Social Media Exposure and Sexual Risk Behaviour among Secondary School Adolescents in Eastern Uganda: A School-Based Cross-Sectional Study

Background Social media platforms have become a central component of adolescents’ daily lives and an important channel through which young people communicate and access information. While these platforms offer opportunities for social interaction and learning, they may also expose adolescents to sexually explicit material and peer influences that promote risky sexual behaviour. In Uganda, adolescent sexual risk behaviour contributes to teenage pregnancy, sexually transmitted infections (STIs), and school dropout. This study assessed the association between social media exposure and sexual risk behaviour among secondary school adolescents in Eastern Uganda. Methods A school-based cross-sectional study was conducted among 384 adolescents in Senior Four to Senior Six in Magamaga Town Council, Mayuge District. Participants were selected using multistage sampling. Data were collected using structured self-administered questionnaires developed by the authors for this study (Supplementary File 1) capturing socio-demographic characteristics, social media use patterns, exposure to sexual content, and sexual behaviours. Data were analyzed using SPSS. Descriptive statistics summarized participant characteristics, and chi-square tests were used to examine associations between social media exposure and sexual risk behaviour at p < 0.05. Results Overall, 88.8% of respondents reported using social media. TikTok (50.8%) and WhatsApp (32.8%) were the most commonly used platforms. Nearly half of respondents (48.4%) reported exposure to sexually explicit content online. Social media users were significantly more likely than non-users to report pornography exposure (52.8% vs 13.9%, p < 0.001), online dating (37.2% vs 2.3%, p < 0.001), sexting (21.5% vs 4.6%, p = 0.002), and early sexual initiation (18.9% vs 6.7%, p = 0.010). Conclusion Social media exposure is highly prevalent among adolescents and is associated with several sexual risk behaviours. Strengthening digital literacy education, comprehensive sexuality education, and parental engagement may help mitigate the potential negative effects of social media exposure on adolescent health.