Revista Adolescência e Saúde

Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ

NESA Publicação oficial
ISSN: 2177-5281 (Online)

Vol. 14 nº 4 - Oct/Dec - 2017

Original Article Imprimir 

Páginas 66 a 76

Use and perception of adolescents about commercial video games with implicit sexual content in Colombia

Utilización y percepción de adolescentes sobre video games comerciales con contenido sexual implícito en Colombia

Utilização e percepção de adolescentes sobre videogames comerciais com conteúdo sexual implícito na Colômbia

Autores: Lucia Stella Tamayo Acevedo1; Mónica Isabel Tamayo Acevedo2; Ma. Guadalupe Chávez Méndez3

1. Doctor in Medical Sciences - Professor - Researcher - School of Microbiology - University of Antioquia ( UdeA ). Medellin , AC, Colombia
2. Master in Art History. University of Antioquia - (Professor - Researcher - Faculty of Communication - University of Medellín ( UdeA ) Medellín, AC, Colombia
3. Doctor in Social Sciences - Researcher Professor - Faculty of Communication and Literature - University of Colima ( UdeC ). Colima, AC, Mexico

Lucia Stella Tamayo Acevedo
Universidad de Antioquia
Calle 67, No. 53 - 108, Bloque 5-406
Ciudad Universitaria. Medellín, AC, Colombia

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Keywords: Adolescent, sexual health, health communication, sex education, information technology.
Palabra Clave: Adolescente, salud sexual, comunicación en salud, educación sexual, tecnología de la información.
Descritores: Adolescente, saúde sexual, comunicação em saúde, educação sexual, tecnologia da informação.

OBJECTIVE: Characterize the use and perception of video games with implied sexual content by high school students in Medellin.
METHODS:Descriptive cross-sectional study with 1124 adolescents within eighth to eleventh grades of four public educational institutions. It was applied an structure questionnaire with socio-demographic, psychosocial, knowledge and risk factors question associated with sexual health and access, use and perception of video games.
RESULTS: Highlights the high consumption of video games, bigger in male adolescents, as the lack of educational video games in sexual health, lack of control regarding the time spend with and adult content. Adolescents felt that video games developed their: mental agility, analysis capacity, problem solving and decision making. The purpose of game use is focused on the goals and overcome their own recorde and friends' records, where men are more competitive. The implied sexual content was identified through: the design of characters, costumes, language, scenarios and relationships between characters, with marked sex difference.
CONCLUSION: The consumption of video games as new cultural products in this study was high, with marked difference by sex. It showed the implied sexual content leading to rethink the traditional forms of sexual education through interactive pedagogical and immersive proposals that simulate reality.

OBJETIVO: Caracterizar el uso y la percepción de los estudiantes de enseñanza medio en Medellín sobre video games con contenido sexual implícito.
MÉTODOS: Estudio descriptivo transversal con 1124 adolescentes do octavo al décimo primer año de cuatro instituciones públicas de enseñanza. Fue aplicado un cuestionario estructurado con preguntas sociodemográficas, psicosociales, conocimientos y factores de riesgo para la salud sexual, acceso, uso y percepción sobre video games.
RESULTADOS: Se destaca el alto consumo de video games, en su mayoría por los adolescentes del sexo masculino, así como la ausencia de video games educativos en salud sexual, falta de control con relación al tiempo dedicado al juego y contenido adulto. Los adolescentes sienten que los video games desarrollan: agilidad mental, capacidad de análisis, resolución de problemas y toma de decisiones. El objetivo de la utilización de los juegos enfoca en metas y superación del propio record y del record de los amigos, donde los jóvenes son más competitivos. El contenido sexual implícito fue identificado a través: del diseño de personajes, ropa, lenguaje, escenarios y relaciones entre los personajes, con una diferencia marcada por sexo.
CONCLUSIÓN: El consumo de video games como nuevos productos culturales en este estudio fue alto, con una diferencia marcada por el sexo. Mostró un contenido sexual implícito, llevando a repensar las formas tradicionales de educación sexual a través de propuestas pedagógicas interactivas y de inmersión que simulan la realidad.

