Risky Business in Student Dorms: Sexual Health and Sexually Transmitted Infection Prevention Programming Imperative for College Campuses

Justine J Reel^* and Erin Hellstrom

Department of Health Promotion and Education, University of Utah, USA

*Corresponding Author:

Justine Reel, PhD, CMHC
CC-AASP Director of Graduate Studies
Department of Health Promotion and Education
University of Utah, Salt Lake City
1901 E. South Campus Drive, #2142; UT 84112, USA
Tel: (801)581-3481
E-mail: Justine.Reel@hsc.utah.edu

Received date May 09, 2013; Accepted date: May 13, 2013; Published date: May 15, 2013

Citation: Reel JJ, Hellstrom E (2013) Risky Business in Student Dorms: Sexual Health and Sexually Transmitted Infection Prevention Programming Imperative for College Campuses. J Community Med Health Educ 3:211. doi:10.4172/2161-0711.1000211

Copyright: © 2013 Reel JJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Not only do college students engage in high rates of risky sexual behaviors (American College Health Association, 2010), but multiple studies e.g. [1] have shown that college students are vulnerable for developing sexually transmitted infections (STIs). For example [1] surveyed 688 college students and found that 77% of students were sexually experienced. Other studies have found that between 50% and 80% of college students are sexually active [1,2] with 25% of female students and 60% of male students engaging in casual sex [1,2]. Furthermore, the 2003 National College Health Risk Behavior Survey found that 34% of college students reported having 6 or more sex partners in their lifetime, and only 30% of students reported using a condom during their last sexual intercourse [1]. The National College Health Assessment (NCHA) [3] also found low rates of consistent condom use. Alarmingly, less than half of the sexually active students responded that they “always or mostly” used condoms during sexual intercourse (American College of Health Association [4].

The Centers for Disease Control and Prevention [5] reported that 1 in 4 individuals between the ages of 14 – 19 has an STI and that age group accounts for 50% of new STIs despite only 25% of the 14-19 year old population being sexually active. Current estimates show that 35% of new HIV infections among females in the US occur among individuals under the age of 29 [5], and it has been estimated that 1 in 500 college students in the U.S. is infected with HIV [6]. Furthermore, .2% of college students in a large national study tested positive for HIV [2].

It is imperative that college campuses provide sexual health programming and provide necessary sexual and reproductive health services and resources. In order to promote sexual health and prevent STIs on college campuses, researchers recommend targeting screening, vaccination, and comprehensive prevention programming [7,8]. Sexual health requires basic understanding of anatomy and reproduction, maturity, and communication. Sexual health also requires social norms that promote healthy behavior and access to services including diagnosis and management of STIs and accurate risk reduction information [9].

Services

Campus health centers need to offer free STI and HIV screening for college students. Given that many college students are not financially independent, additional sexual health programs and STI services (e.g., vaccines) should be provided at a reduced cost. Additionally, college campuses should provide free condoms and safer sex kits, provide contraception options, sexual health counseling, and referrals when necessary. It is also important that student health centers strive to provide a nonjudgmental environment devoid of bias and employ competent health care professionals that will foster this environment. Gorden [8] found that the majority of students do not view their student health center as a trusted resource, with many students stating that they would prefer to go off campus for testing and other sexual and reproductive health services.

Increasing Awareness

A large gap exists between availability of on-campus services and college students’ perceptions of campus service availability. Trapasso [10] found that more than 50% of students did not know that condoms were available on campus or where to find them. This research shows that it is not enough to provide the resources and services, but demonstrates the need to increase awareness of resources and availability of services. In order to raise awareness, college campuses should advertise their services and available resources using appropriate methods to reach the target population. Marketing efforts should include social media such as facebook, twitter, campus websites, student portals, you tube videos, apps, and email. One study examining recruitment efforts for STI prevention programming among college students found that the most effective method was webmail and listserv [11].

Reducing Stigma and Shame

When designing health promotion programs regarding sexual health and STI prevention on college campuses, it is important to understand and address the college culture and barriers for this population. There is significant stigma and shame attached with STIs which presents a barrier to accessing STI prevention and care. Individuals who access STI prevention and care may be subject to discrimination, negative societal attitudes, as well as self-stigma and shame [12,13]. STI-related stigma and shame is related to an individuals’ likelihood of seeking appropriate services, including a delay in seeking screening and medical care [12]. Addressing STI-related shame is one strategy to promote sexual health and STI prevention on college campuses. College campuses should promote STI testing as ‘responsible sexual behavior’, thus supporting and normalizing testing. College campuses should also incorporate social media campaigns that promote healthy behaviors and STI testing to further decrease shame and stigma regarding accessing sexual health services. The Get Yourself Tested (GYT) campaign is a prime example of a social marketing campaign that supports young adults in making responsible decisions about their sexual health (itsyoursexlife.com) and would be ideal for college campuses.

Education

Sexual health education in high schools varies across the nation, and differs depending on the school district and even the classroom [14]. In a recent study conducted by the ACHA, only 36% of students reported receiving information regarding STI prevention from their college. Education regarding STI risk behaviors, transmission, prevalence, and risk reduction should be provided to all college students. Gordon [8] recommends implementing well-designed comprehensive sex education programs at orientation for all college students. Incorporating this education into the orientation process ensures that all college students will receive this education regardless of their educational background. Furthermore, mandatory comprehensive sex education programming will increase the medically-accurate knowledge base of students, increase knowledge of campus-specific resources, and may increase the student’s general comfort level regarding the topic and help reduce stigma and shame.

Conclusion

It is imperative that college campuses provide sexual health promotion programming and provide necessary sexual and reproductive health resources and services. Campus health centers should offer STI and HIV screening for free, or at a reduced cost. In addition, they should provide free condoms and safer sex kits, contraception options, as well as sexual health counseling, and referrals when necessary. Colleges should also as raise awareness for these services and available resources using appropriate methods. College campuses should also address STI-related shame by promoting STI testing as ‘responsible sexual behavior’. Finally, education regarding STI risk behaviors, transmission, prevalence, and risk reduction should be provided to all college students.

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