Sexually explicit and violent media use among high school students in Vietnam: Gender-differentiated links with sexual misconduct victimization, perpetration, and health

In lower-income countries, research is lacking on levels and associations of using sexually explicit, physically non-violent media (SEM) or sexually explicit, physically violent media (SVM) with well-being outcomes in high-school students. We tested theories of gendered aggression and moral incongruence to explain the associations of SEM use and/or SVM use versus non-use with sexual misconduct perpetration/victimization and other well-being outcomes among students attending three high schools in Ho Chi Minh City, Vietnam. 712 students completed surveys about their general health, mental health, alcohol use, academic disengagement, sexual misconduct perpetration and victimization, beliefs about pro-violence peer norms, and any SEM/SVM use in the prior six months. Unadjusted and adjusted regression models were estimated. Most reported SEM (47 %) or SVM (32 %) use. SVM use was higher among boys (39 %) than girls (27 %) (χ 2 p = 0.01). Among boys, compared to non-users, users reported worse self-rated health (SEM acoef = 0.44 (0.10, 0.78); SVM acoef = 0.58 (0.23, 0.93)), higher alcohol use (SEM aOR = 2.42 (1.06, 5.58); SVM aOR = 2.44 (1.05, 5.62)), and higher sexual misconduct perpetration involving physical dating violence, stalking, or sexual violence (SVM aOR = 5.02 (1.39, 18.06)). Among girls, compared to non-users, SVM users reported higher sexual misconduct perpetration (aOR = 2.59 (1.13, 5.92)) and sexual violence victimization (aOR = 5.74 (1.81, 18.22)); SEM users reported higher sexual misconduct victimization involving physical dating violence, sexual harassment, stalking, or sexual violence (OR = 2.32 (1.33, 4.04)). Most high-school students in this study reported sexualized media use, and boys reported SVM use more often than girls. Corroborating gendered aggression theory, sexualized media use tended to predict violence perpetration among boys and victimization among girls. Corroborating moral incongruence theory, boys’ use was associated with worse self-rated health and alcohol use. Contextualized programs may reduce student access to common modalities of sexualized media use and educate school communities about the harms of use. • Sexualized media use (especially by boys) is common in high schools in Vietnam. • Gendered aggression theory helps explain the effects of use on sexual misconduct. • Moral incongruence theory helps explain poorer health among male users. • Addressing sexualized media use is needed to improve student well-being in Vietnam.