Advice Sexuality

Worried About Sending Simplistic Messages to Teens About Sex? Then Don’t!

Heather Corinna

Should a mom provide condoms for her son or not? What about dealing with times she knows her son and a girlfriend will have a house to themselves? Where's the line between "condoning" sex and being a sexually-supportive parent?

Published in partnership with Scarleteen
margaret asks:

My 15 year old son has a first girlfriend who is a year older. My concern is that she lives with her dad only and quite often is home alone. My son has been there twice already and one time I made him leave because the dad was not home. I am besides myself about how to handle this. He said that he is not going to have sex with her but you know how that goes. I know what I was doing at 15. Do I make condoms available? But that would be condoning it. I will have a talk with the girl about not hanging at her house. They are always welcome at mine and I will try to speak to her dad about it.

Heather Corinna replies:

I don’t think making condoms available is “condoning” sex. If providing condoms, all by itself, sends any primary message, I think the message is that were he to engage in sex, you think preventing unwanted pregnancy and the transmission of sexually transmitted infections is really important. I don’t think not providing condoms says you think it’s not okay for him to have sex, either. I think not doing that either doesn’t give him any messages about sex at all or might give the message you don’t think using condoms is important, which probably isn’t a message you want to send.

However, I don’t think it’s sound to talk about what simplistic messages that one action will or won’t give, because it’s critically important that, as his parent, you instead have ongoing, in-depth conversations about sex, sexuality and sexual health which are not simplistic, silent gestures and which don’t send simplistic messages.

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There’s so much more you have to offer him than the message (or lack of message) that sex just is or isn’t okay, or that you do or don’t care if he uses condoms if he engages in sex. By all means, if all a parent offers is condoms or the lack of them, a yes or a no to sex, a “You can be alone with her,” or an “I don’t trust you to be alone with her,” then, yes it makes sense to think the message sent to a teen is going to be a simplistic one. But you don’t have to be simplistic, and ideally, you won’t be. Your son needs more from you than that, because sex and sexuality are WAY more complex than that. And you, and other trusted adults in his life, are the primary people he looks to to help him learn and understand that. And when you really invest the time into having in-depth, involved and invested discussions about sexual choices, your son is going to learn from you how to do that when he makes those choices, rather than getting the wrong idea that these choices are simple or can be made well without that kind of time and care.

So, how about approaching this holistically, with more complexity and a lot more conversation? How about if even something like the decision to provide condoms or not is something that comes with or from a larger conversation you have together to inform your choices and the way you go about making them?

I want to share one of my very favorite stories with you, from the parent of a very young boy when I was still teaching full-time in classrooms.

This parent was the parent of a younger kid, but also of a teenage guy. The teenager had a girlfriend at the time, and his mother and he had talked a great deal about the fact that he was feeling ready for sex with her for a while. Conversations about sex and sexuality had been very open in their family for all of his life, so this being something he brought to her right from the start wasn’t unusual, nor was it unusual that it was something he and she were working out together. The mother’s primary concern with this wasn’t about her son’s readiness: she felt like he could probably handle starting a sexual life well and that, in considering just where he was at, it would probably be healthy and positive for him. Her concern was about his girlfriend, who, based on what she knew, probably wasn’t ready just yet and probably wouldn’t have the most positive experience she could if she starting a sex life at that time. They’d had these conversations for a while, and her son was already pretty on board with her assessment, even if he felt disappointed in recognizing that yes, it would probably be better to wait a bit longer when ideally, he would have preferred not to.

The little boy who was my student and his family went scuba diving, so he had a wet suit. He liked to put it on at home for fun, but every time he did, within nanoseconds he’d be running and yelling in a panic to try and get out of it because he inevitably would have to go to the bathroom immediately after putting it on.

One day, during the time the conversations about sex and his girlfriend were winding down with the older boy, Alex said he wanted to put his wetsuit on. His mother told him that was fine, but he needed to go to the bathroom first because she didn’t want to deal with the pee-panic that always ensued. He agreed. Within a few minutes, she heard him in his room talking very loudly, even though he was alone. She peeked her head around the corner and saw him pointing at his groin, saying, Penis, you can wait.”

