Emergency contraceptive pill, contraceptive, and sexually transmitted infection service availability among U.S. College Health Centers.
Butler, Scott M. ; Black, David R. ; Avery, George 等
Emergency Contraceptive Pill, Contraceptive, and Sexually
Transmitted Infection Service Availability among U.S. College Health
Centers
In the U.S., sexually transmitted infections (STIs) and unintended
pregnancy are associated with a variety of medical, public health, and
economic factors (Centers for Disease Control and Prevention [CDC],
2011; Chesson, Blanford, Gift, Tao, & Irwin, 2004; Institute of
Medicine, 1995; Monea & Thomas, 2011). The Patient Protection and
Affordable Care Act of 2010 (PPACA; U.S. Department of Health and Human
Services, 2010) has facilitated national discourse regarding the role of
sexual healthcare availability and coverage among U.S. colleges and
universities. In addition to other preventative services, the PPACA
provides coverage of FDA-approved contraceptive methods and
contraceptive counseling, HIV screening and counseling, as well as STI
counseling for sexually active women (U.S. Department of Health and
Human Services, 2011a). The PPACA also provides consumer benefits to
students who purchase student health plans through their college or
university (U.S. Department of Health and Human Services, 2011b).
Despite the importance of sexual healthcare availability among
colleges and universities, few studies have been conducted to assess the
prevalence of sexual health services among college health centers. The
identification of these trends may be useful to college health
clinicians, prevention specialists, and administrators who advocate for
comprehensive sexual healthcare within their institution and may
influence health center policy by identifying key service-related
disparities nationally. In addition, large-scale national investigations
are needed to establish sexual healthcare benchmarks among colleges and
universities.
Finer and Zolna (2011) estimated that 51% of the pregnancies in the
U.S. are unintended. A similar study by Finer and Henshaw (2006)
reported an unintended pregnancy rate of 104/1,000 among women 20-24
years old, a rate twice that of the overall population (51/1,000).
According to the 2010 Sexually Transmitted Disease Surveillance Report,
19 million or 6.1% of Americans are diagnosed with an STI each year
(CDC, 2011). Adolescents and young and adults 15-24 years old represent
significant STI-related disparities and account for nearly half of all
new infections (Weinstock, Berman, & Cates, 2004).
Recent findings of the Spring 2011 American College Health
Association (ACHA): National College Health Assessment II Survey
revealed that 70.8% of college students have had vaginal, anal, or oral
sex with at least one partner over the last 12 months (ACHA, 2011a).
Among those who had sex with at least one partner during that time,
collegiate men reported a M of 2.52 (SD = 4.33) sexual partners and
women a M of 1.87 (SD = 2.07) partners. Among students who were sexually
active, 60.6% used birth control pills to prevent pregnancy. In
addition, 16.0% of participants reported that they (or their sexual
partner) had used emergency contraceptive pills (ECP) within the last 12
months.
A national study of 358 institutions conducted by McCarthy (2002)
indicated that 52.2% of schools nationally offer ECP. Recent studies by
Miller (2011) and Miller and Sawyer (2006) have indicated that nearly
half (43% and 49%, respectively) of colleges and universities in
Mid-Atlantic States offer ECP to their students. According to the 2011
study by Miller, 56.9% of schools offering ECP to students are public
institutions, 43.1% were private, 100% were 4-year institutions, and
none were faith-based institutions. In addition, faith affiliation and
institutional ideology have been reported as significant barriers to
condom and safer sex product availability within colleges and
universities in rural settings (Butler, Procopio, Ragan, Funke, &
Black, 2010).
Another study by Koumans and colleagues (2005) assessed STI-related
services including testing and education strategies among higher
education institutions. Of the 910 colleges selected for participation,
the investigators received completed questionnaires from 736
institutions (81% response rate). Results indicated more than 75% of
health centers currently offered common STI testing for students
including chlamydia (91%), gonorrhea (90%), herpes simplex virus (HSV;
81%), and HIV (78%). Similarly, 88% of all schools offered Pap tests for
students. However, only 38% currently offered syphilis testing. An
assessment of demographic variables indicated that when compared to
2-year colleges and universities, 4-year institutions were more likely
to offer six of the eight key STI testing services (p < .05)
including bacterial vaginosis, chlamydia, gonorrhea, herpes simplex
virus, and trichomonas testing, as well as Papanicolaou (Pap) tests.