OBJETIVO: Caracterizar o uso e a percepção dos estudantes do ensino médio em Medellín sobre videogames com conteúdo sexual implícito.
MÉTODOS: Estudo descritivo transversal com 1124 adolescentes do oitavo ao décimo primeiro ano de quatro instituições públicas de ensino. Foi aplicado um questionário estruturado com questões sociodemográficas, psicossociais, conhecimentos e fatores de risco para a saúde sexual, acesso, uso e percepção sobre videogames.
RESULTADOS: Destaca-se o consumo elevado de videogames, na maioria pelos adolescentes do sexo masculino, assim como a ausência de videogames educativos em saúde sexual, falta de controle com relação ao tempo dedicado ao jogo e conteúdo adulto. Os adolescentes sentem que os vídeo-games desenvolvem: agilidade mental, capacidade de análise, resolução de problemas e tomada de decisões. O objetivo da utilização dos jogos foca em metas e superação do próprio recorde e do recorde dos amigos, onde os rapazes são mais competitivos. O conteúdo sexual implícito foi identificado através: do design de personagens, roupas, linguagem, cenários e relações entre as personagens, com uma diferença marcada por sexo.
CONCLUSÃO: O consumo de videogames como novos produtos culturais neste estudo foi alto, com uma diferença marcada pelo sexo. Mostrou um conteúdo sexual implícito, levando a repensar as formas tradicionais de educação sexual através de propostas pedagógicas interativas e imersivas que simulam a realidade.


This century is marked by technology. This implies that the education of adolescents has a direct link with it. In this media scenario, videogames are an excellent way to increase learning due to its playful, interactive and immersive nature that facilitates the acquisition of knowledge, the development of basic skills, inductive-deductive reasoning, and the construction and implementation of cognitive strategies in an organized way, allowing individuals to appropriate, understand and value their social and cultural environment1,2.

The virtual world is inhabited, felt and lived without the pressures, obligations and consequences of reality. The transfer of the real to the digital scene is one of the biggest attractions of videogames, its recreations of reality are useful to secureanalytical skills in decision making and solving everyday problems3. Despite their possibilities and benefits, there is a strong concern of parents and educators regarding the use of video games and a lack of knowledge, derived from generational differences and fear of digital technology, of how adolescents see these new products. For Jenkins, video games redefine communication and access to information for new ways of producing knowledge, where immersion and interactivity play a preponderant role in the transmission of ideologies and values4. According to Matysiak and Valleur, there are three key points when considering videogames as a means of communication: i) represents an independent medium that can not be interpreted in relation to traditional forms of communication; ii) its potential lies in the possibility of transmitting messages in an unusual way; and iii) it has shared authorship between creators and players, which allows the generation of communication and knowledge networks, especially in the collaborative game5.

The investigations about videogames as a means of communication for health date back to the 1990s and its aim is to prevent, promote and train health personnel from simulations6. Web 2.0 offers a wealth of information about sexual content from a commercial and educational point of view. Adolescents have free access, but in the meantime they are not prepared for the right choice and reading of these audiovisual products. In contrast, traditional communicative and educational sex education strategies for adolescents have had a smaller impact, which in particular for Medellín, still persist the high rates of adolescent pregnancy, sexually transmitted infections (STIs) and sexual risk behaviors for health7,8. These traditional ways of informing, communicating and getting accustomed to move away from new ways of creating and appropriating knowledge in a society linked to digital media production and consumption, which leads to the need to investigate the possibilities and effects of video games in the education of adolescents, including sexual health.

In adolescence, sexuality is more important due to biological, psychological and social changes, and the appropriation of knowledge and values regarding sexual health, which in turn will influence the fulfillment of a full and responsible life9,10. In this sense, it is necessary to develop strategies focused on the prevention of adverse consequences such as unplanned pregnancy, STIs and psycho-affective problems.

In Colombia, adolescents represent approximately 12.5% of the population. On average, the onset of sexual intercourse occurs between the ages of 15 and 1911, at which point they expose themselves to risky practices based on deficient knowledge and the presence of other factors such as: consumption of alcoholic beverages, tobacco and hallucinogenic substances, absence of father figure and early attachment to the informal labor market12,13. Under these conditions, adolescents live their sexuality with negative effects on their life projects, in addition to the high social and economic costs that they mean for the country.

