Online sexual health information seeking, digital literacy, and risk behaviors among Brazilian university students

Authors

DOI:

https://doi.org/10.29352/mill0229.44627

Keywords:

social media; sexual health; digital health literacy; mental well-being; young adults

Abstract

Introduction: Social media are a central source of sexual and mental health information for young adults, yet the impact of this exposure on their practices and well-being remains unclear. It is necessary to understand how online sexual information seeking, digital health literacy, and problematic social media use relate to the knowledge, attitudes, and sexual behaviors of this population.

Objective: Analyze how exposure to digital content related to sexual and mental health influences the knowledge, attitudes, and behaviors of young adult college students.

Methods: A cross-sectional online survey was conducted with 65 Brazilian university students aged 18–30 years. The questionnaire assessed online sexual information seeking, digital health literacy (eHEALS), mental health literacy (MHLq), problematic social media use (SMDS), symptoms of depression, anxiety, and stress (DASS-21), and risky sexual behaviors. Data were analyzed using descriptive statistics, chi-square tests, and correlations, and multivariable logistic and linear regression models, controlling for relevant sociodemographic variables.

Results: Among the participants, most reported having searched for sexual information online, but this behavior was not associated with a lower likelihood of risky sexual practices. No significant associations were found between online sexual information seeking, digital health literacy, or perceived ability to evaluate online information and sexual risk behaviors. In contrast, older age and sexual minority status were associated with a higher probability of reporting at least one risky sexual behavior. Problematic social media use showed a consistent association with higher levels of depression, anxiety, and stress symptoms, with no clear link to sexual risk behaviors.

Conclusion: In this sample of Brazilian university students, online sexual information seeking and higher perceived digital health literacy were not clearly associated with safer sexual practices. Sociodemographic factors such as age and sexual minority status played a more prominent role in explaining sexual risk, whereas problematic social media use emerged as an important marker of greater psychological distress.

Downloads

Download data is not yet available.

References

Barros, J., Oliveira, L., Souza, R., & Yamaguchi, M. (2022). Adaptação transcultural e evidências da validade da eHealth Literacy Scale para uso no Brasil. Revista de Enfermagem Referência, 6(1). https://doi.org/10.12707/RV21066

Boer, M., van den Eijnden, R. J. J. M., Finkenauer, C., Boniel‐Nissim, M., Marino, C., Inchley, J., Cosma, A., Paakkari, L., & Stevens, G. W. J. M. (2022). Cross‐national validation of the social media disorder scale: Findings from adolescents from 44 countries. Addiction, 117(3), 784–795. https://doi.org/10.1111/add.15709

Borji‐Navan, S., Maleki, N., & Keramat, A. (2024). Efficacy of digital health interventions used for adolescent’s sexual health: An umbrella review. Health Science Reports, 7(12). https://doi.org/10.1002/hsr2.70212

Campos, S., Ferreira, M., Cardoso, A. P., Guiné, R., Aparício, G., & Nelas, P. (2022). Literacia em saúde nos estudantes do ensino superior: estudo exploratório. Millenium - Journal of Education, Technologies, and Health, 2(10e), 37–45. https://doi.org/10.29352/mill0210e.25529

Chou, W. Y. S., Gaysynsky, A., & Cappella, J. N. (2020). Where we go from here: Health misinformation on social media. American Journal of Public Health, 110(S3), S273–S275. https://doi.org/10.2105/AJPH.2020.305905

Corradini, E. (2024). Deconstructing cultural appropriation in online communities: A multilayer network analysis approach. Information Processing & Management, 61(3), 103662. https://doi.org/10.1016/j.ipm.2024.103662

Döring, N., & Conde, M. (2021). Sexuelle Gesundheitsinformationen in sozialen Medien: Ein systematisches Scoping Review. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, 64(11), 1416–1429. https://doi.org/10.1007/s00103-021-03431-9

Ferreira, A., Moreira, M. T., Rodrigues, S., Lima, A., Ferreira, S., & Fernandes, C. S. (2025). Use of technologies in promoting adolescent mental health: A scoping review. Creative Nursing, 31(2), 111–118. https://doi.org/10.1177/10784535251313554

Fisher, C. B., Tao, X., & Ford, M. (2024). Social media: A double-edged sword for LGBTQ+ youth. Computers in Human Behavior, 156, 108194. https://doi.org/10.1016/j.chb.2024.108194

Gaysynsky, A., Senft Everson, N., Heley, K., & Chou, W.-Y. S. (2024). Perceptions of health misinformation on social media: Cross-sectional survey study. JMIR Infodemiology, 4, e51127. https://doi.org/10.2196/51127

Guedes, D. P., & Lopes, C. C. (2010). Validação da versão brasileira do Youth Risk Behavior Survey 2007. Revista de Saúde Pública, 44(5), 840–850. https://doi.org/10.1590/S0034-89102010000500009

Holch, P., & Marwood, J. R. (2020). EHealth literacy in UK teenagers and young adults: Exploration of predictors and factor structure of the eHealth Literacy Scale (eHEALS). JMIR Formative Research, 4(9), e14450. https://doi.org/10.2196/14450

Kaňková, J., Binder, A., & Matthes, J. (2025). Health-Related communication of social media influencers: A scoping review. Health Communication, 40(7), 1300–1313. https://doi.org/10.1080/10410236.2024.2397268