Institutions with on-campus residential housing also were more likely to
offer 6 of the 8 services (p < .05) including bacterial vaginosis,
chlamydia, gonorrhea, herpes simplex virus, and trichomonas testing, as
well as Pap tests Private institutions were less likely to offer HIV
testing when compared to non-faith-based schools (83% vs. 71%
respectively; p < .05).
According to the 2010 American College Health Association Pap Test
and STI Survey (n = 174), 97.7% of colleges and universities surveyed
nationally offer routine STI screening for asymptomatic women and 92.4%
for asymptomatic men (ACHA, 2011b). Nearly all (85.1%-96.0%) offer
chlamydia, gonorrhea, HIV, and syphilis screening for asymptomatic
students and just over half (57.5%) offer HSV screening. With regard to
HIV testing, three-quarters (75.9%) offer standard blood tests, while
the minority offer HIV rapid blood and HIV rapid oral tests (23.6% and
21.3%, respectively).
The purpose of the present study was to assess ECP, hormonal and
barrier contraceptive, and STI services within college health centers
nationwide. Specifically, the foci of the study are four-fold and
assessed the following: (a) percentage of college health centers
nationally that distribute ECP to their student population with and
without prescription, (b) percentage of college health centers that
offer key barrier and hormonal contraceptive services, (c) percentage of
college health centers that offer STI-related services including testing
and vaccinations, and (d) ability of college and university demographics
to predict presence of the aforementioned services among college and
university health centers.
Method
Recruitment Procedures
Permission was received from the University Institutional Review
Board prior to conducting this study and collecting data. A
geographically representative sample of 1,200 colleges and universities
with student health centers was identified (see Butler et al., 2011a).
Questionnaire and consent forms were both mailed and emailed to the
directors of the student health center. Within 2-weeks, a reminder card
was mailed to each of the student health center directors who had not
returned the completed questionnaire. All recruitment procedures were
completed by May 2009. Of the initial 1,200 institutions in the sampling
frame, 358 (29.8%) completed the questionnaire. [See the Statistical
Power Estimates and Sample Frame sections of our previous report by
Butler and colleagues (2011a) for additional details regarding
preliminary power assessments and construction of the sampling frame,
which indicated sufficient power to detect a significant differences, if
they existed.] Data were collected as part of a large-scale national
study of ECP, hormonal and barrier contraceptive, and STI vaccination
and testing; as well as health center sexuality employee availability
and prevalence/duties of sexuality peer educators. For the purpose of
the present report, only data regarding ECP, contraceptive, and STI
service availability were included in the final analyses. [See Butler,
Black, and Coster (2011a) and Butler and Black (2011) for additional
reports assessing condom availability and use of sexuality peer
educators.]
Measures
Directors of the participating student health centers completed the
Sexual Health Services Questionnaire (SHSQ) developed by Butler, Black,
Avery, Kelly, and Coster (2011b). The SHSQ is a valid and reliable
instrument specifically designed to comprehensively assess the
availability of contraceptive and STI vaccination and testing as well as
sexuality employee and peer-helper prevalence rates. As reported by
Butler and colleagues (2011b), the SHSQ was reviewed by college health,
public health, and human sexuality experts during developmental stages.
In addition, the overall internal consistency of the instrument was .94,
with internal consistency for individual subscales from .62-.93. The
internal consistency for the hormonal and barrier contraceptive items
was .89 and STI vaccine and testing items were .92.
A test-retest assessment of 28 participants indicated a 87.37%
reliability across all service-related items. The SHSQ includes 2 items
regarding ECP distribution (with prescription and without prescription),
11 items assessing hormonal and barrier contraceptives, 2 items STI
vaccines (HPV and Hepatitis B), 11 items STI testing availability, 4
items assessing gynecological and post-sexual assault services, and 12
items regarding participant and institutional demographics.
Contraceptive and STI items are dichotomous (yes/no) with 1 scored as
yes and 0 for no.
