"What would Samantha and Miranda do?" That's what viewers of the past HBO series Sex and the City may ask themselves when faced with the prospect of uncomfortable discussions about sexual health with partners, friends and doctors.
Researchers found that college students were more than twice as likely to talk about sexual health issues with their partners after watching a Sex and the City episode featuring the characters Samantha and Miranda having similar conversations, compared to students who saw different episodes.
"One of the powerful things about entertainment programming is that it can get people talking about important issues that they might not otherwise talk about," said Emily Moyer-Gusé, assistant professor of communication at Ohio State University and lead author of the study.
But the key is that the TV show can't just raise the topic of sexual health -- the characters in the TV show have to be shown having frank discussions with their friends, partners and doctors.
"Viewers will model their behavior after the TV characters, and have these conversations in their own lives," she said.
Moyer-Gusé conducted the research with Adrienne Chung and Parul Jain, both graduate students at Ohio State. The study appears in the June 2011 issue of the Journal of Communication.
The study involved 243 college students with an average age of about 20. They were shown one of three versions of an episode from Sex and the City, all of which were edited for purposes of the study.
In one version, Samantha and Miranda have discussions with friends, doctors and sexual partners related to the sexually transmitted diseases chlamydia and HIV.
Other participants saw a version of the same episode that included content about HIV and chlamydia, but did not include any scenes in which the characters extensively discussed with others their issues with these diseases.
A third group of participants saw a completely different episode of Sex and the City with no relation to sexual diseases.
Immediately after viewing the program, participants completed a questionnaire assessing their reaction to the program, and a range of other questions about their identification with the characters and their thoughts and plans concerning talking about sexually transmitted diseases.
Two weeks later, all participants completed an online questionnaire concerning whether they had talked to others about sexual health issues.
The results suggested that many people may be more likely to discuss sexual health issues with others when they see favorite characters on TV do the same, Moyer-Gusé said.
Almost half (46 percent) of the participants who saw the Sex and the City characters discuss sexual health issues ended up talking to their romantic partner about the subject in the following two weeks.
In contrast, only 21 percent who saw the similar episode about sexual health issues, but with no character discussions, ended up talking about the issues with their romantic partner. (About 15 percent of those who watched the unrelated episode had such discussions with their partner.)
"That's a pretty substantial behavioral effect after watching just one episode of a TV show," Moyer-Gusé said.
"When participants saw the characters demonstrate the confidence and ability to successfully navigate these tricky conversations, it gave them a social script to follow in their own lives. They felt they had the ability to bring up these difficult issues."
One key, though, was that the viewers had to identify with the Sex and the City characters in order for the episode to affect their behavior, the study showed.
In other words, viewers had to feel the emotions the characters were experiencing and feel like they knew what they were going through.
After watching the episode, viewers who identified with the characters reported that they felt more confident that they could discuss sexually transmitted diseases with their partner, friends and health care providers, Moyer-Gusé said.
They were also less likely to find flaws in how information was presented in the Sex and the City episode or feel like "arguing back" with what was going on onscreen.
"Those who identified with the characters were less likely to find faults with the story and were more likely to feel like they could talk about their sexual history, just like they saw on the program," she said.
Another interesting finding was that, immediately after viewing the show, even those who saw the episode in which the characters discussed sexual health were not more likely than others to say they would discuss these issues with partners, friends or doctors.
"It took a while for the program to really have an effect. They may not have thought that watching the episode affected them, but in the end it did change their behavior," she said.
The results of the study applied to both men and women who watched the program.
"While women probably watch Sex and the City more often than do men, it didn't seem to bother the men in our study to watch the episode," she said. "They had reactions that were very similar to what we found in women viewers."
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