Relationship Between Self-Esteem and Risky Sexual Behavior among Adolescents and Young Adults: A Systematic Review

This systematic review aimed to understand the effects of self-esteem on risky sexual behavior (RSB) among adolescents and young adults. We followed the procedures outlined in the Cooper's five-step approach, and used the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 reporting requirements. Published studies were identified using nine electronic databases. Studies were included based on (a) a focus on populations aged between 10 and 25 years; (b) an examination of the association between self-esteem-related factors, in line with RSB outcomes among adolescents and young adults; and (c) early sexual debut before 16 years, having multiple sex partners, and unprotected sex. In total, 11,216 studies were identified, of which nine studies met the inclusion criteria. AU articles received high quality ratings. Despite methodological limitations, results showed that early sexual debut positively associated with self-esteem among female participants; condom use showed a negative association with lower self-esteem among female participants, while condom use decreased with decreasing self-esteem. Several sexual partners were found not to be associated with self-esteem. Intervention programs to increase the self-esteem of adolescents are recommended by educators to reduce risky sexual behavior among adolescents and young adults. Moreover, subsequent studies should develop instruments that assess self-esteem using subscales and educational programs that enhance healthy self-esteem development and correct sexual norms in peer groups and local communities.