Data Analyses
Descriptive analyses were conducted on the contraceptive, STI, and
participant demographic items. Mean and standard deviations were
computed for the student population variable. Values from this variable
were then converted to a categorically-based ordinal scale of
measurement to assess the prevalence rate of contraceptive and STI
services by population group. Multivariate logistic regression analyses
were computed to assess the ability of the institution demographic
variables to predict the availability of nine selected key
sexuality-related services including the following: ECP with
prescription, ECP without prescription, hormonal transdermal skin patch,
hormonal vaginal ring, HIV testing (of any type), HIV rapid testing, HIV
swab testing, HPV vaccine, and HPV DNA test for women.
Included in the analyses were the following demographic variables:
region (South, Northeast, Midwest, West), type of institution (public,
private), setting (urban, suburban, small town, rural), student
population size (< 5,000, 5,000-9,999, 10,000-24,999, [greater than
or equal to] 25,000), and religious affiliation (non-faith-based,
faith-based).
Results
Data were collected from 358 college and universities with student
health centers located within 47 U.S. states and Washington D.C. The sum
of the student bodies of the participating institutions (n = 351) was
3.71 million students. The student population mean was 10,555.98 (SD =
11,588.72). Regional, institutional, and student population demographics
are contained in Table 1. The majority of the institutions offered
baccalaureate (92.7%) and master (80.7%) degrees, while 45% of
institutions offered doctoral, 32.1% associate, and 20.9% offered
professional degrees. Forty-nine or 13.7% housed a medical school, 3.4%
were from a Historically Black College or University, 2% were all female
intuitions, and 1% all male.
ECP, Hormonal, and Barrier Contraceptive Availability
Overall, 80.2% of all student health centers prescribed some form
of hormonal contraception, with just over half offering ECP with and
without prescription (52.9% and 52.1%, respectively). In addition, 50.6%
of centers prescribe at least one non-hormonal contraceptive and 80.1%
provide contraceptive counseling. Data regarding the percentage of
institutions that offer hormonal and non-hormonal contraceptives are in
Table 2.
Results of the multivariate logistic regression analyses indicated
that schools in the West were more likely than schools in the South to
offer ECP by prescription (OR = 3.07, CI = 1.44 -6.55, p = .004). In
addition, faith-based institutions were less likely to offer ECP by
prescription than non-faith-based schools (OR = .18, CI = .07 -.44, p
< .001). When compared to institutions with student a population of
> 5,000, schools with populations of 10,000 - 24,999 and those with
greater than 25,000 were more likely to offer ECP without prescription
(OR = 4.50, CI = 2.19 - 9.14, p < .01; OR = 16.72, CI = 5.00 55.92, p
< .01, respectively). The final models for demographic predictors of
ECP by prescription and ECP without prescription are contained in Tables
3 and 4. Additional data regarding predictive ability of demographics
for the hormonal implant, hormonal vaginal ring, and hormonal patch are
contained in Tables 5-7.
STI and Gynecological Services
The majority of the participants (99.7%) reported data regarding
their STI vaccination, testing, and gynecological services. Nearly
three-quarters of institutions (71.1%) offered at least one type of HIV
testing. However, less than half offered HIV swab and HIV rapid tests
(30.3% and 23.0%, respectively). When compared to schools in the South,
institutions in the West were more likely to offer at least one type of
HIV testing (OR = 3.80, CI = 1.42 - 10.12, p < .05). In addition,
when compared to schools with student populations of < 5,000,
institutions with populations of 5,000-9,999, 10,000-24,999 and >
25,000 were more likely to offer at least one type of HIV testing (OR =
2.42, CI = 1.12-5.21, p < .05; OR = 4.21, CI = 1.88 - 9.47, p <
.001; OR = 6.07, CI = 1.78 - 20.74, p < .001, respectively). Finally,
commuter schools were less likely to offer at least one form of HIV
testing when compared to residential institutions (OR =.42, CI = .20 -
.86, p < .05). Similarly, nearly three-quarters (72.3%) offer HPV
vaccination. Schools in the West were more likely to offer HPV
vaccination when compared to those in the South (OR = 2.85, CI = 1.15 -
7.02, p < .05) and faith-based schools were less likely to offer HPV
vaccination when compared to non-faith-based schools (OR = .29, CI = .13
- .64, p < .01). Finally, when compared to schools with student
populations of < 5,000, institutions with populations of
10,000-24,999 and > 25,000 were more likely to offer the HPV
vaccination (OR = 3.70, CI = 1.67 - 8.23, p < .01; OR = 27.00, CI =
3.33 - 218.00, p < .01, respectively).