Kbaier, D., Kane, A., McJury, M., & Kenny, I. (2024). Prevalence of health misinformation on social media—Challenges and mitigation before, during, and beyond the COVID-19 pandemic: Scoping literature review. Journal of Medical Internet Research, 26, e38786. https://doi.org/10.2196/38786

Keles, B., McCrae, N., & Grealish, A. (2020). A systematic review: The influence of social media on depression, anxiety and psychological distress in adolescents. International Journal of Adolescence and Youth, 25(1), 79–93. https://doi.org/10.1080/02673843.2019.1590851

Költő, A., Young, H., Willis, M., Godeau, E., Nic Gabhainn, S., & Saewyc, E. M. (2025). Sexual behavior in sexual minority and non-minority youth from eight European countries. The Journal of Sex Research, 62(7), 1173–1185. https://doi.org/10.1080/00224499.2024.2429535

Lameiras-Fernández, M., Martínez-Román, R., Carrera-Fernández, M. V., & Rodríguez-Castro, Y. (2021). Sex education in the spotlight: What Is working? Systematic review. International Journal of Environmental Research and Public Health, 18(5), 2555. https://doi.org/10.3390/ijerph18052555

Livingstone, S., Mascheroni, G., & Staksrud, E. (2018). European research on children’s internet use: Assessing the past and anticipating the future. New Media & Society, 20(3), 1103–1122. https://doi.org/10.1177/1461444816685930

Milanti, A., Norman, C., Chan, D. N. S., So, W. K. W., & Skinner, H. (2025). eHealth Literacy 3.0: Updating the Norman and Skinner 2006 model. Journal of Medical Internet Research, 27, e70112. https://doi.org/10.2196/70112

Moreira WC, Campos L, Dias P, & Nóbrega MPSS. (2025). Adaptation and content validation of the Brazilian version of the Mental Health Literacy Questionnaire. Revista Brasileira de Enfermagem, 78(4). https://doi.org/10.1590/0034-7167-2024-0309

Norman, C. D., & Skinner, H. A. (2006). eHealth literacy: Essential skills for consumer health in a Networked World. Journal of Medical Internet Research, 8(2), e9. https://doi.org/10.2196/jmir.8.2.e9

Petty, R. E., & Cacioppo, J. T. (1986). The Elaboration Likelihood Model of Persuasion. Advances in Experimental Social Psychology, 19, 123-205. https://doi.org/10.1016/S0065-2601(08)60214-2

Pollitt, A. M., & Mallory, A. B. (2021). Mental and sexual health disparities among bisexual and unsure Latino/a and Black sexual minority youth. LGBT Health, 8(4), 254–262. https://doi.org/10.1089/lgbt.2020.0374

Reeves, J. M., Griner, S. B., Johnson, K. C., Jones, E. C., & Shangani, S. (2024). Exploring relationships between dating app use and sexual activity among young adult college students. Frontiers in Reproductive Health, 6. https://doi.org/10.3389/frph.2024.1453423

Shannon, H., Bush, K., Villeneuve, P. J., Hellemans, K. G., & Guimond, S. (2022). Problematic social media use in adolescents and young adults: Systematic review and meta-analysis. JMIR Mental Health, 9(4), e33450. https://doi.org/10.2196/33450

Stimpson, J. P., Park, S., Adhikari, E. H., Nelson, D. B., & Ortega, A. N. (2025). Perceived health misinformation on social media and public trust in Health Care. Medical Care, 63(9), 686–693. https://doi.org/10.1097/MLR.0000000000002180

Swire-Thompson, B., & Lazer, D. (2020). Public health and online misinformation: Challenges and recommendations. Annual Review of Public Health, 41(1), 433–451. https://doi.org/10.1146/annurev-publhealth-040119-094127

Twenge, J. M., Joiner, T. E., Rogers, M. L., & Martin, G. N. (2018). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among U.S. adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science, 6(1), 3–17. https://doi.org/10.1177/2167702617723376

Vandenbosch, L., & Eggermont, S. (2013). Sexualization of adolescent boys. Men and Masculinities, 16(3), 283–306. https://doi.org/10.1177/1097184X13477866

Vignola, R. C. B., & Tucci, A. M. (2014). Adaptation and validation of the depression, anxiety and stress scale (DASS) to Brazilian Portuguese. Journal of Affective Disorders, 155, 104–109. https://doi.org/10.1016/j.jad.2013.10.031

Yonker, L. M., Zan, S., Scirica, C. V, Jethwani, K., & Kinane, T. B. (2015). “Friending” teens: Systematic review of social media in adolescent and young adult health care. Journal of Medical Internet Research, 17(1), e4. https://doi.org/10.2196/jmir.3692

Zhou, X., Edirippulige, S., Bai, X., & Bambling, M. (2021). Are online mental health interventions for youth effective? A systematic review. Journal of Telemedicine and Telecare, 27(10), 638–666. https://doi.org/10.1177/1357633X211047285

Downloads

Published

2026-02-27

How to Cite

Couto, G., Oliveira, I., Moreira, M. T., & Nóbrega, M. do P. (2026). Online sexual health information seeking, digital literacy, and risk behaviors among Brazilian university students. Millenium - Journal of Education, Technologies, and Health, 2(29), e44627. https://doi.org/10.29352/mill0229.44627

Issue

Section

Life and Healthcare Sciences