Making the Grade: Assessing the Provision of Sexual Health Services at U.S. Colleges & Universities

Background: College health centers (HCs) can play a pivotal role in the introduction and normalization of timely STD screenings. We surveyed colleges and universities across the United States to describe the array of sexual health services provided.

Methods: We sampled 885 US colleges from the Integrated Postsecondary Education Data System (2014-2015). Only active, 2- or 4-year, degree-granting, accredited institutions, which enrolled at least 500 students were included. 482 schools responded to the survey (55%), and were weighted to be nationally-representative. We reported on STD services provided and stratified results by minority-serving institutions (MSIs) and non-MSIs as well as 2-year and 4-year institutions; differences were tested using Chi-square analyses.

Results: Of the weighted sample 67.7% of colleges reported having a student HC, of which 74.4% offered STD diagnosis and treatment (4y vs. 2y; 78.3% vs. 57.6%, p<.001); 73.5% of HCs reported routine chlamydia (CT) screening in women (4y vs. 2y; 75.4% vs. 63.6%, p=.004) and 24.7% offered express STD testing (26.1% vs 15.6%, p=.005); follow-up CT screening and self-collected vaginal swabs were offered at 82.7% and 31.0% of HCs, though no significant differences existed. Nearly all HCs offered HIV testing (92.3%) with MSIs reporting higher availability of HIV testing compared to non-MSIs (96.2% vs. 91.2%, p=.005). In regard to services for MSM, 46.8% of HCs offered pharyngeal and rectal (43.8%) STD testing.  HPV vaccination was offered at 70.3% of HCs. Free testing was offered at only 10.3% of HCs. Of note, 37.0% of HCs reported that a local health department or outside organization were the primary offerors of STD services.

Conclusions: Colleges with HCs are providing a variety of sexual health services, but 2-year colleges may require additional support. Improvements could entail increasing routine CT screening for women, extra-genital STD testing for MSM, and removing barriers to testing by offering express and self-testing.