The majority of institutions (73.7%) reported having a Clinical
Laboratory Improvement Amendment (CLIA) certificate, whereas 22.7% did
not have a CLIA certificate, and 2.5% were unsure. With regard to
gynecological services, 85.7% offered clinical breast examinations,
82.6% Pap tests, 79.8% bimanual pelvic examinations, and 17.9%
colposcopy services. In addition, 21% of student health centers
conducted post sexual assault examinations and testing for students.
Additional data regarding the availability of STI vaccination and
testing are in Tables 8-13.
Discussion
Findings from this national study reveal that the majority of
college health centers nationwide offer key contraceptive and STI
services including hormonal contraceptives, ECP with/without
prescription, HIV testing, and the HPV vaccine. These results indicate
that college and university health centers have adapted to the
availability of innovative sexual health products such as the vaginal
ring, the transdermal patch, HPV DNA testing, and the HPV vaccine.
However, of all the contractive services assessed, only the oral
contraceptive pill was reported in [greater than or equal to] 75% of
health centers nationally and less than half of all centers offer each
of the non-hormonal contraceptive services. Similarly, only 5 STI
services (gonorrhea, chlamydia, syphilis, trichomoniasis, and HSV
testing) were reported among [greater than or equal to] 75% of health
centers nationally. While the majority of centers offer at least one
form of HIV testing (71.1%), less than one third offer HIV swab testing
(30.3%) as well as HIV rapid testing (23.0%). Overall, findings suggest
that the present service availability among health centers may not be
sufficient to the meet the sexual healthcare needs of students and that
additional initiatives are needed to increase availability.
The present study provides insight about the predictive ability of
demographic variables of nine key sexual services. With regard to
contraceptive services, significant differences were observed among
institutions by region, student population, residential characteristic,
and faith-based affiliation. Specifically, the Western region was more
likely to offer ECP with prescription as well as the hormonal vaginal
ring when compared to the South. In addition, institutions with larger
student populations were more likely to offer ECP without prescription,
the hormonal vaginal ring, and the contraceptive patch. Schools whose
campus was primarily residential were more likely to offer the hormonal
implant when compared to commuter schools and residential/commuter
schools. Finally, faith-based institutions were less likely to offer ECP
with prescription, ECP without prescription, and the hormonal vaginal
ring.
Similar results were found with regard to STI-related services.
Colleges and universities and universities with larger student
populations were more likely to offer key services including HIV
testing, HIV rapid testing, HIV swab testing, HPV DNA testing, and the
HPV vaccine. Similarly, institutions with primarily residential student
populations were more likely to offer HIV testing and HIV rapid testing
and faith-based schools were less likely to offer HPV DNA testing and
the HPV vaccine. When considering all of the multivariate comparisons in
concert, student population size was the statistically significant
predictor found in 80% of comparisons across both contraceptive and STI
services. Overall, these findings suggest that student population size,
geographic location, residential characteristic, and faith affiliation
are associated with barriers to contraceptive services.
Findings of the present study are consistent with previous
investigations of STI services among colleges and universities. For
example, McCarthy (2002) found that 52.8% of student health centers
nationally offer ECP by prescription, whereas the present study
indicates that 52% offer ECP with/without prescription. While the
present study is not a direct follow-up assessment to of the McCarthy
(2002) study, findings suggest that the availability of ECP by
prescription among U.S. college health centers has remained constant
since 2002. In addition, results of present investigation are consistent
with those of Miller and Sawyer (2006) as well as Miller (2011) who
reported ECP availability among 49% and 43%, respectively within the
Mid-Atlantic region of the U.S and those of Koumans and colleagues
(2005) who reported HIV testing availability among 78% of colleges and
universities nationwide. Koumans and colleagues (2005) investigation
also reported less frequent HIV testing availability among private
institutions as well as a positive relationship between STI prevention
efforts and student population. Finally, findings from the present study
are consistent with our previous reports (Butler & Black, 2011;
Butler, Black, & Coster, 2011a), which found statistically
significant differences among condom availability, number of condoms
distributed/year, and use of sexuality peer educators across demographic
characteristics among colleges and universities.
