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Over the last 3 decades, content analyses have documented large amounts of sexual content in mainstream entertainment media, on television and streaming services as well as in films, music, and video games. Most sexual content is conveyed through conversations about sex and, to a somewhat lesser extent, through the portrayal of sexual behaviors, primarily passionate kissing and suggestive actions. Attitudes—evaluations linking attributes to objects—are often presented in the media and may also be the outcomes of media exposure to sexual content. In the context of sexuality, some commonly studied attitudes include attitudes toward casual or extrarelational sexual encounters, attitudes toward contraception use, and attitudes toward sexual abuse or the acceptance of rape myths. Among the most prominent theoretical perspectives examining the links between media exposure and audience outcomes are theories of script building and activation, theories of a worldview cultivation, and theories of cognitive learning of social behaviors, and the attitudes and emotions that underlie them. Sexual attitudes can be conveyed through mainstream entertainment media content in diverse ways. First, the mere presence of certain topics in the content (e.g., casual sexual encounters) might convey an attitude about the behavior’s importance and relevance to people’s lives. At times, such inclusive depictions can empower audience members. The opposite—the exclusion of certain sexual topics from media content (e.g., sexual minority characters) might undermine the serious attitude with which they should be addressed. Second, attitudes may be conveyed through the focus placed upon them in the mediated content. Sexual health, recognized as intrinsically associated with sexual behaviors in the real world, is largely missing from media depictions. The rise in the prevalence of sexual crime storylines, especially in television law-and-order crime drama series, has introduced diversity in the attitudes conveyed toward this topic in the media. Sexual consent is another topic that has received more attention in entertainment media in the last couple of decades; the attitudes most commonly depicted about sexual consent seem to be the minimization of its importance through the portrayal of either altogether absent or implicit and nonverbal consent cues. Third, sexual attitudes in mainstream entertainment content may be depicted through the portrayal of consequences of sexual references and behaviors and through the depiction of the emotions associated with them. Research finds that portrayals of sexual consequences are relatively rare in entertainment narratives but when present, they tend to focus on the emotional and negative outcomes of sex. Fourth, sexual attitudes are often depicted in the media in the context of humor. Humor in its many forms may communicate a lighthearted, discomfort-easing attitude toward sex, but it might also trivialize the behavior and endorse a less serious attitude toward the decisions it entails. Finally, sexual attitudes are often depicted through stereotypes in media content. Common stereotypes in entertainment media include the narrow and biased presentation of sexual minority characters, which tends to marginalize their sexuality and support a heteronormative attitude. Other stereotypes include sexual gender roles and the sexualization of female characters, both communicating demeaning and nonvalidating attitudes toward women and their sexuality.

Adolescence, spanning 10 to 19 years of age, begins with biological changes while transitioning from a social status of a child to an adult. For millions of adolescents in low- and middle-income countries (LMICs), this is a period of exposure to vulnerabilities and risks related to sexual and reproductive health (SRH), compounded by challenges in having their SHR needs met. Globally, adolescent sexual and reproductive ill-health disease burden is concentrated in LMICs, with sexually transmitted infections and complications from pregnancy and childbirth accounting for the majority of the burden. Adolescents around the world are using their voices to champion access to high-quality, comprehensive SRH information and services. Thus, it is imperative that adolescents’ SRH and rights be reinforced and that investments in services be prioritized.

Both academic and lay definitions of sex vary. However, definitions generally gravitate around reproduction and the experience of pleasure. Some theoretical approaches, such as psychoanalysis and evolutionary psychology, have positioned sexuality at the center of psychological phenomena. Much research has also linked sex to health and disease. On the one hand, certain sexual thoughts, feelings, behaviors, and identities have been described as pathological. Over time, some of these have been accepted as normal (especially homosexuality), while new forms of pathology have also been proposed (e.g., “porn addiction”). On the other hand, some aspects of sexuality are being researched due to their relevance to public health (e.g., sex education) or to counseling (e.g., assisted reproduction). Sex research has always been controversial, paradoxically receiving both positive attention and disdain. These contradictory social forces have arguably affected both the content and the scientific quality of sex research.