Later that night, at the dinner table, she told her older son that something funny happened that day with Alex she wanted to tell him about. She told him what had happened. Then she said, “Alex is 4. If his penis can wait, so can yours.”

Her older son’s response to this was warm, full of laughter, but also full of a comfortable recognition that yes, he got it, and yes he — and his penis — certainly could wait until the timing and circumstances really were right for both him and his girlfriend, and that’s what he really wanted. Her telling that story wasn’t some kind of snarky, gotcha-zinger at her teenage son. Rather, it was a funny, relaxed punchline to a series of open, ongoing, caring and mutually respectful talks. It was a way of injecting humor into a conclusion they’d both come to that had its challenges, but was ultimately something they both had and took the care and patience to get to together. It was a ha-ha about a process where the emphasis wasn’t on control or just averting the bad stuff, but on helping him make choices that were going to make sex most likely to be something he felt good about and enjoyed. None of that — nor an earnest, not a shameful, laugh to a punchline like that — can come from a one one-sided talk, a hard limit with no sound rationale or one simplistic gesture. Telling that story all by itself certainly would not have sufficed as a way to communicate its message well.

I also want to share a letter I got from a parent the other day with you:

Thanks so much to Heather and the volunteers at Scarleteen for your hard work and sacrifices. What an awesome site I stumbled upon years ago. My daughter has always been so open and honest with me and I was always ready with an answer… until she started asking very frank questions about sex. “What does it feel like?, Can I try it?, Who should I try it with?” What I really wanted was for her to start her sex life with pride rather than guilt and safe enjoyment rather than a risky back-seat quickie. I am a nurse so the anatomy questions are easy for me but I’m also a recovering Catholic who was taught that, “Christian men should not let the horsies out of the barn and fornication is a sin,” so I had some baggage to get rid of. I poured over your site, article by article. This helped prepare me to answer her awesomely blunt questions.

Your readiness checklist helped her decide that she wasn’t ready at that time. Abuse articles and the forums helped her see signs in a guy she was dating. He had been pressuring her for sex and putting her down. She broke it off with him telling him he lacked respect for her. When she did decide she was ready, it was with an awesome guy. She seems to understand her sexuality and knows what she needs to be safe physically and emotionally. She is leagues ahead of where I was when it comes to making sound decisions with guys. Your site is a treasure trove of unbiased and honest information which helps facilitate this. Thanks so much!

I think it’s fantastic how this parent utilized our materials with her daughter, and how she took stock of her own baggage and of places where she knew she needed some help or different approaches than she was raised with. You’ll also note that she, like you, was feeling really overwhelmed. So many parents feel that way — it’s not just you, I promise — but that doesn’t mean you can’t do this well. If anything, I think having an awareness that it feels overwhelming, that you feel lost or confused, and that how you do this really matters is more likely to result in good outcomes than not having that awareness, thinking you know it all or treating this like it’s no big whoop.

This likely isn’t the first time you’ve felt lost as a parent, but since your kid has lived to become a teenager, and you’ve lived through 15 years of parenting yourself, you’ve obviously worked through parenting challenges and come through them before. You know this is important and it matters, you’re invested and you’re asking for help. I think you can handle this well. Let’s take a look at some of the places I can help get you started based on what you’ve said here.

One thing you’re clear about seems to be that you, yourself, were sexually active at his age. How do you feel about that? How were those experiences for you? What, for you, made them result in positives, or what in negatives? What would you have wanted to know then that you didn’t?

These are things you can share with him, within healthy boundaries and also an admission that these are your own, subjective experiences. You want to be careful not to overshare — people usually don’t want to hear their parents sex stories or lots of gory details — and also want to walk the line between sharing your feelings and making those feelings and your personal experiences seem like universals, since they’re not. But you can do it: just speak candidly and from the heart keeping in mind that sexuality and our sex lives are very personal and diverse and there is no one size fits all. The goal here isn’t for your experiences to dictate or become his, but for you to share them to explain some of your concerns and feelings, and as a way you can give him a perspective to consider that comes from someone he knows care about him.