The purpose of this article is to characterize the use and perception of secondary students of Medellín in relation to commercial video games with implicit sexual content by them, with the purpose of contributing to the knowledge for pedagogical proposals that incorporate new communicative and educational strategies in sexual health. This article is part of the research project "Video game as a means to develop strategies in communication for health: a proposal to foster a culture of prevention and self-care of sexual health in young people in Medellín - Colombia and Colima - Mexico", the product of work collaborative between the universities of Antioquia, Medellín and Colima-Mexico.


A cross-sectional descriptive study was carried out with 1,124 adolescents enrolled from eighth to eleventh grade in four public education institutions in Medellín, selected for convenience to socially, culturally, geographically and economically represent the situation of schoolchildren in the city.

A representative sample size of 1,162 students was calculated under the parameters: 95% confidence level, 3% sample error, 50% probability of using video games. This was stratified proportionally to the number of students from the four institutions convened. Assistants who accepted voluntary participation were included.

Authorizations were requested in the technical-administrative instances of the education sector. The project presented itself to the educational community to indicate its importance in the design of new educational and communicative strategies in sexual health. All students were explained their participation in the project and their consent was informed. Once the information was understood, the consent and application of a self-administered poll was divided into sections: Sociodemographic characterization, Perceived socioeconomic and psychosocial situation, Perception and use of video games, Commercial video games with implicit sexual content of more use, Sexual health: knowledge, sexual practices and self-care. In the last one, a questionnaire of 20 multiple-choice questions was used, qualified between 0 and 10 points, whose approval criterion was based on 6 points. The research was answered during school hours, during approximately 40 minutes, under the presence of the researchers. Each questionnaire was previously identified with a code. Once it was answered, it was revised to detect inconsistencies and faults.

We controlled information and selection bias with the standardization of researchers, question control and validation of the instrument through a pilot test conducted with 20 students from another educational institution, different from those selected. The data was processed in Excel, version 7.0, employing double typing to control errors and inconsistencies. The sample size reached compared to the calculated was 96.7%.

Data analysis was performed in the SPSS program, version 21. Relative and absolute frequencies and central tendency measures were determined for the variables under study. Subsequently the bi-varied analysis was carried out contrasting the group of players with those of non-players. In the players the use and perception, compared by sex as an indicator of possible gender inequalities, were characterized. Differences were set at p <0.05.

According to Resolution no. 008430 of 1993 from the Ministry of Health of Colombia, this investigation has no health risk, as it is free of invasive procedures14. The overall project was endorsed by a legally recognized bioethics committee. Students' privacy, cultural diversity, religious diversity, sexual orientation and gender identity were protected. In the answers to the questions, the option "I do not wish to respond" was included, in case the student felt his private life exposed. The fundamental principles of research ethics were observed: respect, beneficence, non-maleficence and justice.


In the present study, 1124 students participated, 46.9% male and 53.1% female, with a mean age of 15 years, without significant differences by sex (t = 1,601, p = 0.110). A 65.4% of the adolescents live in the northeast of the city from low economic strata and 30.2% live in the southwest zone and are of medium and low strata. 10% had some form of paid informal work and 54% had low academic performance.

Regarding sexual practices and conditioning factors, 40.9% had started sexual intercourse at 15.2 years, on average (standard deviation 1.4), and boys started activities earlier (at 13.5 years) than the women (14.8 years) (t = 4.906, p = 0.000). In 20.9% of cases, sexual intercourse was frequent, 43% reported that they did not use a condom at the last sexual intercourse, 30.3% indicated informal sexual relations, 19.5% were 10 years older and 7, 1% of the cases were for cash. At some point in their life, 57.2% had consumed alcoholic beverages, 9.2% tobacco and 8.1% marijuana. With regard to differences by gender, men reported having sex with peers ten years older, and consuming tobacco; and for women not using condoms at the last sexual intercourse and frequent sexual intercourse (p <0.005).

A 63.9% of teens (696/1124) said to play video games. The differences found in relation to non-players were given with higher frequencies for males, under 15 years, being in the eighth grade and belonging to low socioeconomic strata. Regarding sexual knowledge and practices, differences were observed in the non-approval of the knowledge test and the non-use of the condom at the last sexual intercourse (Table 1).