Although communication scholars have been exploring the role of partner communication in sexual health promotion since the 1960s, the term safer sex, and its corollary safer sex communication, emerged in the late 1980s in the wake of the HIV/AIDS epidemic, which was and still is disproportionately affecting queer individuals. Numerous studies, along with some meta-analyses, point to the protective potential of safer sex discussions, defined here as the communicative management of health concerns with sex partners. Despite scholarly agreement regarding its importance, the term safer sex communication has received little explication, and much of what is known about it comes from studies with predominantly heterosexual samples. A review of the literature on queer safer sex communication points to some key issues related to age, race, trauma history, place, and pre-exposure prophylaxis (PrEP), and suggests important considerations for future research efforts.

Embarrassment, according to Fischer and Tangney, is an “aversive state of mortification, abashment, and chagrin that follows public social predicaments.” It is usually related to our perceptions of how others perceive us as well as their judgments of us, and it is associated with a loss of self-esteem when we perceive that others have judged us as inadequate or incompetent. However, even mere exposure or attention publicly placed on someone can elicit embarrassment (think of someone pointing at you and laughing). Embarrassment is considered a self-conscious emotion. Self-conscious emotions include those that are evoked by self-reflection and self-evaluation: embarrassment, shame, guilt, and pride. Shame, an intense form of embarrassment, also has structural and larger social contexts, while embarrassment is more individually experienced. Self-conscious emotions play an important role in regulating behavior; they assist us in behaving according to social standards and guide us in responding when those rules are broken. While these emotions provide feedback in social situations, they also provide feedback for anticipated outcomes. Embarrassment can play an important role in health, both in communication and behavior, and occurs through different forms. Primary embarrassment is the first rush of blood to the face and increased heart rate that usually lasts a few moments. Secondary embarrassment is the after-effect that shapes future behavior. Anticipatory embarrassment is the emotion surrounding the potential for embarrassment in an upcoming situation. Solitary embarrassment is the one that no one actually observes. Three stigmatized areas of health—mental health, healthcare, and sexual health—may be assessed as case studies through which to understand the literature around embarrassment, as both an affect and an emotion.

In the United States, gender and health in adolescence are sites of contestation and conflict marked by both hyperrepresentations and absences. Youth who are multiply marginalized by interlocking systems of racism, sexism, classism, heterosexism, cissexism, ableism, and so on are overrepresented in cultural and policy domains as “at risk” for negative health outcomes. At the same time, absences surrounding young people’s complex health needs and experiences abound in schools, healthcare settings, families, and the media. For instance, debates around sex education and teen pregnancy prevention have dominated the policy landscape for decades, with no signs of receding any time soon. Missing from these debates has been an analysis of how the intersections of race, class, gender, and sexuality structure the health outcomes and educational experiences of diverse youth. Likewise, queer, transgender, and gender-expansive youth are overrepresented in discussions about bullying to the detriment of the social structural factors that produce poor mental health outcomes. Understanding how gender and health play out in the lives of adolescents, as well as at the level of social institutions and structures, is central to teasing out the dynamics of gender, health, and social inequalities.

This entry defines sexuality and identifies dominant explanatory models. In doing so, the entry outlines the central debate regarding the relative contributions of biology and social context. In addition, it highlights current key issues in the field of sexuality: the connection between sexuality and social inequality, the growing emphasis on the promotion of sexual health and well-being rather than just the prevention of sexual risk, the salience of sexuality across the life course, and the debate regarding sexuality education policy. Finally, it identifies parallels between these trends and social work, including the relation of sexuality to social work roles and practice.

