When we think about public health, and efforts to reduce disease, we think of the success stories— the eradication of smallpox, massive global vaccination drives for polio and SARS-CoV2, and the introduction of antibiotics making previously deadly illnesses easily treatable. However, with sexually transmitted infections or STIs, we are far from a success story: rates are rising across the country and have been for years.
For example: in 2010 there were 193,869 cases of Gonorrhea reported to the CDC but 10 years later in 2020 there were 286,271— a more than 30 percent increase. The American College Health Association’s survey of college health centers showed a positivity rate for Chlamydia of 5.3 percent in 2012, and eight percent in 2020, as well as increasing trends for Gonorrhea and Syphilis.
Why is this happening? According to Kimberly Boim, a spokesperson from the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention suggested reductions in STD services and funding, increasing substance use, COVID and the variety of social and economic barriers which confound any public health issue —poverty, stigma, lack of access to medical insurance, and many more.
Another reason named by the CDC is that condom use is decreasing, particularly among young people and gay and bisexual men. In the National College Health Assessment (NCHA II) administered in 2015, 47.8 percent of students who reported having sex in the past 30 days said they used a condom or other protective barrier during vaginal sex, but in an updated version of the NCHA administered in 2020 only 41.9 percent did. Increased access to non-barrier methods of contraception, and PrEP (the use of medicines to protect against contracting HIV) have lowered some of the risks associated with unprotected sex, but others remain.
Boim claims that, “STIs continue to be stigmatized. This stigma can bury the truth that all people deserve quality sexual healthcare in order to live healthy lives and deter people and groups from taking action to prevent and treat sexually transmitted infections.” One attempt to reduce this stigma came from the Campus Activities Board and Finger Lakes Community Health with their “Sex Bingo” Event, which distributed safer sex supplies and sex toys to students along with a bingo game themed around safe sex and healthy relationships.
While college is theoretically a space for young people to find themselves and explore their identity, students don’t leave their prior experiences behind when enrolling. Lacking sex education programs in American high schools and societal biases certainly influence people’s mindsets. Ideally, the Colleges will provide opportunities for students to access services and education they might have missed out on earlier in life, but more could certainly be done.
Inevitably, a smaller campus has less resources to offer for specialized programs. For example, while other schools might have a large office charged with health promotion, such services are nestled within Campus Life at HWS. The Hubbs Health Center, contracted out to the Finger Lakes Health system, offers many services like STI testing and reproductive healthcare, but many options aren’t well advertised. A student looking at the Colleges’ website might not know that they offer PrEP, or that there are options to help students pay for care their insurance doesn’t cover or that they are concerned about paying for with their parents’ insurance.
In closing, Boim claims that “The factors contributing to STDs are complex and multifaceted, so the solution to the barriers will have to be as well.” A future article will detail the perspective of the school’s administration.