You can set the stage for a positive, non-judgmental tone by qualifying you want to share your feelings and concerns, and some of how this went for you, because it’s part of why you feel however you do — as it always is — but you’re not trying to say what happened for you is what will for him, or that your right or wrong choices will be right or wrong for him. You just want to let him in on your thought process and give him your perspective to help him make his own best choices and so he can get some of where you’re coming from. That kind of transparency and flexibility will serve you both well, and make it more likely he’ll be open to understanding where you’re at than he would be if he didn’t know what’s informing or shaping your feelings, reactions and thoughts. Plus, so much of the time, the conversations teens have among friends about sexual experiences can be full of posturing, pressures and half-truths, so having the chance to have an honest conversation about early sexual experiences with someone they know cares about them is of real value to young people.

I also hear you’re concerned about them having a time alone because you feel that may result in sex. What are your concerns about that, specifically? Those are also things to talk with him about. For instance, since you’re thinking about providing him with condoms, my guess is you are, soundly, concerned about pregnancy or STIs. So, talk about those concerns. What else? Do you feel like sex — of whatever kind you’re thinking may happen — is something they both feel ready for? Do you feel like their relationship is a healthy one? Do you think sex together would be something positive for them as the two people they are and as a couple? Do you distrust either of them? If so, why?

These are things to talk about clearly and with specifics. With whatever those things are, what do you think would remedy them or change your feelings or the situation? These are things you can share which, again, offer them so much more than sex-is-okay or sex-is-not-okay or just a no or a yes to time alone.

I’d first think, on your own, about why it is you’re worried about them being alone, and also all the things that time alone, in a safe space can offer them that are positives, rather than just going to the scary place. Try not to project you-at-15 unto him-at-15: he might be very different. Young people don’t always see home-alone time as automatically being about sex. Plenty see that time as time to cuddle, time to talk for hours without worry of being overheard, time to experience being together as older couples often can without feeling like animals being watched at the zoo. Wanting privacy is a normal thing for people to want, and isn’t just about sex. As well, having real time and privacy alone can mean not rushing into sex or having it be something done hurriedly — where negative outcomes are more likely — because they don’t feel like they have to fit everything they want to do together into five stolen minutes of alone-time.

I’d suggest you reconsider making it a rule they are never alone, and also remember that controlling that doesn’t mean you can control if, when or where sex is something they’ll do. After all, if they do want to engage in sex, they’ll find a way and a place to do it, even if it means somewhere much less private and safe than at home (which is something else to think and talk about). Too, young people, like most people, don’t tend to react well to that kind of absolute control put on them, especially without sound reasons. And one part of parenting teens well is preparing them for a transition to adulthood where they will be alone with others. I think if you want to make a restriction like that, you owe them a discussion and the chance to talk about your rationales. But I also think you can probably come up with a compromise together you all will feel better about, which they’ll react more positively to and which ultimately serves them better. It may even be that once you really start talking, you won’t have the same concerns you do now about time they spend alone.

You say they’re always welcome at your house, so if you feel better about that, even if sex is something that they eventually choose to do there, you can talk about that and why that is. Stay honest and real: even if they don’t agree with you, or share your concerns, they’re going to appreciate you speaking from your heart, filling them in on your thoughts and including the in your process. Bring up ways you feel able to negotiate with this: that’s another skill you can also be teaching them about healthy sexual lives, which often involve negotiation.

With all of these issues and conversations with your son, be sure that you’re doing at least as much listening as talking. A parental lecture series about sex rarely, if ever, offers young people anything of value. The only person that usually offers something of value to is just the parent, because then they can feel like they had The Sex Talk they are supposed to and not feel like crummy parents. Teens don’t want a lecture: they usually want to really talk and be heard, even if it feels awkward.

Plus, it might be that he’s nowhere near sex yet, but you’re assuming that because of your teen years, his age, his gender or because he has a girlfriend. Some young people who are slower-paced with sex than their peers are or parents were can feel pushed into being sexual if everyone around them is acting like they must be or should be. I know is that for as often as a young person says they’re not going to be sexual and are, a young person says they’re not going to be sexual and aren’t. So again, I’d avoid projections or assumptions about what your son has said based on your own teen years. It’s entirely possible that — for his own reasons, not because of what you say you allow or don’t — he may not intend to engage in sex with his girlfriend soon or just because they’re alone.

