This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Young People Still Feel Invincible Against STIs (and Don’t Get Tested)

Sexually transmitted infections (STIs) are rising among young people, with more than half of new cases occurring among those who are between the ages of 15 and 24. A few years ago, the Centers for Disease Control and Prevention (CDC) estimated that one in four young women had an STI. And yet, a new survey finds that young people feel invincible and aren’t concerned that they will contract STIs like chlamydia and gonorrhea.

Quest Diagnostics, a network of medical labs across the country, surveyed 3,400 women in this age group and found that only 39 percent of those who were sexually active had used a condom the last time they had sex. But most of them (nine in ten) did not feel vulnerable to chlamydia or gonorrhea infection.

The survey also found that only 56 percent of sexually active young women surveyed had ever gotten tested for STIs. The relationship between young women and their health-care providers may be to blame for the low rate of testing. Many young women (27 percent) said that they were embarrassed to talk about sex with their providers, 27 percent admitted not telling their providers the truth about their sexual history, and only 28 percent of them had asked providers for STI tests.

But providers are falling down on the job as well. Despite knowing that young people are at high risk for STIs, only half of participants (51 percent) said a clinician had asked them whether they wanted an STI check.

Deborah Arrindell, vice president for health policy at the American Sexual Health Association, told Rewire.News, “Open, honest conversations about sexual health between young people and their providers and parents are essential. Getting tested and treated for STIs is no big deal. But not getting tested—especially when so many STIs don’t have any symptoms—is like just waiting for avoidable problems.”

The CDC recommends that all sexually active women younger than 25 be tested for both chlamydia and gonorrhea at least once a year.

Survey Asks About Sex and Condom Use During Women’s Periods

There are so many euphemisms for menstruation—the nonspecific “that time of the month,” the cutesy “a visit from Aunt Flo”, and the unappealing “on the rag”—that it’s pretty clear we’re not all that comfortable talking about our periods.

The subject of sex during our periods is even more taboo. But the people at Clue, a Berlin-based fertility app and website, want to change that. They partnered with researchers at the Kinsey Institute, a sexual health research organization in Indiana, to ask women what they think about sex during their period and what they do when “surfing the crimson wave.”

The survey included 95,000 people in more than 200 countries. To be included in the survey, respondents had to have menstruated in the past three months.

The research found that only 15 percent of women engage in their normal sexual behavior during their periods. About half of women (49 percent) avoid any genital contact during that time, 41 percent report avoiding contact with their own genitals and focusing on their partner’s pleasure instead, and 21 percent avoid all sex including nongenital behaviors. Genderqueer and nonbinary women were more likely to engage in their normal sexual behavior during their periods (21 percent).

The survey also found that condom use declined during a woman’s period. Among respondents who were having vaginal intercourse, 64 percent reported using a condom when they were not bleeding, but only 49 percent said they used a condom during their periods as well. Overall, those surveyed did not seem concerned about pregnancy or STIs during their period: Thirty percent of those who didn’t use a condom during their period said they were less concerned about pregnancy at that time, and one in three said they were unconcerned about STI transmission during that time.

Clue and the Kinsey Institute point out that these assumptions are based on misinformation. A woman can get pregnant during her period.

Moreover, STI acquisition rates are actually higher during menstruation than they are during other times of the month. They explain: “During certain times of your cycle, including your period, the changes in your immune function and vaginal environment may make it more likely you’ll contract an STI/HIV if you’re exposed.” They go on to say, “If you get a period and have sex with people with penises … always use a condom with an untested partner, especially on your period.”

Rife With Bias, Texas Pamphlet on Minors’ Abortion Access Comes Under Fire

The Texas Department of State Health Services redesigned a pamphlet designed to explain judicial bypass—the process by which minors can get a judge’s permission for an abortion in lieu of parental permission—to pregnant teens. The pamphlet, aptly titled “So You’re Pregnant, Now What?,” is required by statute to include information about alternatives to abortion and information about health risks of abortion.

But advocates in the state say the new version is far worse than the original.

A number of organizations including NARAL Pro-Choice Texas and Jane’s Due Process have sent letters to the department, pointing out errors that they claim are based on ideology and not science. The organizations point to manipulative language (such as referring to all fetuses as babies and all pregnant women as mothers) as well as inaccurate and incomplete information.

In its letter, NARAL Pro-Choice Texas notes that the revised brochure lists death as the first risk of abortion procedures and says that this is misleading because “abortion is one of the safest outpatient procedures and far safer than childbirth, which carries a risk of death 14 times higher than abortion.” In addition, the pamphlet discuss links between abortion and breast cancer, mental health issues, and future infertility. All of the claims run counter to scientific research which has found no link between abortion and any of these outcomes.

The letter, signed by Alexa Garcia-Ditta, the organization’s director of communications and policy, states: “Informed consent is a vital component of ethical health care, but this booklet does not contribute to a patient-centered decision making process. It is misinformation intended to coerce minors and perpetuate fear and stigma. This booklet has been influenced and driven by political ideology, not medicine or science, and we believe that pregnant minors deserve better than this.”

In a similar letter, Tina Hester, executive director of Jane’s Due Process, a legal referral and advocacy organization whose purpose is to ensure appropriate legal representation of pregnant teenagers, explains that the pamphlet provides inaccurate and incomplete information about judicial bypass itself. For example, while the pamphlet repeatedly refers to “your parents’ consent,” suggesting teens need permission from both parents, the law only requires one parent to consent. Moreover, the pamphlet never mentions that nonparent legal guardians and managing conservators can also provide consent. Hester says that these errors harm the young people they serve, many of whom are not in contact with one or both of their biological parents.

Carrie Williams, a spokesperson for the health department, told the Austin Chronicle that the department is reviewing and considering the comments and will post the final draft of the brochure when it has finished.

No Teen Sex Near Traffic Circles, Says Norwegian Roads Department

If you needed further proof that Europeans have an entirely different attitude toward teenage sex than Americans, look no further than the latest campaign by Public Roads Administration of Norway.

The government agency recently warned graduating high school students to avoid sex on “roundabouts” during a monthlong celebration of the end of their studies. Students celebrating their accomplishment are known to drink heavily, party a lot, and sometimes challenge social norms, hence the need for the warning.

The fact that this is an accepted and not hidden aspect of teen life is itself a notable difference between Norway and the United States, but we here at This Week in Sex were most struck by the rationale behind the new no-sex-in-traffic-circles campaign.

Terje Moe Gustavsen, the head of the Public Roads Administration explained: “Everyone understands that being in and around roundabouts is a traffic hazard. It may not be so dangerous for someone to be without clothes on the bridge, but drivers can get too much of a surprise and completely forget they are driving.”

We cannot imagine Transportation Secretary Elaine Chao saying anything about teen sex. But if she did, we’re betting it would have more of an abstinence-only message. Something like “Sex in rotaries before marriage will inevitably lead to pregnancy, STDs, and death.” Definitely a billboard in the making.