It’s called sexting, the act of sending and/or receiving sexually explicit text or photo messages via your mobile phone. And one in five middle school-aged students are doing it, according to a new study published in the medical journal Pediatrics.

Among the 1,285 Los Angeles students aged 10 to 15 surveyed for the study, 20% reported having received at least one sext, while 5% reported having sent at least one sext.

“Very frequently it’s the image or the sex, that is finding its way to the middle schooler first, prior to any sort of conversation or education” by parents, said Ian Kerner, a sexuality counselor and father to two boys. “That makes it even more confusing (for kids).”

The study authors also looked at how sexting relates to sexual behavior among these adolescents. The survey showed that those who reported receiving a sext, were six times more likely to report being sexually active than teens who hadn’t received a sext. Those who sent a sext were about 4 times more likely to report being sexually active.

The researchers also found that those who sext were more likely to report having unprotected sex.

While the study does not offer an explanation for the link – Are sexting teens simply more likely to admit to their sexual activity? Does sexual activity lead to sexting or vice versa? – the authors do elaborate on the relationship between sexting and sexual behaviors.

Kerner, who was not involved in the research, suggests parents try to remember the confusion over sex they experienced as teens, and then imagine going through it again in the digital age.

“I think that technology definitely acts as an amplifier. If you think about previous generations, it was much harder to access, much less share, sexual imagery,” Kerner said.

Previous research has shown that having sex earlier in life can lead to risky sexual behaviors, such as engaging with multiple partners, teenage pregnancy and sexually transmitted infections.

A policy statement recently released by the American Academy of Pediatrics says that the prevalence rates of many sexually transmitted infections are highest among adolescents. The second-highest rates for chlamydia and gonorrhea, for example, are in females 15 to 19 years old.

The study authors say parents should have the “sexting” conversation with their child as soon as he or she is given a mobile phone.

“Most kids by middle school will have a cell phone or regular access to one, and many will send multiple, if not hundreds, of texts each day,” said Dr. Yolanda Evans, a board certified pediatrician in the division of adolescent medicine at Seattle Children’s Hospital.

Kerner says parents play a big role in how kids deal with sex – as middle schoolers and as adults.

“I feel like the information age, the digital age, pornography – it’s all here to stay… And I don’t think the right attitude is to just pretend it’s not there,” he said. “The thing that we need to do as parents and educators is help our kids develop healthy sexual identities and patterns and choices.”