So, with all of this, listen, take cues from him, and ask questions, including asking what he wants to talk about and feels like he needs right now and for the near future. Remember, these are about talks together. It may be that some of what I’ve brought up here to discuss isn’t even near where he’s at yet. If you get in the pattern of having talks like these, and just make clear he can come to you with questions or things to talk about when he needs to, you don’t have to worry so much about figuring out what to say and when to say it.

These might be conversations to have with his girlfriend, too. Rather than just telling her you don’t want them alone at her house, how about really speaking to your actual concerns with her and your son with all three of you around? Then both of them could have an older person who cares about them who they know is willing to help them make these choices, rather than another older person just trying to keep them from sex, or offering them little more than a no, a yes, or a bunch of condoms. Since you talk to her father, you could ask him if he’d feel comfortable with you telling her she can talk to you alone about sex if she wants to: she might really appreciate that.

It is also okay to be honest with them about feeling a bit lost or about worries that you might not do this right. You can voice that these talks are uncomfortable for you: they can feel the same way for teens, so just acknowledging you’re feeling like they probably are, too, can provide some instant connectivity. In my opinion, this is one of the places where the last thing you want to do is present yourself as The Super Expert Parent Who Knows All. Because, of course, you don’t. Heck, I have these conversations all day, every day, for my living and I don’t know everything. Humility goes a long way with young people. They’re going to tend to be a lot more willing to be honest and open with a parent who makes clear they, too, can feel confused or overwhelmed about sex and other big choices. They’re going to be more willing to go through the process of working this out with you, rather than without you, when you make clear it’s a process for all of you, not just them.

I’ll leave you with some books I think might help you navigate your way through this. One of the books I’m including is a new book which talks about the differences between the culture of the United States when it comes to parents, teens and sex and the culture of the Netherlands in that regard, where the outcomes of teen sex tend to be a lot more positive than they often are here. The primary difference, as that author explains, is an acceptance for teen romantic relationships and sexuality as a common reality — and something that really is developmentally sound when it’s at the right pace for an individual teen, something any of us who works in adolescent development knows — as well as an openness in discussions, just like I’ve talked about here. I’m also including a link to my own book if you’d like to get him a comprehensive sexuality and relationships guide for himself, and plenty in it would probably benefit you, too. Those books are:

Here are also some links lots of young people have used here to help them make sexual choices well, and which plenty of parents have also used to help them have these conversations with the teens in their lives. You can sit down and go through these together, you can read them yourself and use some of what you glean from them to lead these conversations, you can share them with your son and his girlfriend to look at before or after you have your own conversations with them: whichever feels best to you.

I feel confident that with a little help and a reminder to yourself that, gosh darnit, you CAN do this, you can do this well, and feel a lot better about all of it than you have been. I know it asks a lot of you, but as you know, parenting asks a lot of you, far more at some times than others. But you can do this thing: you can show up for your son around this place where he needs your help and support the most and knock it out of the park. If you need some support for yourself or more assistance as you go, you are more than welcome to ask for it again here. We’re always happy to help.




P.S. I think one of the easiest ways to deal with the condom issue is like this: you do make clear they’re available if he wants them, and if and when he does want to choose to engage in sex, you’d like him to do so responsibly, which includes safer sex and birth control. After all, whatever your son decides, you will obviously want him to safeguard his health and know that’s something he needs to think about, and young people sometimes have a hard time accessing condoms. So, on top of having in-depth conversations, you can put condoms in a drawer in a shared bathroom and make clear to him where they are. You can tell him they’re there for him if he does decide to engage in genital sex, and that he can choose to just take them without a discussion with you, or can discuss it with you, whichever he prefers.

Culture & Conversation Human Rights

Let’s Stop Conflating Self-Care and Actual Care

Katie Klabusich

It's time for a shift in the use of “self-care” that creates space for actual care apart from the extra kindnesses and important, small indulgences that may be part of our self-care rituals, depending on our ability to access such activities.

As a chronically ill, chronically poor person, I have feelings about when, why, and how the phrase “self-care” is invoked. When International Self-Care Day came to my attention, I realized that while I laud the effort to prevent some of the 16 million people the World Health Organization reports die prematurely every year from noncommunicable diseases, the American notion of self-care—ironically—needs some work.