The present study has limitations to consider. First, the data
procured are based upon self-reported assessment of the ECP,
contraceptive, and STI service availability among college and university
health centers. Given the overarching purpose of the investigation,
self-report was the most viable option for a nationwide assessment.
Second, while the sample size of the present study met the statistical
assumptions associated with our sample size estimations (cf. Butler,
Black, & Coster, 2011a), there may be limitations in generalizing
findings from institutions with low demographic representation (e.g,
Historically Black Colleges and Universities). However, the present
investigation is consistent with that of McCarthy (2002), Miller and
Sawyer (2006), Miller (2011), as well the 2010 ACHA Pap Test and STI
Survey (ACHA, 2011b) that reported sample sizes of 174-358. Third, data
were collected prior to the passing of the PPACA and therefore this
legislation had no impact upon service availability. However, the
present study may serve as a viable national assessment of service
availability prior to PPACA and therefore, could be used for future pre-
and post-comparisons. Finally, while the overarching purpose of the
present study was to assess the availability of selected sexual
health-related services on campuses, as well as demographic predictors
of these services, no data were collected on the overall utilization of
services by the student population or the prevalence rates of university
employees who refer students to outside agencies for sexual healthcare
when services are not available on campus.
Future research is needed to further investigate the availability
of sexual health services among health centers. Specifically,
representative studies with large sample sizes would be beneficial in
identifying service-related disparities among college and university
health centers. In addition, studies are needed to assess factors which
influence the availability of services such as resource allocation,
institutional ideology, policy development and implementation, as well
as social and physical environmental factors.
There is a dearth of published investigations to assess the
prevalence of sexuality-related services among U.S. college health
centers. Findings from the present investigation provide a comprehensive
assessment of services on a national level and have implications for
prevention programs among colleges and universities. In addition, this
study is the first to provide multivariate assessments of the predictive
ability of key university demographic variables. Overall, these findings
can assist in the establishment of contraceptive and STI service
benchmarks among health centers nationally and corresponds with the
recent focus on prevention recently passed by the Supreme Court.
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Scott M. Butler, PhD, MPH
Department of Kinesiology, Georgia College & State University
David R. Black, PhD, MPH, HSPP, CHES, CPPE, FASHA, FSBM, FAAHB,
FAAHE
Department of Health and Kinesiology, Purdue University
George Avery, PhD, MPA
Independent Consultant
Contact Author: Scott M. Butler, PhD, MPH, Department of
Kinesiology, Georgia College & State University, Campus Box 112,
Milledgeville, GA 31061 scott.butler at gcsu.edu 478-445-1218
Author Note: This publication was supported in part by a grant
provided by the Georgia College & State University Foundation.
Table 1
Regional, Institutional, and Setting Demographics of Participant
Institutions (n = 358).
Respondents
Demographic n %
Region
South 110 30.7
Northeast 104 29.1
Midwest 81 22.8
West 61 17.1
Unreported 2 .6
Type of Institution
Public 207 57.8
Private 150 41.9
Unreported 1 .3
Setting
Urban 136 38
Suburban 90 25.1
Small Town 78 21.8
Rural 52 14.5
Unreported 2 .6
Student Population Size
<5,000 158 44.1
5,000-9,999 61 17
10,000-24,999 91 25.4
[greater than or equal to] 25,000 41 11.5
Residential Characteristic
Primarily Residential 150 41.9
Primarily Commuter 129 36
Equal Residential/Commuter 76 21.2
Unreported 3 .8
Religious Affiliation
Non-Faith-Based 302 84.4
Faith-Based 56 15.6
Table 2
ECP, Hormonal, and Non-Hormonal Contraception Prescriptions
(n = 357).
n %
Variable
Hormonal Oral Contraceptive Pill 277 77.9
Progestin 249 69.7
Vaginal Ring 222 62.2
Transdermal Patch 201 56.3
Emergency Contraceptive Pill 189 52.9
(by Prescription)
Progestin Only Pill 187 52.4
Emergency Contraceptive Pill 186 52.1
(Without Prescription)
Hormonal Intrauterine Device 83 23.2
Hormonal Implant 27 7.6
Non-
Hormonal Diaphragm 138 38.7
Fertility Awareness Method 127 35.6
Cervical Cap 54 15.1
Copper Intrauterine Device 41 11.5
Table 3
Demographic Predictors of ECP with Prescription Availability
(n = 347).
