September 23, 2021

How Talk About Sexual Health and STD Testing Without Shame

Brian Carufe

Why is it easier to talk about sex than sexual health? Well for one thing, mainstream TV shows are more likely to be set in bedrooms than examination rooms. And unlike steamy movie scenes that can be one’s first exposure to intimacy, a lot of people are never shown what a conversation about sexual health looks like. You can’t copy what you’ve never seen. So while sex is - well - sexy to talk about, there are ways to destigmatize the discussion of intimate health and make it just as sexy (or at least just as mainstream) as sex itself. 

Be Explicit

Over the decades, at both high schools and universities, clinicians have tried throwing condoms at the problem of unsafe practices, and hoping for the best. It’s been largely unsuccessful. And while schools ultimately need to do more than just expand awareness of diverse sexual health needs (more on that later), it’s a foundation that needs strengthening on campuses across the country. In a national survey of sexual health services on community college campuses, conducted in 2000, 42% of responding colleges reported having a health center, of which 15% and 25% offered HIV and STI testing on campus, respectively. Almost every school surveyed made referrals to outside organizations, while 21% reported testing services were funded by a health department. Even though these studies were conducted more than two decades ago, if the testing rates are slow to grow, then the conversation surrounding them surely is too. 

To change this, some schools have adopted peer-to-peer workshops facilitated by undergraduate students who are highly trained in various health-related topics. American University’s program even offers a workshop called “Sex Jeopardy” - an interactive exercise that explores several different intimate health topics, such as birth control, STIs, protection, sexual health in the LGBTQ community, alcohol, and sex. And with an approach as explicit as that, everyone’s a winner. 

Be Judgement-Free 

No one wants to feel judged in any intimate context. Why should sexual health be any different? Patterns about health, sexuality, relationships, contraception, and childbearing vary significantly across populations. Consequently, universities must make sure health center employees are versed in gender-affirming care, are empathetic to student needs, and avoid producing shame in anyone who could be better educated about sexual health. For example, are we telling gay men about the benefits of PrEP? Are we telling lesbians about how STIs can be transmitted by any shared toys? Are transgender students aware of any new sexual risks they may be exposed to after a transition? It’s up to our healthcare workers to answer these questions that many people may not have even thought to ask. Culturally sensitive and competent healthcare improves students’ engagement in preventive services and even decreases health disparities. With the diverse array of young adults that make up any student body, their actual bodies need to be appreciated for what they are before they can be at their healthiest. 

Be Equipped 

Knowledge may be power, it’s not enough to seal the deal on a properly prepared student populace. Increasing opportunities for testing through targeted outreach and routine screening can increase awareness, normalize the act of testing, and decrease the stigma surrounding HIV and other STIs. A recent study found that free STI testing was offered by only 10.3% of university health centers, and a large portion of schools reported that students looked elsewhere for STI services to avoid high-deductibles and co-pays. Luckily, some colleges addressed this issue by incorporating the cost of STI testing into student health fees; however, less than 40% of the colleges surveyed in the study had enacted this policy.

An even more inclusive solution exists in the growing use of Ash Wellness at-home testing services for all types of STIs, eliminating waits at the clinic, expensive co-pays, and lack of privacy or discretion. It’s the metaphorical tool belt all college students should have when the literal belts start coming off. Talk is important; actions even more so. If schools take it upon themselves to provide these services, the sheer convenience would lead to safer copulation and more conversation. 

With students informed and provided for, universities can destigmatize sexual health on their campuses and in our culture. All we have to do is keep the conversation candid and inclusive, and make the solution suitable to students’ lives. With that in mind, it’s time for Final Sex Jeopardy. Place your wagers…

This activity involves being explicit, open-minded, and definitely well-equipped. 

Answer: A sexual wellness program near you. 


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