I propose a shift in the use of “self-care” that creates space for actual care apart from the extra kindnesses and important, small indulgences that may be part of our self-care rituals, depending on our ability to access such activities. How we think about what constitutes vital versus optional care affects whether/when we do those things we should for our health and well-being. Some of what we have come to designate as self-care—getting sufficient sleep, treating chronic illness, allowing ourselves needed sick days—shouldn’t be seen as optional; our culture should prioritize these things rather than praising us when we scrape by without them.

International Self-Care Day began in China, and it has spread over the past few years to include other countries and an effort seeking official recognition at the United Nations of July 24 (get it? 7/24: 24 hours a day, 7 days a week) as an important advocacy day. The online academic journal SelfCare calls its namesake “a very broad concept” that by definition varies from person to person.

“Self-care means different things to different people: to the person with a headache it might mean a buying a tablet, but to the person with a chronic illness it can mean every element of self-management that takes place outside the doctor’s office,” according to SelfCare. “[I]n the broadest sense of the term, self-care is a philosophy that transcends national boundaries and the healthcare systems which they contain.”

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In short, self-care was never intended to be the health version of duct tape—a way to patch ourselves up when we’re in pieces from the outrageous demands of our work-centric society. It’s supposed to be part of our preventive care plan alongside working out, eating right, getting enough sleep, and/or other activities that are important for our personalized needs.

The notion of self-care has gotten a recent visibility boost as those of us who work in human rights and/or are activists encourage each other publicly to recharge. Most of the people I know who remind themselves and those in our movements to take time off do so to combat the productivity anxiety embedded in our work. We’re underpaid and overworked, but still feel guilty taking a break or, worse, spending money on ourselves when it could go to something movement- or bill-related.

The guilt is intensified by our capitalist system having infected the self-care philosophy, much as it seems to have infected everything else. Our bootstrap, do-it-yourself culture demands we work to the point of exhaustion—some of us because it’s the only way to almost make ends meet and others because putting work/career first is expected and applauded. Our previous president called it “uniquely American” that someone at his Omaha, Nebraska, event promoting “reform” of (aka cuts to) Social Security worked three jobs.

“Uniquely American, isn’t it?” he said. “I mean, that is fantastic that you’re doing that. (Applause.) Get any sleep? (Laughter.)”

The audience was applauding working hours that are disastrous for health and well-being, laughing at sleep as though our bodies don’t require it to function properly. Bush actually nailed it: Throughout our country, we hold Who Worked the Most Hours This Week competitions and attempt to one-up the people at the coffee shop, bar, gym, or book club with what we accomplished. We have reached a point where we consider getting more than five or six hours of sleep a night to be “self-care” even though it should simply be part of regular care.

Most of us know intuitively that, in general, we don’t take good enough care of ourselves on a day-to-day basis. This isn’t something that just happened; it’s a function of our work culture. Don’t let the statistic that we work on average 34.4 hours per week fool you—that includes people working part time by choice or necessity, which distorts the reality for those of us who work full time. (Full time is defined by the Internal Revenue Service as 30 or more hours per week.) Gallup’s annual Work and Education Survey conducted in 2014 found that 39 percent of us work 50 or more hours per week. Only 8 percent of us on average work less than 40 hours per week. Millennials are projected to enjoy a lifetime of multiple jobs or a full-time job with one or more side hustles via the “gig economy.”

Despite worker productivity skyrocketing during the past 40 years, we don’t work fewer hours or make more money once cost of living is factored in. As Gillian White outlined at the Atlantic last year, despite politicians and “job creators” blaming financial crises for wage stagnation, it’s more about priorities:

Though productivity (defined as the output of goods and services per hours worked) grew by about 74 percent between 1973 and 2013, compensation for workers grew at a much slower rate of only 9 percent during the same time period, according to data from the Economic Policy Institute.

