Sexual Health and COVID on Campus: What Colleges Should Consider This Semester

Colleges and universities around the country are currently re-opening. As they do, they’re developing, revising, and re-revising their plans as they learn from student experience in the first few weeks and as we continue to learn more about COVID-19. Many schools were optimistic about having students return in-person for the fall. Despite initial challenges, some are still moving forward with in-those plans, limiting classroom size, forbidding large gatherings, and cutting sports and extracurricular activities. Other schools began in-person or hybrid but have already pivoted to a virtual format after seeing significant increases in cases in the first few days or weeks of having students on campus. Still others began, and have remained, entirely virtual. The myriad formats this semester mean that schools have a great deal to consider as they map out their school’s sexual health care services.

Research should back any decisions colleges make about sexual health care services. Adolescent brain development expert Laurence Steinberg outlined several reasons why students being back on campus this fall is a “perfect storm” for adolescent risk-taking in his article “Expecting Students to Play It Safe if Colleges Reopen Is a Fantasy.” College students are of an age where they weigh potential rewards more heavily than risks, particularly in social environments with their peers. They have more difficulty exercising self-control than those in their late 20’s and beyond. And at that age, young people are actually rewarded for choices that involve some risk, as such behavior activates the reward center in the brain. When we translate this to an in-person campus environment, it was pretty easy to foreshadow what we currently see on campuses around the nation.

Despite colleges’ best efforts at directing students to practice social distancing, students are getting close to each other—socially and sexually. Sexual activity, without medically accurate, comprehensive education and accessible culturally and linguistically appropriate resources, can lead to increased rates of sexually transmitted infections (STIs) and unplanned pregnancies. Schools that are doing their best to avoid or battle COVID outbreaks do not need to compound these challenges.

So, what can schools do now and throughout this semester to prepare for what some might say is inevitable? Here are our recommendations for school administrators as they welcome students “back to school:”

1. Don’t shy away from the subject. Schools must engage in non-judgmental conversations with students about how to make sexual activities safer, both in terms of COVID-19 spread and general sexual health. Identify the various staff that students might talk to about sexual health topics (e.g., resident advisors, student health staff, freshman orientation leaders, etc.) and provide them with training and resources on how to have these conversations. Some experts even suggest that conversations about safe sexual behavior can offer important lessons for how to talk about safe social interaction in the time of COVID, so pair the two together and educate young people on how to minimize various kinds of risk.
2. Make sure that critical sexual health services are available and accessible. Budget cuts are a harsh reality in the current climate, but students’ health cannot be sacrificed. Administrators must ensure that there are adequate resources, including telehealth, contraception, mental health, and Title IX services. For instance, many schools have deemed their student health center an essential service in order to keep it open, even if the services provided may be limited due to staff capacity. Administrators of large college systems with various campuses should ensure that sexual health services are available to students across all campuses. Schools that do not have a student health center or whose health center may not be the best resource for sexual health services can provide referrals to community resources, including the local health department or community health centers. Bedsider is a trusted source of information for general sexual reproductive health information, birth control options, and local providers.
3. Increase availability and distribution of contraceptive methods. Schools that have students on campus, regardless of their class format, should have condoms available for free in places like student health centers, academic buildings, restrooms, and dorms. Distribution of emergency contraception on campuses has increased in recent years as well, especially through vending machines and peer-to-peer distribution groups. These gains are important, but there is still more that can be done. Consider the placement and availability of these items on campus and identify additional access points where students can pick up these products. (Tip: If you don’t know where comfortable, discreet access points might be located, ask the students! They are the experts in the student experience.) If the budget is limited, contact your local or state health department to see whether they have a condom distribution program with free condoms. Several companies also have programs for schools and non-profits to request large quantities of condoms and/or emergency contraception at free or heavily discounted rates. Schools that do not have students on campus this semester should provide students with information and access to a variety of resources, including local health networks that provide contraception, or Bedsider, where students can find over-the-counter birth control options or identify local providers.
4. Explore a variety of online platforms to provide healthcare services and information. Students may be uncomfortable or unable to go to a physical health care center on campus for a variety of reasons, not the least of which is potential COVID-19 exposure. If feasible, administrators should ensure that online platforms are available with easy access to medical records, telehealth services, appointment reminders, and prescription delivery. Student health centers can also act as a disseminator of public health messages and share important information to the entire college community. They can utilize their social media accounts to post and re-share sexual and reproductive health information, and they can utilize their school website to link students to resources. This might include an email account where students can submit questions, a list of the health center’s hours of operations and steps to access services, or information about off-campus resources that are medically-accurate, culturally and linguistically appropriate, and inclusive of all races, genders, and sexualities.

Colleges and universities have a vested interest in helping their students stay safe, stay in school, graduate, and build a lifetime of success. Ensuring that students can stay sexually healthy this semester, virtually or in person, is a key part of that.

To help colleges address students’ sexual health needs, Power to Decide created the Campus Sexual Health Program. Colleges across the country use our planning framework to advance strategies that are sustainable, scalable, systemic, customizable, relevant, adaptable, and measurable. Contact us to learn more or to participate in this process.