It's no surprise that young people have the highest rates of sexually transmitted diseases. But last week, the Centers for Disease Control and Prevention reported new findings that alarmed many campus health professionals.
The CDC found that the combined total cases of gonorrhea, chlamydia and syphilis in the United States reached an unprecedented high in 2015 -- and people age 15 to 24 accounted for a large number of these new cases.
There were over 1.5 million new cases of chlamydia, about 395,000 new cases of gonorrhea and nearly 24,000 cases of syphilis. The 15-24 age group accounted for 53 percent of gonorrhea cases and 65 percent of chlamydia cases. Syphilis was most commonly found among men who had sex with other men.
The relatively large proportion of young people among those contracting STDs is nothing new -- young adults have always been the hardest hit with sexually transmitted diseases, said Lesley Eicher, health education coordinator and adjunct instructor at James Madison University Health Center.
Traditionally, college students fall into this age range. But when it comes to educating students on sexual health and offering testing and treatment for STDs, colleges and universities are scattershot. Some college health centers are investing multiple resources into sexual health education; others are not.
The University of Oregon is one institution that has added initiatives.
The university opened an STD screening clinic in September, where students can pay $15 to speak to a trained nurse. If needed, they can be tested, for an extra fee (except for HIV tests, which are free). The clinic is a success, now booked two weeks in advance, said Elisabeth Maxwell, health promotion specialist at the University of Oregon health center.
Oregon has also added two locations where students can pick up condoms. In addition to the health center, which has provided them for some time, students can now get safe sex supplies at the wellness center in the student union and at the recreation center, too. That's not all -- students are taking advantage, too. According to Maxwell, the university goes through 600 condoms per week.
Not every university provides these resources, and many report cuts in state support for prevention efforts.
The University of Wisconsin at Madison, for instance, used to offer screenings free of charge to students and nonstudents in the local area. But although it still serves students, the university stopped community screenings after state funding was cut.
Still, though, the free screenings for students are a vital resource. In addition, after the CDC data were released, administrators at University Health Services have been discussing how to reach out to high-risk patients and close the gap in the university’s educational outreach and screenings, according to William Kinsey, director of medical services at Madison.
Explaining the Increases
Although the data indicate that cases of these STDs are on the rise for the second year in a row, especially among young people, it doesn’t tell us why they are increasing, according to Donnica Smalls of the CDC. But experts certainly have theories.
The college age group is “a tough population for everything,” said Maxwell. “It’s a tough population for drugs and alcohol, a tough population for sexual health, a tough population for consent.”
In other words, it may be difficult for adolescents and young adults to approach decisions and conversations regarding these topics. Those concerns are bound up in other barriers, too, such as embarrassment in discussing risky behaviors or concerns about confidentiality, said Smalls.
It’s not enough for higher education institutions to assume that students have been educated on sexual health before they reach college, said Diane Straub, chief of the adolescent medicine division and professor of pediatric health at the University of South Florida.
Instead, colleges must be proactive in education and prevention.
For one example: at the University of Oregon, six peer educators work through the wellness center to help educate students living in residence halls, fraternities and sororities on the topic of sexual health.
Universities should also make sexual health a priority during orientation, when students should be informed on their legal rights, said Straub. Often students avoid consulting a doctor or getting tested for STDs because they are afraid the bill will be sent to their parents. But many of those students are unaware of the privacy laws regarding STDs and are subsequently unaware that those medical records can remain confidential, even from their parents.
In addition, sexual health must be addressed in a comprehensive way, Straub said. That means educators must acknowledge that STDs are connected to conversations about contraceptives, and those conversations are related to discussions about consent. It's important to tie these topics together, she said.
Colleges should also follow the example of Oregon and Wisconsin and provide contraceptives, screening and testing to their students, Straub said. “If we don’t address this now, it’s going to spiral out of control.”