VARIABLE OR 95% CI
Region
South (reference)
Northeast 1.67 .89-3.11
Midwest 1.05 .55-2.00
West 3.07 * 1.44-6.55
Type of Institution
Public (reference)
Private .51 .26-1.03
Setting
Urban (reference)
Suburban 1.2 .65-2.22
Small town 1.16 .59-2.27
Rural 1.95 .89-4.26
Student Population
<5,000 (reference)
5,000-9,999 1.09 .54-2.20
10,000-24,999 1.15 .58-2.31
[greater than or equal to] 25,000 2.18 .85-5.59
Residential Characteristic
Primarily Residential (reference)
Primarily Commuter .73 .38-1.38
Equal Residential/Commuter .72 .37-1.38
Non-faith-based (reference)
Faith-based .18 * .07-.44
* p < .01.
Table 4
Demographic Predictors of ECP without Prescription Availability
(n = 347).
VARIABLE OR 95%CI
Region
South (reference)
Northeast 1.2 .63-2.23
Midwest .81 .41-1.62
West 1.44 .68-3.09
Type of Institution
Public (reference)
Private 1.51 .75-3.07
Setting
Urban (reference)
Suburban 1.15 .61-2.20
Small town .76 .38-1.52
Rural 1.31 .60-2.90
Student Population
<5,000 (reference)
5,000-9,999 .92 .46-1.84
10,000-24,999 4.50 * 2.19-9.14
[greater than or equal to] 25,000 16.72 * 5.00-55.92
Residential Characteristic
Primarily Residential (reference)
Primarily Commuter .69 .35-1.34
Equal Residential/Commuter .89 .46-1.74
Non-faith-based (reference)
Faith-based .17 * .07-.41
* p < .01.
Table 5
Demographic Predictors of Hormonal Implant Availability
(n = 347).
VARIABLE OR 95%CI
Region
South (reference)
Northeast .25 .03-2.22
Midwest 1.81 .57-5.71
West 1.74 .53-5.71
Type of Institution
Public (reference)
Private .19 .03-1.13
Setting
Urban (reference)
Suburban .57 .15-2.06
Small town 1.13 .36-3.55
Rural .32 .04-2.90
Student Population
<5,000 (reference)
5,000-9,999 .64 .10-4.01
10,000-24,999 2.93 .71-12.10
[greater than or equal to] 25,000 2.57 .50-13.25
Residential Characteristic
Primarily Residential (reference)
Primarily Commuter .19 ** .06-.55
Equal Residential/Commuter .14 * .03-1.13
Non-faith-based (reference)
Faith-based .87 .07-.10.21
* p < .05. ** p < .01
Table 6
Demographic Predictors of Hormonal Vaginal Ring Availability
(n = 347).
VARIABLE OR 95%CI
Region
South (reference)
Northeast 1.82 .96-3.47
Midwest 2.16 * 1.08-4.34
West 3.23 ** 1.43-7.33
Type of Institution
Public (reference)
Private .96 .47-1.95
Setting
Urban (reference)
Suburban 1.07 .55-2.08
Small town .57 .28-1.14
Rural 1.12 51-2.47
Student Population
<5,000 (reference)
5,000-9,999 .64 .32-1.28
10,000-24,999 2.64 ** 1.28-5.45
[greater than or equal to] 25,000 8.56 ** 2.26-32.37
Residential Characteristic
Primarily Residential (reference)
Primarily Commuter .70 .36-1.37
Equal Residential/Commuter .73 .36-1.42
Non-faith-based (reference)
Faith-based .20 ** .09-.45
* p < .05. ** p < .01.
Table 7
Demographic Predictors of Contraceptive Patch Availability
(n = 347).