Both significant progress and profound backlash have occurred in the inclusion of sexual and gender diversity across eastern and southern Africa. This includes the decriminalization of homosexuality in Mozambique in 2015 and the introduction of the Anti-Homosexuality Act (later annulled) in Uganda in the preceding year. Simultaneously there is increased pressure on Ministries of Education to engage more robustly with sexual and reproductive health and rights (SRHR) education in education systems across the region. Emerging regional research points to a narrow, heteronormative focus in comprehensive sexuality education; access barriers to sexual and reproductive health services; and pervasive school-related gender-based violence, including homophobic and transphobic violence. Civil society organizations (CSOs) play a key role in developing best practice in advancing the SRHR of sexual and gender minority youth and are therefore a valuable resource for government SRHR policies and programmatic responses. The regional SRHR education policy landscape is underpinned by two policy narratives: that of young people’s SRHR as a public health concern and a focus on young people’s human rights. These policy narratives not only underpin SRHR policy in the region but also in many instances are drawn on in CSO advocacy when positioning the SRHR of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) young people as an important policy concern. These two dominant policy narratives, however, have a narrow focus on young people’s risks and vulnerabilities, may inadvertently perpetuate stigma and marginalization of LGBTQI youth, and may limit youth voice and agency. These narratives also do not sufficiently engage local sociocultural and structural conditions that drive negative SRHR outcomes for young people in the region. Research, advocacy, and policy development toward the full realization of the SRHR of sexual and gender minority youth can address some of the limitations of health and rights-based policy narratives by drawing on a sexual and reproductive justice framework. Such a framework expands the policy focus on health risks and individual rights to include engagement with sociocultural and structural constraints on young people’s ability to exercise their rights. A sexual and reproductive justice framework provides a more robust toolkit when working toward full inclusion of sexual and gender diversity in regional school-based SRHR policy and programs.

Health behaviors are a major source of morbidity and mortality in the developed and much of the developing world. The social nature of many of these behaviors, such as eating or using alcohol, and the normative connotations that accompany others (i.e., sexual behavior, illegal drug use) make them quite susceptible to peer influence. This chapter assesses the role of social interactions in the determination of health behaviors. It highlights the methodological progress of the past two decades in addressing the multiple challenges inherent in the estimation of peer effects, and notes methodological issues that still need to be confronted. A comprehensive review of the economics empirical literature—mostly for developed countries—shows strong and robust peer effects across a wide set of health behaviors, including alcohol use, body weight, food intake, body fitness, teen pregnancy, and sexual behaviors. The evidence is mixed when assessing tobacco use, illicit drug use, and mental health. The article also explores the as yet incipient literature on the mechanisms behind peer influence and on new developments in the study of social networks that are shedding light on the dynamics of social influence. There is suggestive evidence that social norms and social conformism lie behind peer effects in substance use, obesity, and teen pregnancy, while social learning has been pointed out as a channel behind fertility decisions, mental health utilization, and uptake of medication. Future research needs to deepen the understanding of the mechanisms behind peer influence in health behaviors in order to design more targeted welfare-enhancing policies.

Frederick Augustus Salvador Cox (April 15, 1944–July 12, 2009) was a teacher, social worker, and lay minister who campaigned for sexual and reproductive rights, advocated for the preservation of the family, and worked tirelessly to encourage men to play a meaningful role in society. Born on April 15, 1944, in the rural community of Freetown, Pomeroon, Guyana, Frederick moved to the capital city, Georgetown, where he trained as a teacher and social worker. He contributed to Guyana’s social development in many ways, including as a principal (Sophia Special School), president (Guyana Association of Professional Social Workers), chairman (Medical Termination of Pregnancy Board) as the longest serving executive director of the Guyana Responsible Parenthood Association and a lay minister with the Church of the Transfiguration. Apart from maintaining an active public profile and addressing various social issues, Frederick gained national attention hosting Social Work and You, a weekly radio program. His activism and contributions were such that in paying tribute to him on his death on July 12, 2009, then Minister of Health Dr. Leslie Ramsammy told the media that Frederick Cox was an asset who would be difficult to replace. Indeed, since the passing of this consummate social worker, Guyana has not seen another male of his caliber assume a public role to advocate for sexual and reproductive health and women’s rights.

Conditional economic incentives are a theoretically grounded approach for eliciting behavior change. The rationale stems from present-biased preferences, by which individuals attach greater value to benefits in the present and heavily discount long-term health. A growing literature documents the use of economic incentives in the HIV field. Small and frequent conditional economic incentives offered to vulnerable populations can contribute to behavior change. Economic incentives accompanied with other strategies can help overcome obstacles to access health services and in general seem to improve linkage to HIV care, prevention interventions, and adherence to HIV treatment. Future identification of promising combinations of intervention components, modalities, and strategies may yield maximum impact.