Earlier this month, the U.S. Centers for Disease Control and Prevention (CDC) announced that cases of common sexually transmitted infections (STIs) in the United States had reached an all-time high, with cases of gonorrhea, chlamydia, and syphilis rising for the fifth consecutive year.

This represents a total of more than 2.4 million infections in 2018 alone—and certain infections are disproportionately occurring among young people. For example, in 2018, young women ages 15 to 24 accounted for 44 percent of all reported cases of chlamydia, the most commonly reported STI.

Although a number of factors contribute to the uptick in STIs, advocates say abstinence-only sex education may be partly to blame.

Bukky Ogunrinola, a sophomore at Howard University and a representative of Advocates for Youth—which fights for sexual health, rights, and justice—went to a public high school in Idaho. She told Rewire.News she has seen firsthand the way fear-based tactics can backfire among a group of sexually curious young people. “As a product of fear-based sex ed, it’s never productive,” she said. “Now young people feel they need to hide everything when it comes to their sexual health.”

Ogunrinola is set to join Advocates for Youth activists on Wednesday for a demonstration in Washington, D.C., in support of evidence-based sex education. Their campaign—a massive billboard made of chewed gum—was inspired by sex ed programs that use shaming metaphors to teach kids about sex. For example, sex educators may tell kids that they are like a piece of gum, and that the more sex they have, the more chewed and disgusting the gum becomes. “The message is: You are not chewed gum,” Ogunrinola said of the billboard.

Since 1996, Congress has allocated more than $2 billion to abstinence-only sex education programs, according to an analysis by the advocacy group Sexuality Information and Education Council of the United States (SIECUS).

“These programs, at their core, set young people up to fail,” said Logan Levkoff, a sexuality, relationships, and parenting educator who holds a doctorate’s and is working with Advocates for Youth on their campaign. “It is impossible to become a sexually healthy person if you’re being lied to or shamed.”

“When that many people of a new generation are getting that type of information, it’s no wonder we don’t have the skills to make smart empowered decisions about sex,” Levkoff added.

Sex education was first implemented in public schools in the United States in the 1970s, and support for the programs grew amid the HIV/AIDS crisis. The first federal abstinence-only program was enacted under the Reagan administration.

Since the 1980s, studies have demonstrated that abstinence-only programs do not prevent teen pregnancy and STIs, and do not impact sexual risk behavior, such as having multiple sex partners or negotiating condom use. A 2017 literature review from the Guttmacher Institute, a research and policy organization focused on sexual and reproductive health, concluded that “considerable scientific evidence accumulated over the past 20 years has found that [abstinence-only until marriage] programs are not effective.”

Nevertheless, abstinence-only sex education programs persist in public schools. Only 17 states require schools to teach medically accurate sex ed, according to Guttmacher.

Advocates point to several worrying trends that may be contributing to the recent rise in STIs. Although federal funding for abstinence-based sex ed had waned over the past decade, funding has surged again under the Trump administration. Levkoff also noted the deceptive rebranding of these programs as “sexual risk avoidance” programs.

“What happened is that people sometimes think those programs have disappeared,” she said. “They haven’t disappeared, they have just shown up in a new package.”

On the surface, it seems like everyone can get behind the idea of avoiding risk, Levkoff explained. But in fact, these programs are the same as abstinence-only programs—and the rebranding makes it even more difficult for advocates to explain the danger of this type of program to the public and lawmakers.

Levkoff acknowledged many other factors, including unequal access to health care, are also contributing to the rise of STIs. But she says that misleading and inadequate sex education is a big factor.

“It’s a sad state of affairs, not just for the rise in STIs, but because we seem to forget that sexuality is a huge part of someone’s identity and human experience throughout the lifespan,” she said.