Sexting has become increasingly common among youth worldwide, yet evidence from mainland China is limited. This study aimed to estimate the prevalence of sexting and examine how its characteristics-such as frequency, partner relationship, medium, and non-consensual experiences-are associated with depression among youth in Guangzhou. A cross-sectional survey was conducted between October and November 2022 among 17,035 vocational college students aged 16-24 years, selected through multistage stratified cluster sampling (response rate: 57.0%). Sexting characteristics were assessed across five dimensions: frequency, partner relationship, transmission medium, media type, and non-consensual experiences. Depression was measured using the CES-D10 scale. Logistic regression models were applied to examine associations. Overall, 2.5% (n = 427) reported ever engaging in sexting. Among them, 62.8% exhibited depressive symptoms. Specific characteristics of sexting showed differential associations with depression. Monthly (ORa = 2.66, 95% CI: 1.45-4.98) and weekly sexting (ORa = 3.19, 95% CI: 1.77-5.90) were significantly associated with depression, while daily sexting was not. Non-consensual sexting-sending nude images under pressure (ORa = 2.70, 95% CI: 1.27-6.28) or receiving unsolicited nude images (ORa = 2.42, 95% CI: 1.20-5.24)-was also linked to increased depression risk. In contrast, variations in partner type, medium, or media form showed no significant associations. Despite the relatively low prevalence of sexting, specific characteristics-particularly sporadic and non-consensual sexting-were associated with elevated risk of depression. These findings highlight the importance of culturally tailored sexual health education addressing digital consent, privacy, and mental well-being among Chinese youth.
Keywords: Adolescent; China Mainland; Depression; Mental health; Non-consensual sexting; Sexting.
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