
Humans	Not humans
Published between 210–2021	Not published between 2010–2021
Qualitative approach (self-reported data, interviews, focus groups etc.)	Quantitative approach (content analyses, experiments etc.)

Table

Author	Year	Main Topic/Outcome	Form of Social Media	Theory	Benefits and Potentials	Barriers and Challenges
Burns et al.	2021	Condom use forSTI prevention	Social media in general	Theory of Planned Behaviour (TPB)	−social media already used for other educational purposes −straight forward −entertaining −easy to find information −to recruit for further face-to-face communication −messages can be delivered through leader/important personalities or other respected persons by the target group −interaction with target group −fast, accessible −meeting individuals in their own settings −use more than one platform to spread messages −young people can easily express themselves as well	−not mentioned
Byron et al.	2013	Sexual health topics in general	Social media in general and specifically Facebook	Not mentioned	−keeping up with current events −immediacy of engagement −rather generalized campaigns instead of explicit information −using humour −make sexual health information more accessible −use real/personal stories rather than facts	−potential for embarrassment and drama in overt discussions of sexual health in these spaces −unlikely to be shared due to stigma −public nature of SNS unsuitable for detailed discussion −disruption of social media practices (not suitable) −too negative or serious approach −many ways to use SNS −Facebook not suitable −privacy −acute awareness of the dangers of publicly expressing private matters −overseen or ignored like other ads
Ewert et al.	2016	Barriers to access for sexual health care & promotional strategies for sexual health for young men	Facebook	Not mentioned	−Facebook: novel way to communicate to young people	−Facebook: not the right place for this sort of information −concerned about being associated with it publicly
Jones et al.	2019	Educational Facebook intervention for STD prevention, knowledge and awareness	Internet, social media, Facebook (Intervention Caryn Forya)	Not mentioned	−versatility and flexibility −use of videos, attention grabbing images, and up-to date messaging −quick retrieval of information −links to other sources −entertainment aspect −integrate interactive games −use professional speakers -use of different forms together (i.e. sites and apps) −linked to other social media applications −create opportunities for improved parent-child communication −organized and easy to find information potential of reaching individuals seeking trustworthy sexual health information and affecting subsequent risky sexual behaviours −reach large amount of users	−may be received as condescending −Facebook might be outdated (also use other social media forms like Twitter, Tumblr, Snapchat or Instagram) −large amount of information can be deterrent −different effects in different age groups −privacy concerns (anonymity) −will not be taken seriously
McKee et al.	2018	Best way to reach young men with vulgar comedy videos that provide sexual health information	iPad App 7 Funny Guys vs. social media platforms	Van Dijck’s (2013) framework of ‘platformed sociality’ or ‘cultures of connectivity’	−use of videos −(mobile) social media is ideal way to deliver such information −free and sharable for everyone −new ways of participation −entertaining −young people can become peer educators by sharing the content −algorithmic capacities of social media platforms to ‘push’ educational content to target audiences	−entertainment vs. education −stakeholders are afraid of using social media even if they know that the target group would prefer this way of health promotion −avoid being preachy or lecturing -control is limited (distribution of the message etc.) −risk of making content shareable -> unpredictable outcome -might be seen by children who are too young and/or young people might misunderstand the messages
Pedrana et al.	2013	HIV prevention, sexual health promotion for gay men	Social networking sites (SNS), YouTube & Facebook	Not mentioned	−interactive web-based soap-opera style −opportunity for gay community to discuss sexual health content on Facebook with peers −good balance between education and entertainment (Edutainment approach) −target group can get/feels involved −format (video drama series)	−too many things on Facebook so the content may not be noticed −public nature of Facebook -> careful about commenting because it would show up in status updates (concerns of privacy) −Facebook not suitable/appropriate for discussing sexual health −preference to view the content but not to interact −high production quality is important −credibility of video content is important
Ralph et al.	2011	Use of SNS to connect youth to sexual health services	Social networking sites (SNS), MySpace	Not mentioned	−connecting with target populations in their own environments −privacy, anonymity and convenience −through a clinic’s SNS, teens can find information vetted by a reputable health provider −quickly accessible information −engage hard to reach youth -interaction/involvement	−concerns about the accuracy of the information available online −SNS more appropriate for social interaction −concerns about peer or parental reactions −prefer to connect with health professionals face-to-face -inaccuracy and “information overload −rapid development of new technologies
Selkie et al.	2011	Adolescents’ views how technologies could be used for sexual health education (SNS and text messaging)	SNS	Grounded Theory	−health education program run by other adolescents would be considered trustworthy −provide additional information −interaction −providing a ‘safe’ setting to interact with real people via technology	−lack of anonymity in SNSs

Van Dijck, J. 2013. The Culture of Connectivity: A Critical History of Social Media. Oxford University Press. doi:10.1093/acprof:oso/9780199970773.001.0001.

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