As parents, we have endless conversations with our kids about how to keep safe and protect themselves from harmful situations. We talk about stranger danger, navigating relationships and how to cross roads safely, but there's one danger we're not talking enough about: STIs (sexually transmitted infections).
And it's a conversation we need to be having, now more than ever.
STIs are on the rise in Australia and other developed nations, with health data from the Kirby Institute showing a massive rise in cases of gonorrhoea in Australia, from 8388 in 2006 to 18,588 in 2015.
A recent US study released by the Centers for Disease Control and Prevention (CDC) found a similar rise there, with over two million cases of chlamydia, gonorrhoea and syphilis reported in 2016.
What's most alarming about those figures is that the study found young people to be most at risk. The CDC reported young men and women aged 15 to 24 acquire half of all new STIs, and that one in four sexually active adolescent girls has an STI, such as chlamydia or human papillomavirus (HPV).
Many young people don't even know they have an STI unless they're tested because some come with no symptoms, but STIs can cause chronic pelvic inflammatory disease, infertility and (in the case of HPV) cervical cancer.
A new survey suggests the causes of the STI rise include false beliefs about STI risk, and miscommunication between young women and their mothers.
The Quest Diagnostics poll surveyed young women, their parents, gynaecologists and other specialists about sexual behaviour, sexual health and knowledge and testing for STIs. The poll focused on young women because the CDC guidelines recommend that doctors screen sexually active young women under 25 at least once a year for chlamydia and gonorrhoea, even if they don't have symptoms.
The results of the poll show many young women are at high risk of acquiring an STI without realising it. More than half of the young women surveyed between 15 and 24 said they were sexually active, but only 39 per cent of those women used a condom the last time they had sex. And only 56 per cent of the sexually active young women said they'd ever been tested for an STI.
A massive 62 per cent of those untested said they haven't done it because they don't feel at risk.
The study found that many parents whose children were sexually active had no idea. Sexologist Isiah McKimmie says it's important for parents to start talking about sex early with their children.
"We should be having age-appropriate conversations with our children from a young age," she says. "From nine to 12 they should know what sex is and that they can become pregnant the first time they have sex. In their early teen years is a good time to start talking about STIs.
"The average age of sexual initiation is now mid-teens, so we need to be having the conversation before then."
Gold Coast mum Emma Nugent is raising two teenagers – a boy and a girl – and she admits she hates talking about sex with her kids.
"Oh gosh, it's so awkward," she laughs. "They hate it. I hate it. I try to pretend I'm comfortable but we all just want it to be over!"
Ms Nugent says she has no idea whether he children are sexually active – and doesn't want to know – but it's important to her to be open and to ensure her kids know about safe sex.
"I've been talking to my kids since they were about 12, I supposed, about sex. It started out pretty general but as they've gotten older we get more specific about physical and emotional issues such as protection, consent, emotions, and all that.
"I know they're getting information elsewhere too but I'm raising them and I feel like it's my job to ensure I pass my values onto them. What they do with all of that is their own decision."
The Quest survey found a disconnect in the way mothers are talking to their daughters about sex and STIs. Most mothers said they were direct with their daughters, with an overwhelming majority saying they have discussed risk of STIs (88 per cent), having safe sex (86 per cent), using birth control (86 per cent), going to the gynaecologist (84 per cent), or delaying sexual activity until at least the age of 18 (82 per cent).
But when the daughters were questioned, only one in three said their mothers had talked to them about these issues.
Isiah McKimmie says it's important for parents to not just have one talk about sex and then assume their work is done. "If sex is something that's openly talked about often, it takes the pressure off an individual conversation, supports your child, and allows them to feel more comfortable discussing it with you," she says.
Ms McKimmie says the more comfortable the parent is with the subject matter, the more comfortable the child will be too. "And that should also encourage them to approach you and talk about it, if and when they need to."
It's also important to use correct terms, rather than euphemisms, for genitals, according to Isiah. "Using correct terms actually sends a message that it's a normal, okay thing to talk about," she says.
Brisbane mum of a 15-year-old daughter Shari Lidell says she realises now she hasn't communicated effectively with her child about sex and STIs.
"I talk to my daughter from time to time about sex and all the issues that surround it, but I find myself speaking in metaphors and dancing around the subject to try to keep things less weird between us," she says.
"But now I realise I might need to toughen up and speak more plainly with my daughter."
Ms McKimmie says while it's important to warn children of the dangers of unsafe sex and STIs, it's also crucial to focus on the positives.
"So much sex education is focused on information about biology and safe sex," she says. "What is often missing are discussions around enjoyment of sex and true intimacy.
"We need our children to learn that sex should and can be enjoyable. That it's a beautiful way to connect with someone you love."