Enhancements were made to reproductive health care referral systems for students in intervention high schools. Activities included development of a community-based provider referral network, educational and policy meetings with school nurses, and work with administrators to reduce barriers and increase access to confidential services. Among students in intervention schools, significant increases from baseline to Time 3 occurred in the percent who received reproductive health care in the last year (p<.03), had ever been tested for an STD (p<.001), and had ever been tested for HIV (p<.001). There were no changes in these variables among students in the comparison high schools.