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This review examined associations of adolescent sexting and specific sexual behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, PsycInfo, Web of Science, CMMC, and MEDLINE were searched in December 2023, February 2024, and September 2025 yielding 5310 references. Eligible studies examined associations between sexting and sexual behaviours among adolescents (10\u201319 years), published in English. Two reviewers independently screened and extracted data per PRISMA guidelines. Quality was assessed using the JBI Critical Appraisal Checklist. Meta\u2010analyses used a random\u2010effects model, with heterogeneity assessed via I\u00b2 statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen studies from the EU, Australia and USA, comprising 54,373 adolescents were included in this review; nine contributed to the meta\u2010analysis. Most studies framed sexting as a risk behaviour, fewer adopted normative or dual perspectives. Sexting was associated with multiple sexual behaviours, particularly among older adolescents, LGBTQ+ teenagers, and those in romantic relationships. Meta\u2010analysis found sexting was significantly associated with sexual intercourse (OR\u2009=\u20095.69), oral sex (OR\u2009=\u200912.50), vaginal intercourse (OR\u2009=\u20099.50), anal intercourse (OR\u2009=\u200912.30), and multiple sexual partners (OR\u2009=\u20092.10). Subgroup analysis found specific measures of vaginal intercourse yielded more consistent estimates than unspecified sexual intercourse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These associations highlight the need for multisystem interventions that address both the risks of adolescent sexting and its role in adolescent sexual development in the digital era. Effective responses to sexting should integrate both its risks and its role in adolescent development into policy, education, and health strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jad.70101","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T10:39:25Z","timestamp":1767091165000},"page":"678-697","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Associations Between Sexting and Sexual Behaviours in Adolescents: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"98","author":[{"given":"Thea Nicholla Everille","family":"Benjamin","sequence":"first","affiliation":[{"name":"International Health Program National Yang Ming Chiao Tung University Taipei Taiwan"},{"name":"Institute of Public Health National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilailak","family":"Saengsri","sequence":"additional","affiliation":[{"name":"International Health Program National Yang Ming Chiao Tung University Taipei Taiwan"},{"name":"International Health Policy Program Foundation Nonthaburi Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Hsu","family":"Lin","sequence":"additional","affiliation":[{"name":"Institute of Health and Welfare Policy National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song\u2010Lih","family":"Huang","sequence":"additional","affiliation":[{"name":"International Health Program National Yang Ming Chiao Tung University Taipei Taiwan"},{"name":"Institute of Public Health National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9949-6306","authenticated-orcid":false,"given":"Alexander","family":"Waits","sequence":"additional","affiliation":[{"name":"International Health Program National Yang Ming Chiao Tung University Taipei Taiwan"},{"name":"Institute of Public Health National Yang Ming Chiao Tung University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2008.031351"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/10304312.2012.665840"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/10304312.2012.665840"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.46743\/2160-3715\/2017.2951"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/00324728.2022.2094452"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.05.009"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40894-022-00199-0"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.610474"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/0092623X.2019.1613463"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12144-019-00398-4"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/02724316221113351"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","unstructured":"Breiner H. 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