The World Health Organization describes sexual health as “a state of physical, mental and social wellbeing in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence”. The majority of NYU students are sexually active, and college is a time when many young people first become sexually active. Students frequently enter college without adequate sexual health knowledge, and, subsequently, they often engage in sexual behaviors that place them at increased risk for unintended health outcomes such as pregnancy, human immunodeficiency virus (HIV), and other sexually transmitted infections (STIs). It is crucial to enhance sexual health resources to improve students’ sexual health, increase safer sex behaviors, and reduce STI and HIV transmission.
- 64.7% of NYU students reported engaging in oral, vaginal, or anal intercourse within the last 12 months.1
- In 2009, there were 48,100 new HIV cases in the United States, with 19.7% occurring in young people age 15 to 24.2
- Although young people ages 15 to 24 represent 25% of the sexually experienced population, this age group accounts for nearly 50% of all new STIs, totaling about 9 million cases in 2008.3
- Over 1.2 million cases of chlamydia were reported in 2008, the most since record keeping for the disease began and the highest number of cases for any STI required to be reported by physicians.3
- 20 to 24-year-olds are significantly more likely to experience an unintended pregnancy than women aged 19 or younger.4
- STI rates are twice as common among 20 to 24-year-olds as 15 to 19-year-olds (7 v. 3%).5
- Many young people misperceive their vulnerability to infection, which can affect
decisions around sexual behavior.6
- Expand education and promotion strategies addressing the full spectrum of sexual behaviors, including abstinence, oral sex, and intercourse.
Comprehensive sexual education, which emphasizes the benefits of abstinence while also teaching about contraception and disease-prevention methods, has been proven to reduce rates of unintended pregnancy and HIV/STI infection.7 By increasing the visibility and breadth of its sexual health education and promotion resources and diversifying modalities for engaging students, NYU will be able to reach and connect with more students, increasing their capacity to make knowledgeable decisions and to be engaged in their sexual health.8
- Expand awareness and understanding of the diverse sexual health needs of the NYU community among NYU Student Health Center clinicians.
Values, attitudes, and beliefs; levels of knowledge; and communication patterns about health, sexuality, relationships, contraception, and childbearing vary significantly across cultural and ethnic groups.9 Ensuring that clinicians have a thorough understanding of the diverse needs of the multifaceted NYU population and the skills to assess and provide culturally competent care is vital in order to best serve each individual student.10 Culturally sensitive and competent healthcare improves students’ engagement in preventive services and reduces health disparities.11-12 Brief and intensive interactive counseling approaches directed at a student’s personal risk, the situations in which risk occurs, and the use of personalized goal-setting strategies are effective in STI/HIV prevention among diverse populations.13
- Engage social support networks in positively influencing students’ sexual health.
Students’ social support networks can play an important role in the information they receive and the decisions they make regarding their sexual health.9 Friends and family can influence the attitudes and sexual health behaviors of students by providing them with ongoing health and prevention messages.14 Students also develop new relationships as they integrate into college life, expanding their social network density. Involvement in clubs and programs, such as religious or cultural ones, provides students with connections not only to other students but also to advisors and staff. Interactions with friends, peers, parents, clubs, and advisors all make unique contributions and shape students’ knowledge base, attitudes, and self-efficacy in their sexual health.
- Expand access to safer sex supplies.
Safer sex supplies, such as male and female condoms, are effective means for reducing unintended pregnancies, HIV, and other sexually transmitted infections.15 Many students report wanting to use safer sex supplies; however, barriers include lack of money or fear of judgment when purchasing them.16 Distribution of free, safer sex supplies on college campuses has been shown to be effectual in “increasing condom use, increasing condom acquisition or condom carrying, and reducing incident STIs.”17
- Improve access to HIV/STI testing.
College students are at high risk for contracting sexually transmitted infections, yet there are numerous factors that affect appropriate testing and treatment.2,3,8 Testing for HIV/STIs is a new experience for many students that can be intimidating.18,19 Perceived stigma, as well as perceived risk versus actual risk, can also influence HIV/STI testing. Increasing opportunities for testing – through targeted outreach and routine screening, and using safe spaces to engage students – can increase awareness and normalize the act of testing.19 Offering HIV/STI tests to students as part of regular healthcare decreases stigma increases the number of young adults getting tested, and allows more students to take charge of their sexual health.
Indicator Technical Notes
a) HIV Testing
- Data Source: ACHA #39F
- Survey Question: Have you ever been tested for HIV infection?