A 64.7% of the players were men and 35.7% were women. On average, they remember to have been in contact with videogames at 8.3 years of age (standard deviation = 2.7), with a difference between men (7.9 years) and women (9 years) (t = 5,353, p = 0.000). 82% played daily, 88% used commercial video games, and none knew of sexual health education video games. 12.5% recognized that they play video games with erotic and sexual content. Commercial video games with implicit sexual content of greater use were: GTA São Andreas, Godof War and CallofDuty. A 48.2% had no control over the hours played and in 65.3% of cases the video game had adult content.

Table 2 shows the purpose of videogames, showing that for both men and women, the most attractive is to achieve goals (53.5%), followed by surpassing the own record (32.2%), and the record of friends (29.2%). Men, unlike women, believe the interesting thing is to beat their own record and that of their friends. Living adventures was second only to women. For both sexes, turning into the character of the videogame and living novels was of little interest. Only significant differences were found in overcoming the record of friends in favor of men (p <0.004).

According to the students, the video game improves the following abilities: mental agility (64.3%), reflexes (54.1%), attention capacity (39.3%), potentiates imagination (29.4%) and ability of analysis (23.4%). The rest of the skills reported frequencies below 20%. Regarding the gender of adolescents, significant differences were found for reflexes and decision making, being greater in men (Table 3).

For adolescents, in the audiovisual narratives, the implicit sexual content can be appreciated in the dressing of the characters (29.6%), in the verbal and corporal language (27.9%), and in the appearance of the characters, (27,2% %). For women, the characters' dressing is an important element in determining sexual content (p <0.022), and for men, the scenarios (p <0.006). The appearance of the characters, verbal and bodily languages ​​were equally relevant for both sexes (Table 4). In the perception of the relations between the characters, it was highlighted: friendship (31.2%), sexual relations (30.9%) and rivalry (26.5%). For men, support relationships were more important (p <0.034) and for women sexual relations (p <0.052) (Table 4).

Figure 1. Control of game time and game content by adults.


In this study, 63.9% of adolescents played video games as part of leisure activities, especially men. This result is consistent with studies in Chile, where 449 teenagers from high school, 78% men and 22% women 15 and another conducted in Spain with 4,000 teenagers who reported 69% players, and most men (85%)16. These findings denote possible gender inequalities in access to videogames. It is a reality that today's teenagers use videogames, which opens up possibilities for their effective implementation in the classroom as an educational strategy for the acquisition of healthy knowledge and practices in sexual health. It also reaffirms the positions indicated by Gros3 regarding their usefulness in attuning young people to the analytical skills required for decision-making and problem solving, and that of Marquis 1 in meaningful learning allow the understanding and valuation of the sociocultural environment.

Another finding that characterizes access to videogame is the frequency of use, where 82% played daily, a figure that doubles by the results found by the Instituto Defensor del Menor in Spain, where 43% of students devote less than one hour a day to video games, if conflicts in familiar surroundings for the time dedicated to the games, which subtracts time to school and social activities with family and friends16. To a certain extent, this effect is the fear of parents and teachers towards the use of video games that contrasts with the implementation of their use in class4. However, the dynamics of relationship change as technology becomes a new form of communication, of which video games are part. These allow other forms of encounter and socialization through a collective practice that generates networks of communication and knowledge5.

Attention is drawn to the low participation of parents and adults in the surveillance of playing time and content of video games. This situation was evident in this study, where only 44.9% had time regulation and 66.6% content. One Spanish study reports a similar situation, where 38% of adolescents recognized that if their parents knew the content of some video games, they would not be allowed to use them16. This shows that despite the existence of age classification systems, such as ESRB17, PEGI18 and CERO19, which label audio-visual entertainment products according to their content to guide parents and adults 4 , it is undeniable that is presented. This is the case of the game Grand Theft Auto: San Andreas, one of the most played games by the adolescents of this study, whose classification in the systems mentioned figure for over 18 years, given the high content of violence, racial discrimination and sex scenes.

