Increasing Adolescent Access to Sexual Health Services Via Schools: Findings from an Expert Panel

Background:  Adolescents and young people are at disproportionate risk for negative sexual health outcomes. Nearly half of the 20 million new sexually transmitted diseases (STD) reported each year are among 15-24-year-olds. Clinical services can help prevent STD by increasing testing, treating infections, and reducing risk behaviors. US schools have a critical role in facilitating delivery of needed adolescent preventive services as they have contact with nearly 15 million adolescent students in grades 9-12. For these reasons, CDC’s Division of Adolescent and School Health (DASH) is engaging school-district partners to facilitate adolescent students’ access to sexual health services.

Methods:  DASH convened a panel of 14 experts in public health and school health to highlight promising strategies state and local school districts can use to increase adolescents’ access to sexual health services. These were discussed within varying healthcare infrastructures in schools, including school based health centers (SBHCs) school nursing services, and schools that offered no services onsite.

Results:  Suggested activities varied by health care infrastructure in schools. For instance, STD testing in SBHCs may require assessing and changing policies and increased reimbursement from third parties. For schools with nursing services, officials can expand scope of practice and develop a system to make referrals to community providers. Schools with no healthcare infrastructure may implement public awareness campaigns and link with a health department to deliver routine onsite screening. More generally, essential activities included creating linkages with health departments and other community providers; developing a referral system from schools to community providers; assessing and changing policy; using data to target services; engaging parents as advocates; and increasing funding for services.

Conclusions:  Regardless of school health care infrastructure, opportunities exist to expand adolescent access to sexual health services.  Activities vary by school context and partnerships between schools and community providers are critical in these efforts.