It’s no wonder we don’t sleep. The Centers for Disease Control and Prevention (CDC) has been sounding the alarm for some time. The American Academy of Sleep Medicine and the Sleep Research Society recommend people between 18 and 60 years old get seven or more hours sleep each night “to promote optimal health and well-being.” The CDC website has an entire section under the heading “Insufficient Sleep Is a Public Health Problem,” outlining statistics and negative outcomes from our inability to find time to tend to this most basic need.

We also don’t get to the doctor when we should for preventive care. Roughly half of us, according to the CDC, never visit a primary care or family physician for an annual check-up. We go in when we are sick, but not to have screenings and discuss a basic wellness plan. And rarely do those of us who do go tell our doctors about all of our symptoms.

I recently had my first really wonderful check-up with a new primary care physician who made a point of asking about all the “little things” leading her to encourage me to consider further diagnosis for fibromyalgia. I started crying in her office, relieved that someone had finally listened and at the idea that my headaches, difficulty sleeping, recovering from illness, exhaustion, and pain might have an actual source.

Considering our deeply-ingrained priority problems, it’s no wonder that when I post on social media that I’ve taken a sick day—a concept I’ve struggled with after 20 years of working multiple jobs, often more than 80 hours a week trying to make ends meet—people applaud me for “doing self-care.” Calling my sick day “self-care” tells me that the commenter sees my post-traumatic stress disorder or depression as something I could work through if I so chose, amplifying the stigma I’m pushing back on by owning that a mental illness is an appropriate reason to take off work. And it’s not the commenter’s fault; the notion that working constantly is a virtue is so pervasive, it affects all of us.

Things in addition to sick days and sleep that I’ve had to learn are not engaging in self-care: going to the doctor, eating, taking my meds, going to therapy, turning off my computer after a 12-hour day, drinking enough water, writing, and traveling for work. Because it’s so important, I’m going to say it separately: Preventive health care—Pap smears, check-ups, cancer screenings, follow-ups—is not self-care. We do extras and nice things for ourselves to prevent burnout, not as bandaids to put ourselves back together when we break down. You can’t bandaid over skipping doctors appointments, not sleeping, and working your body until it’s a breath away from collapsing. If you’re already at that point, you need straight-up care.

Plenty of activities are self-care! My absolutely not comprehensive personal list includes: brunch with friends, adult coloring (especially the swear word books and glitter pens), soy wax with essential oils, painting my toenails, reading a book that’s not for review, a glass of wine with dinner, ice cream, spending time outside, last-minute dinner with my boyfriend, the puzzle app on my iPad, Netflix, participating in Caturday, and alone time.

My someday self-care wish list includes things like vacation, concerts, the theater, regular massages, visiting my nieces, decent wine, the occasional dinner out, and so very, very many books. A lot of what constitutes self-care is rather expensive (think weekly pedicures, spa days, and hobbies with gear and/or outfit requirements)—which leads to the privilege of getting to call any part of one’s routine self-care in the first place.

It would serve us well to consciously add an intersectional view to our enthusiasm for self-care when encouraging others to engage in activities that may be out of reach financially, may disregard disability, or may not be right for them for a variety of other reasons, including compounded oppression and violence, which affects women of color differently.

Over the past year I’ve noticed a spike in articles on how much of the emotional labor burden women carry—at the Toast, the Atlantic, Slate, the Guardian, and the Huffington Post. This category of labor disproportionately affects women of color. As Minaa B described at the Huffington Post last month:

I hear the term self-care a lot and often it is defined as practicing yoga, journaling, speaking positive affirmations and meditation. I agree that those are successful and inspiring forms of self-care, but what we often don’t hear people talking about is self-care at the intersection of race and trauma, social justice and most importantly, the unawareness of repressed emotional issues that make us victims of our past.

The often-quoted Audre Lorde wrote in A Burst of Light: “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”

While her words ring true for me, they are certainly more weighted and applicable for those who don’t share my white and cisgender privilege. As covered at Ravishly, the Feminist Wire, Blavity, the Root, and the Crunk Feminist Collective recently, self-care for Black women will always have different expressions and roots than for white women.

But as we continue to talk about self-care, we need to be clear about the difference between self-care and actual care and work to bring the necessities of life within reach for everyone. Actual care should not have to be optional. It should be a priority in our culture so that it can be a priority in all our lives.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

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

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.