It is recognized the importance of video games in the development of affective and motor cognitive abilities, emphasizing for this study the mental ability (64.3%), being lower than in the Chilean study (86%) 15 . Then, stimulation of the imagination (29.4%), ability to analyze (23.4%), problem solving (17.6%), and decision making (19.4%) were the most important. Compared with the Chilean study previously mentioned, the values found for the abilities were higher with 71%, 69%, 71% and 70% respectively, which can be attributed to sociocultural and methodological factors.

In this sense, for Gros, one of the characteristics of video games is that they require original solutions from the provocations exposed to the players. That is, one way or another causes them to develop creative skills from the generation of ideas, hypothesis and predictions that allow them to recreate situations that simulate real life, without the pressures, responsibilities and consequences of reality3.

Students, working with videogame as part of a didactic process, expose their stubbornness, trial-error and confrontation of problems exposed in the game, looking for creative solutions that the teacher had not contemplated. Thus, it is possible to consolidate new skills, strategies, thoughts, advantages and disadvantages before deciding20. In this sense, it was relevant to videogames to achieve goals (53.3%), to surpass their own record (32.2%) and to live adventures (26.8%), corroborating with the Chilean investigation 15 , whose participants considered (56%) and 56%, and with Spanish research, where the focus was on adventures (47.4%), achievement of goals (40.3%) and overcoming the own record (24.5%)21, with competitiveness being a substantial element in videogames.

In Etxeberria's perspective22, the success achieved by videogames in the children's and youth community is based on many values, attitudes and behaviors that prevail today. Competitiveness stands out as one of the axes of our society, which is much more driven in video games, both in competition with other players and with the same.

In relation to the elements that define the sexual content of videogames, 29.6% of adolescents emphasized dress, 27.9% verbal and corporal language and 27.2% the appearance of the characters. In an analysis carried out to identify the values, attitudes, action patterns and roles played in top-selling videogames, it was found that in 30% of them, the treatment of the female figure was to represent her as an erotic object and within the canons of the macho culture, so that the use of sex for commercial purposes, of diffusion and promotion of the differentiated sexual role, has a strong echo in videogames23.

Adolescents, especially boys, also reported that relationships between characters in video games hint at or evidence sexual intercourse (30.9%), receiving messages that may influence their sexuality, perpetuating cultural stereotypes present in contemporary visual culture. For Balaguer24, video games recreate images as mimesis of reality, a copy of the real world that acquires its own life in a binary space, in which the player acts as the own character appropriating the proposed reports and models.

Hence the appropriateness of including video games in the classroom for sex education in order to construct a reflexive and critical look around the said visual recreations. As Jenkins4 puts it, we must implement methodologies that allow the analysis of the possibilities and positive effects of videogames in the communicative field. The analysis of the influence of the new cultural products, which contrasts with the traditional educational models7,8, can have strategies of communication and education in sexual health articulated to the dynamics proper of this century.

The intention of this investigation was not to prove that sexual health knowledge, attitudes and practices were a consequence of the consumption of video games with implicit sexual content, but rather to approach the relationship they establish with adolescents to contextualize other forms of adolescent learning and explore its application in innovative educational strategies in sexual health.


The appropriation of videogames is a reality lived by the students of this study. Contact with them from a very early age shows a change in the dynamics of technological consumption of the new generations, which hastens to establish educational strategies in the digital natives.

Adolescents recognize in videogames the development of cognitive ability for mental agility for analysis and decision-making in the face of an exposed situation at play, and emphasize competitiveness as an important and attractive element in the choice of video game.

The little control with respect to the playing time and content of video games by parents and adults reveals the meager accompaniment to the reflection and analysis of narratives that include implicit sexual content. In this way, adolescents receive and process messages that erroneously feed their body of knowledge, attitudes and practices inherent in sexual health. All this in the face of the lack of developments in educational videogames for sex education that teach traditional educational strategies.

The implicit sexual content of videogames is being displayed through character design, dress, verbal and corporal expression, and scenarios, which, together with the type of friendship, sex, and rivalry relations between men and women, project stereotypes that can perpetuate inequalities in culture, affecting their sexual health.

Based on the findings of this study, it is suggested the implementation of new educational methodologies, using videogames to approach sexual health, in which, together with the visual culture of the adolescent and the literacy of parents and teachers, a reading the visual images present in the contemporary Iconsphere.


The authors thank the adolescents, teachers and directors who made this project possible.


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