Condom use has declined for everyone in the U.S., but researchers say the trend is particularly strong among teenagers and young adults.
A few factors play a role: medical advancements such as long-term birth control and medications that prevent sexually transmitted infections; decreasing fear of contracting HIV; and widely varying levels of sexual education in high schools.
While this may not mean the end of condoms, public health experts are considering how to help younger generations engage in safe sex, be aware of their options—including condoms—and get tested regularly for STDs.
“Old condom ads were designed to scare you, and we’ve all been very scared for a long time,” says Dr. Joseph Cherabie, medical director of the St. Louis HIV Prevention Training Center. “Now we are trying to move away from that and focus more on what works for you.”
Medical advancements are changing attitudes
As the fear of contracting HIV has declined, condoms are no longer a priority for men who have sex with men.
There are now many options for preventing HIV and other STDs, including pre-exposure prophylaxis (PrEP) and doxycycline post-exposure prophylaxis (doxy PEP), which can be taken within 72 hours after unprotected sex to help prevent chlamydia, gonorrhea, and syphilis.
The downward trend is clearly visible among men who have sex with men on apps like Grindr, a popular dating app for gay men, which lists condom use under ‘hooking up’ instead of ‘health.’
Researcher Steven Goodreau believes that the lack of use is filtering down to younger generations, and that the promotion of PrEP has overshadowed condoms as a strategy for preventing STDs. Two federal HIV strategies make no mention of condoms.
Andres Acosta Ardilla, who works at an Orlando-based clinic serving Latinos with HIV, said that condom use among men who have sex with men is “virtually a thing of the past.”
Similarly, options like IUDs and birth control pills are gaining popularity among younger heterosexual women as methods of preventing pregnancy.
Middle-aged women say young men discourage condom use and often feel offended by the implication that they might have an STD.
Controversy over sex education
There are no federal standards for sex education, leaving it up to states to decide what is taught.
In some states, like Mississippi, condom demonstrations are banned. In other states, like Oregon, students already observe condom demonstrations in high school.
Conservative groups and advocates believe that teaching abstinence until marriage should be the focus of sex education, while other groups, such as the Sexuality Information and Education Council for the United States (SIECUS), say that comprehensive sex education prepares young people for healthy relationships.
“We would never send a soldier into war without training or without the resources he needs to protect himself… so why is it okay if we send young people to college without the information they need to protect themselves?” said Michelle Slaybaugh, director of policy and advocacy for SIECUS.
Shifting Trends in Condom Use Among Young Americans
Recent research indicates a significant decline in condom use across the United States, particularly among teenagers and young adults. This shift can be attributed to several factors, including advancements in long-term contraceptive options and medications that prevent sexually transmitted infections (STIs). The fear of contracting HIV has also diminished, while the quality of sexual education varies widely across high schools.
Despite ongoing conversations about responsible sexual practices, experts are focused on how to guide younger generations towards safer sex. Dr. Joseph Cherabie, a medical director at the St. Louis HIV Prevention Training Center, notes a marked shift from the fear-based messaging of past condom campaigns. Instead, there is a contemporary emphasis on what works best for individuals today.
The Influence of Medical Advancements
The reduction in HIV-related anxiety has led to a decrease in condom use, especially among men who have sex with men (MSM). New preventive options, such as pre-exposure prophylaxis (PrEP) and doxycycline post-exposure prophylaxis (doxy PEP), which can help prevent chlamydia, gonorrhea, and syphilis, are becoming more popular. Studies indicate that platforms like Grindr emphasize sexual encounters over health concerns, reflecting changing attitudes toward safety and prevention among MSM.
Researchers suggest that this decline in condom use is trickling down to younger generations, with PrEP’s promotion overshadowing condoms as a strategy for STI prevention. Notably, two federal HIV strategies have chosen not to incorporate condom use in their recommendations, which may further influence perceptions. Experts, like Andres Acosta Ardilla from an Orlando clinic, claim that for many MSM, condom use is almost a relic of the past.
Contraceptive Choices and Gender Dynamics
Young heterosexual women are increasingly opting for methods like IUDs and birth control pills, shifting away from condom reliance. Older women report that young men often discourage condom use, leading to discomfort and even feelings of offense when the topic arises. This dynamic reflects broader trends in sexual health attitudes and gender expectations.
Controversy over Sexual Education
The absence of federal standards for sexual education leaves states to determine their curricula, resulting in a patchwork of approaches. In states like Mississippi, condom demonstrations are prohibited, while in progressive areas like Oregon, such demonstrations are part of the educational experience. Conservative groups push for abstinence-only teachings, whereas organizations like the Sexuality Information and Education Council for the United States (SIECUS) advocate for comprehensive sexual education to prepare youth for healthy relationships.
As Michelle Slaybaugh of SIECUS poignantly stated, just as soldiers are trained and equipped for battle, young people deserve the knowledge and resources to protect themselves in the realm of sexual health.