It's not unusual for a horror movie to connect sex with death: Scream even made a joke of the fact that the best way to stay alive in a slasher flick is to be a virgin, since the horny teens always get offed first. So there's not much novelty to the fact that the much-hyped indie It Follows draws its initial scares from a little screwing. But it goes other places soon enough—albeit not always successfully—and gets a little more idiosyncratic, more personal. In love with old-school John Carpenter scares, this film will unsettle you from its first moments. Some of its ideas are just as chilling as its shocks.

One of the must buzzed-about films at last year's Cannes—not exactly a festival anyone associates with top-notch horror—It Follows (which opens this weekend in select theaters and on VOD) is the second effort from art-house writer-director David Robert Mitchell. His first, 2011's The Myth of the American Sleepover, was a beautifully observed, understated ensemble drama about teenagers in suburban Michigan; this one echoes many of the same concerns about acceptance and growing up, except this time there's a body count.

Up-and-comer Maika Monroe stars as Jay, a 19-year-old who really likes her new boyfriend, Hugh (Jake Weary). After they have sex for the first time, though, he chloroforms her and ties her to a chair. Hugh isn't some twisted serial killer, though: He explains that he has passed along a disturbing curse in which a phantom figure will slowly approach her to kill her. If Jay wants to rid herself of the curse, she'll have to sleep with someone else, and make sure that person isn't killed by the phantom—otherwise, the curse returns to the last person infected.

This is a simple, frightening concept for a horror movie, sort of like The Ring but with STDs. But It Follows isn't a sex-crazed variation on Final Destination in which lots of dumb kids start boning each other to avoid certain death. Instead, Mitchell uses that premise to go deeper. Which isn't to say that he's not interested in providing the prerequisite horror-movie scares. Working with cinematographer Mike Gioulakis, he fills the frame with incredibly impressive lo-fi terror that's often built around long takes and inventive use of moving cameras. The trick of this strange curse is that only the affected person can see who's pursing him or her, and the phantom figure can take any form, even that of a friend or loved one, which inspires plenty of paranoid moments. (There's an Invasion of the Body Snatchers quality here, as well as a slight nod to zombie movies, since the phantom figures walk at a normal pace toward their prey with a dispassionate relentlessness.)

Goosed by a retro, synth-heavy score from composer Disasterpiece (aka Rich Vreeland) that practically screams, "Didn't '70s and '80s horror movies sound awesome?" the result is a self-conscious throwback film that explores issues of peer pressure, belonging, unrequited love, and the fear of looming adulthood. It Follows doesn't spend any time figuring out how this curse started or what can be done to permanently break it—this isn't one of those horror films where the characters uncover some big, dusty, spooky book with all the answers—so Jay mostly hangs out with her friends trying to stay a step ahead of the phantom figure. And what we see is a little microcosm of teenage angst, especially with her dweeby friend Paul (Keir Gilchrist), who's always pined for her even though she doesn't see him that way. (The movie creates the darkly funny scenario that the geeky guy finally has the perfect way to encourage his crush to have sex with him: Maybe it'll remove her curse!)

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As with Sleepover,this is a modest character drama, the lifelike, underplayed protagonists far smarter and more sensitive than the typical brain-dead teens we see in movies, horror or otherwise. Mitchell clearly wants this to be about more than the fear of sex. It's striking that wherever Jay and her friends go, there seem to be no adults, no parents, no authority figures whatsoever. The dangers of the adult world (as personified by the phantom) seem to be forever looming just out of sight—the kids know they're out there, and so it adds a tinge of dread to even the film's most un-scary moments. Unlike your normal horror movie, Jay never runs crying to a grownup for help. On some level, she and her pals understand that they're on their own, and the absence of adults gives It Follows an eerie emptiness that's oddly appropriate for those high school feelings of alienation and tortured self-absorption.

The movie has flaws, though. Despite an incredibly tense first act, things start to drift once Jay, Paul, and the rest of the gang begin to come to terms with Jay's curse. And for such smart characters, sometimes they do really silly things just so Mitchell can ramp up the tension. (Inexplicably, Jay keeps putting herself in situations where she's alone. Wouldn't it be better to be around people you knew weren't the phantom, so you could identify it when it arrived?) But as with last year's The Babadook—the superb Australian indie about a mother, her son, and a creepy children's book—It Follows uses horror as a springboard to examine unspoken, sometimes shameful emotions. Sex won't necessarily kill you in Mitchell's film. But like in the real world, it can certainly change your life in ways you could never imagine.

Grade: B.

Grierson & Leitch is a regular column about the movies. Follow us on Twitter, @griersonleitch.