Condoms at my boarding school were difficult to come by. Theoretically, one could go to the health center and ask for them, but the school handbook said that students found engaging in sexual activity on campus would be subject to disciplinary action (clear messages about sex weren’t easily accessed, either). So condoms were a four-mile walk down a highway in rural western Massachusetts, or a $20 cab ride away, plus the occasional judgmental stare from the CVS cashier.
So imagine my delight when, upon my arrival at Swarthmore, condoms were everywhere: thrown at us during the orientation play, spilling from the dorm lounge cabinets, stuffed in the tied-off legs of a pair of cutoff shorts affixed to someone’s door on AP 3rd. Though I still don’t know how to use the dental dam offered to me on my way to lunch freshman year, and though the actors in the orientation play are no longer allowed to hurl condoms at students, access to protection is alive and well on campus.
Sexual health is a pressing issue at colleges across the nation. According to a 2012 report by Georgetown’s Health Education Services, 25 percent of college students have some form of sexually transmitted infection. This is troubling, but not surprising: Trojan Condoms, in a recent study, found that only 41 percent of college-aged adults report always using a condom. Besides, condoms do not prevent the transmission of all possible STIs.
At Swarthmore, the Sexual Health Advocates and Worth Health Center attempt to address a wide variety of issues related to sexual health, providing information, education, resources, and services including contraceptives, condoms, and HIV and STI testing. The SHA program, which recently transitioned from its student-run structure to operating under the supervision of Student Wellness Program Coordinator Noemí Fernandez, places at least one student in each dorm, who stays equipped with male and female condoms, dental dams, gloves, and lubricant for students to use.
The SHAs do a great deal more than merely provide supplies, however. They also serve as resources for students who wish to discuss sexual-health related issues. SHAs undergo multiple two-hour training sessions around different sexual health topics, and, during each monthly meeting, go over the best responses to questions they have been asked or approaches to students’ problems. This month, for instance, the SHAs’ meeting will focus on HIV and AIDS, and members will discuss the history and science of HIV/AIDS, including prevention, treatment, and stigmas.
Laura Hyder ’16, a member of the SHAs, believes this educational approach is extremely helpful for the group.
“You have a full picture, and so it’s easier to help someone deal with issues if you have a larger understanding of what the problem is,” she said.
Hyder noted that Swarthmore is free from some of the challenges of addressing sexual health at other schools, such as those where students are not allowed to distribute free condoms (Boston College is one such institution). Though Hyder and her fellow SHAs may sometimes have difficulty acquiring enough supplies, these are still paid for by the college, she noted.
Though the SHAs host study breaks and events, table at Sharples, and are discussing the idea of hosting office hours, Hyder said that it is challenging to reach a large number of students.
“Since we’re here for people to come to us, it’s largely dependent on people wanting to reach out,” Hyder said. “It’s kind of a self-selecting group — those that are willing to talk about it are the ones who come, while those with less information or who are less comfortable are the ones that aren’t going to reach out.”
Only one person has approached Hyder this year with a question, she said. Though Hyder is glad students have access to a wealth of information about sexual health via the internet, she also thinks a conversation with an informed peer is more helpful and calming than Googling.
“I think hearing it out loud is a much more comfortable way,” Hyder said. “If someone comes to me, and they’re concerned about their birth control not working, Googling it is way more likely to raise alarms than help you think calmly and clearly about what you’re going to do.”
The SHAs also consider consent a key part of overall sexual health, and are trained to discuss healthy relationships and to gear conversations towards directing students to other resources. Though SHAs are not confidential resources, they are able to discuss why certain situations might be concerning to students and to point them towards other information or college personnel.
Hyder said that Fernandez has been particularly helpful in encouraging SHAs to be as open and welcoming as possible for students with sexual health-related issues, and that she and the other SHAs have learned to get students to share information rather than assuming their concerns or questions.
“We might not be able to give them advice, but the more that we make it comfortable for them to open up about their issue, the more they’ll answer their own question or it’ll become clear what they need to do,” Hyder said.
Worth, meanwhile, provides a variety of sexual health-related resources. A senior who wished to remain anonymous, Mary*, has used Worth for many of these services, including STI and pregnancy testing as well as acquiring birth control and Plan B. (Worth has also partnered with one of its physicians who is at the health center weekly and can insert IUDs at her office three miles from the college.) For Mary, all of her experiences at Worth were positive and comfortable, and she felt she was given a great deal of choice and privacy.
For instance, at the end of Mary’s freshman year, she believed she had contracted an STI. Mary went to Worth and met with a nurse practitioner, who collected samples to be tested and provided advice.
“She really just gave me complete autonomy and choice in what I was going to do and made me feel very comfortable,” Mary said. “It was a really good experience — I didn’t feel scared at all.”
Health and Wellness Services Director Alice Holland, who joined the college in July, said that students who call or walk in to schedule an STI screening will be seen the same day or the next at latest. Tests for certain infections require a urine sample or a swab of the genital area, while others require a blood test. Samples are then sent to an outside lab, and students can pay via insurance. Holland said that if students do not want to use their insurance, they can visit a Planned Parenthood (there are clinics ten minutes away in Media, twenty minutes from the college in Upper Darby, and several in Philadelphia).
Mary noted that she appreciates the convenience of having Worth’s services on campus, as well as the health center’s discretion. Though STI testing, birth control, and other services will be billed to one’s student account, these will all show up as consultations at Worth rather than specific items.
“It doesn’t explicitly state what you were there for, so even if you’re scared about your parents finding out, they’re not going to find out,” Mary said.
Students who receive STI testing are always made aware of the results, whether these show nothing or come back positive. Next steps depend on what STIs a student may have contracted, Holland said. While some infections can be treated and cured, others are permanent, though Worth can provide medicine to help symptoms heal faster. Worth also provides counseling as well as education about modes of transmission and prevention of the spread of viruses. Depending on the infection, Worth may advise students to notify any sexual partners so that they can be tested and treated in order to prevent further spread.
During her junior year, Mary thought that she might be pregnant and again had a positive and straightforward experience at Worth. When asked at the front desk why she wanted an appointment, Mary said she did not want to discuss her concern aloud in the waiting room, and was granted this privacy.
Mary has also gone to Worth to purchase Plan B several times. She was somewhat nervous the first time she did this, due to the fact that she was asked to give information about how many people she had slept with, but believes that Worth’s focus is on ensuring safety rather than on judging students or telling them what to do.
Holland explained that in hiring nurse practitioners, she has focused on candidates’ experience with sexual health and with diversity and inclusion, among other criteria. (The health center employs three nurse practitioners and three physicians, all of whom are capable of conducting testing for STIs.)
“We really want to be a safe and comprehensive office,” Holland, who has a PhD in human sexuality, said.
Holland, who has been working in higher education for 12 years and previously served as the director of the health center at Quinnipiac University, particularly enjoys working with the college population due to its sex-positivity, she said.
“They come in, and they ask questions, and they want to take care of themselves and they want to get tested and they want to know what’s available to them,” Holland said. “It’s a great population, because they’re really attuned to their bodies and they want to stay healthy. I’ve seen that all of the places I’ve been and I’ve just been very impressed.”