“I am here to admit that I am in fact HIV positive,” Charlie Sheen said on the Today Show this week. His statement was confessional — “I admit” — but Sheen, as it turns out, is in good company as someone living with a sexually transmitted disease. This week the Centers for Disease Control released new statistics that show STD infections have hit a record high. Reported cases of chlamydia, gonorrhea, and syphilis have all increased since 2013 — some at an “alarming” rate, according to the center. And although the CDC doesn’t track herpes or HPV, those infections are common enough that we all know (and have probably slept with) someone who has one or both. (In contrast, the rate of HIV infection has remained relatively stable — although still too high.)
Sheen claimed he used protection, but those numbers indicate many do not — young adults, in particular. Most individuals contracting STDs are not Sheen’s age. They’re young. “Despite being a relatively small portion of the sexually active population, young people between the ages of 15 and 24 accounted for the highest rates of chlamydia and gonorrhea in 2014 and almost two thirds of all reported cases,” says the CDC. We’re talking about college students and teenagers — a generation raised during the era of abstinence-only education. It’s also a generation that’s coming of age at a time when STDs are seen as treatable and even HIV is seen as non-life-threatening. It’s possible that they just don’t think unprotected sex is a big deal.
It is, of course, but they sure don’t learn about that in the classroom. For the past two decades, federal and state dollars — more than $1.8 billion in total — have been funneled to schools in support of abstinence-only until marriage programs, which stress virginity maintenance and refuse to touch on some of the most basic information about human sexuality. That means no discussion of reproductive anatomy. No demonstration of how to put on a condom. No explanation of STD symptoms and treatments. No mention of safe sex.
“Abstinence-only education funding was on the increase in the late ’90s and into the early 2000s,” says Nora Gelperin, director of education and training at Advocates for Youth. Sex ed (or lack thereof) varies greatly state-by-state, and even district-by-district. But if administrators want federal money to support their sex-ed program, they have to decide not to talk about the act itself. And we’re moving in the wrong direction: In 2000, 48 percent of schools had a policy requiring STD-prevention instruction. By 2014, that number had decreased to only 38 percent.
So maybe it’s a lack of knowledge. But there has also been a cultural shift: Safe sex, as a public-health message, has started to sound downright retro — when you even hear about it. The Ad Council, which produces many of the PSAs you see nationally, doesn’t have a safe-sex campaign at the moment. As STDs become more common and accepted, they’re less stigmatized — and given that people are less scared to contract an STD, they’re less likely to wear a condom or get checked regularly. Throw in huge medical advancements like Truvada, the drug that new research shows can prevent users from contracting HIV, and unprotected sex seems less dangerous than ever.
There are some still speaking to the problem. In Los Angeles, where I live, the AIDS Healthcare Foundation purchases a lot of billboard ads — including one that ties STDs to dating apps. “Tinder. Chlamydia. Grindr. Gonorrhea,” It says. The foundation, which has been slapped with a cease-and-desist order from Tinder, explained in a statement, “In many ways, location-based mobile dating apps are becoming a digital bathhouse for millennials wherein the next sexual encounter can literally just be a few feet away — as well as the next STD.” And there have been other notable efforts to update the safe-sex message for the digital generation. Durex is calling for a condom emoji, a savvy combination of marketing and public awareness of risk.
While I’m not sure an emoji is going to solve a massive public-health problem, it’s probably a good idea to start thinking digitally. When schools and parents don’t talk about sex, teenagers, not surprisingly, turn to the internet with their questions. Which means they’re often finding porn. “That information isn’t reliable and accurate,” Gelperin says, in a dramatic understatement. Next year, California voters will decide whether to require porn actors working in the state to use a condom when performing on camera. But the measure is billed as a worker-safety initiative to protect the actors—not a way of sending a public health message about the importance of preventing STDs.
The root of the problem, says Gelperin, is that in the United States, safe sex is entwined with morality, rather than being seen as a simple health issue. “In Western European countries where sexuality is seen as a health issue as opposed to a moral issue, you’ll see much more advertising around STDs, with condoms being a focus,” she says. Whereas in the United States, Congress continues to double down on telling kids to save themselves for marriage. This year congress authorized a $25-million increase in state grants for abstinence-only programs.
Despite what Congress and state school boards may think, Americans are ready to embrace safe sex as a health issue: Upwards of 80 percent of adults support comprehensive sex ed, says Jessica Boyer, interim president of the Sexuality Information and Education Council of the United States (SIECUS). If there’s any silver lining to the record-breaking rates of STD cases, perhaps it’s that such high numbers make clear that this is, in fact, about health. And that the moralizing isn’t working. If we’re going to abstain from anything, it should probably be that.