- Definition: proportion of students responding yes
b) Annual incidence of chlamydia, age 24 and under
- Data Source: ACHA #41A6
- Survey Question: Within the last 12 months, have you been diagnosed or treated by a profession for the following: Chlamydia?
- Definition: rate per 10,000 of students 24 and under who endorsed “yes”
c) Always use condoms or other protective barrier during vaginal intercourse
- Data Source: ACHA # 22B
- Survey Question: Within the last 30 days, how often did you or your partner(s) use a condom or other protective barrier during vaginal intercourse?
- Definition: proportion of students engaging in vaginal intercourse (within the last 30 days) reported “always” using protective barrier
d) Always use condoms or other protective barrier during anal intercourse
- Data Source: ACHA # 22C
- Survey Question: Within the last 30 days, how often did you or your partner(s) use a condom or other protective barrier during anal intercourse?
- Definition: proportion of students engaging in anal intercourse (within the past 30 days) reported “always” using protective barrier
- American College Health Association. (2009). American College Health Association - National College Health Assessment II: New York University Executive Summary Spring 2009. Hanover, MD: Author.
- Centers for Disease Control and Prevention. (2011, September). Diagnoses of HIV Infection and AIDS in the United States and Dependent Areas, 2009. Atlanta, GA: U.S. Department of Health and Human Services.
- Centers for Disease Control and Prevention. (2009, Novem ber). Sexually Transmitted Disease Surveillance, 2008. Atlanta, GA: U.S. Department of Health and Human Services.
- Finer, L.B., Henshaw, S.K. (2004.) Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspectives on Sex and Reproductive Health, 38, 90–6.
- Mosher, W.D., Chandra A., & Jones, J. (2004). Sexual behavior and selected health measures: men and women ages 15–44 years of age. Advance Data, 1–56.
- Academy for Educational Development. (2007). Summary of a review of the literature: Programs to promote chlamydia screening. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.
- Kirby, D. (2008). The impact of abstinence and comprehensive sex and STD/HIV education programs on adolescent sexual behavior. Sexuality Research and Social Policy, 5(3), 18-27. Joint United Nations Programme on HIV/AIDS. Sexual Health Education Does Lead to Safer Sexual Behaviour. Press release, October 22, 1997.
- National Prevention Council. U.S. Department of Health and Human Services. (2011). National Prevention Strategy. Washington, DC: U.S. Department of Health and Human Services. Office of the Surgeon General.
- Davis, L., Arshad, U. (2010). Adolescent sexual health and the dynamics of oppression: A call for cultural competency. Issues at a Glance, Advocates for Youth.
- Lin, J.S., Whitlock, E., O’Connor, E., & Bauer, V. (2008). Behavioral counseling to prevent sexually transmitted infections: A systematic review for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 149(7), 497-508.
- Campinha-Bacote, J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 13(3), 181-184.
- Drabble, L., Keatley, J., Marcelle, G. (2003). Progress and opportunities in lesbian, gay, Bisexual, and Transgender Health Communications. Clinical Research and Regulatory Affairs, 20(2), 205–227.
- Centers for Disease Control and Prevention. (2010, December). Sexually Transmitted Diseases, Treatment Guidelines, 2010. Morbidity and Mortality Weekly Report. Atlanta, GA: U.S. Department of Health and Human Services.
- Deptula, D.P., Henry, D.B., & Schoeny, M.E. (2010). How can parents make a difference? Longitudinal associations with adolescent sexual behavior. Journal of Family Psychology, 24( 6), 731–739.
- Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report (2010, December). Sexually Transmitted Diseases, Treatment Guidelines, 2010. Atlanta, GA: U.S. Department of Health and Human Services.
- Butler, S.C., Procopio, M., Ragan, K., Funke, B., & Black D.R. (2011). Condom and safer sex product availability among colleges and universities in rural setting. The Health Education Monograph Series, 25(2), 10-15.
- Centers for Disease Control and Prevention. (2010, October). Condom Distribution as a Structural Level Intervention. Atlanta, GA: U.S. Department of Health and Human Services.
- Centers for Disease Control and Prevention. (2010, December). Vital Signs: HIV testing in the U.S. Atlanta, GA: U.S. Department of Health and Human Services.
- Barth, K.R., Cook, R.L., Downs, J.S., Switzer, & G.E., Fischhoff, B. (2002). Social stigma and negative consequences: Factors that influence college students’ decision to seek testing for sexually transmitted infections. Journal of American College Health, 50,(4), 153 – 159.