The use of condoms has dropped sharply among younger Americans, according to a new report from the Associated Press.

The study cites several reasons for the decline, including a lack of sex education in school and less fear about the danger of STIs, as well as medical advancements to prevent pregnancy. “Old condom ads were meant to scare you, and all of us were scared for the longest time,” said Dr. Joseph Cherabie, Medical Director of the St. Louis HIV Prevention Training Center. “Now we’re trying to move away from that and focus more on what works for you.”

Young people are also less likely to be sexually active than previous generations. The CDC says condoms are still a valuable tool for preventing disease, alongside other measures.