Social media use frequency and sexual behavior among U.S. high school students

Background High-frequency social media use has been associated with the normalization of sexual activity and earlier initiation through exposure to peer-generated content. Most prior studies rely on coarse screen time measures that conflate passive consumption with compulsive social media engagement, limiting inference about frequency-specific risk. Methods We analyzed restricted-use 2023 National Youth Risk Behavior Survey data, which introduced the first granular measure of social media use frequency and used Linear Probability Models. Results Checking social media more than once per hour was associated with a 9.4 percentage point higher probability of ever having sex (p < 0.01). Associations with sex before age 13, sex before age 16, and having multiple partners were statistically insignificant. Implications School health counselors and educators working with high school students are well positioned to incorporate social media literacy into existing sexual health curricula. Conclusions These findings offer nationally representative evidence relevant to ongoing legislative debates over engagement-maximizing platform design features targeting adolescents and to platform content policies addressing sexual normalization content reaching adolescent audiences. While the findings suggest potential policy relevance, they reflect associations rather than causal effects; further research, including longitudinal studies and other designs suited to causal inference, is needed to confirm these relationships and inform interventions.