VARIABLE OR 95%CI
Region
South (reference)
Northeast 1.81 .96-3.47
Midwest 1.77 .91-3.45
West 2.11 1.00-2.45
Type of Institution
Public (reference)
Private .55 .75-3.07
Setting
Urban (reference)
Suburban .98 .52-1.86
Small town .80 .41-1.58
Rural .78 .37-1.66
Student Population
<5,000 (reference)
5,000-9,999 .41 * .20-1.17
10,000-24,999 2.06 * 1.04-4.08
[greater than or equal to] 25,000 6.82 ** 2.06-22.55
Residential Characteristic
Primarily Residential (reference)
Primarily Commuter .61 .32-1.17
Equal Residential/Commuter .67 .35-1.29
Non-faith-based (reference)
Faith-based .48 .22-1.02
* p < .05 ** p < .01
Table 8
Prevalence of STI Testing and Vaccine Availability (n = 357).
Variable n %
Gonorrhea 299 83.6
Chlamydia 298 83.5
Syphilis 272 83.5
Trichomoniasis 271 75.9
HSV 270 75.6
Hepatitis B 265 74.2
HIV Testing (Any Type) 254 71.1
HPV DNA 240 67.2
HIV Swab 108 30.3
HIV Rapid Test 82 23
Vaccine
Hepatitis 297 83.2
HPV 258 72.3
Table 9
Demographic Predictors of HIV Testing (n = 346).
VARIABLE OR 95%CI
Region
South (reference)
Northeast 1.06 .55-2.06
Midwest .94 .47-1.88
West 3.80 * 1.42-10.12
Type of Institution
Public (reference)
Private .71 .33-1.50
Setting
Urban (reference)
Suburban .87 .44-1.71
Small town 1.09 .52-2.30
Rural .95 .42-2.16
Student Population
<5,000 (reference)
5,000-9,999 2.42 * 1.12-5.21
10,000-24,999 4.21 ** 1.88-9.47
[greater than or equal to] 25,000 6.07 ** 1.78-20.74
Residential Characteristic
Primarily Residential (reference)
Primarily Commuter .42 * .20-.86
Equal Residential/Commuter .72 .36-1.46
Non-faith-based (reference)
Faith-based .54 .26-1.16
* p < .05. ** p < .001.
Table 10
Demographic Predictors of HIV Rapid Testing (n = 346).
VARIABLE OR 95%CI
Region
South (reference)
Northeast 1.14 .55-2.35
Midwest .32 * .14-.75
West .37 * .16-.88
Type of Institution
Public (reference)
Private .72 .30-1.71
Setting
Urban (reference)
Suburban .78 .38-1.59
Small town .43 .17-1.07
Rural 1.09 .44-2.65
Student Population
<5,000 (reference)
5,000-9,999 .44 1.15-1.31
10,000-24,999 3.65 * 1.61-3.30
[greater than or equal to] 25,000 7.64 *** 2.75-21.20
Residential Characteristic
Primarily Residential (reference)
Primarily Commuter .56 .26-1.20
Equal Residential/Commuter .40 * .17-1.92
Non-faith-based (reference)
Faith-based .43 .13-1.43
* p < .05. ** p < .01.*** p < 001.
Table 11
Demographic Predictors of HIV Swab Testing (n = 346).
VARIABLE OR 95%CI
Region
South (reference)
Northeast 2.60 *** 1.31-5.14
Midwest 2.30 * 1.14-4.63
West 1.18 .55-2.53
Type of Institution
Public (reference)
Private .44 * .21-.95
Setting
Urban (reference)
Suburban .82 .43-1.55
Small town .61 .29-1.27
Rural 1.01 .46-2.34
Student Population
<5,000 (reference)
5,000-9,999 2.13 * 1.02-4.44
10,000-24,999 1.50 .71-3.14
[greater than or equal to] 25,000 3.57 ** 1.43-8.96
Residential Characteristic
Primarily Residential (reference)
Primarily Commuter .83 .44-1.58
Equal Residential/Commuter .69 .34-1.40
Non-faith-based (reference)
Faith-based 1.15 .46-2.85
* p < .05. ** p < .01.
Table 12
Demographic Predictors of HPV DNA Testing (n = 346).
VARIABLE OR 95%CI
Region
South (reference)
Northeast 1.26 .65-2.41
Midwest .68 .35-1.31
West 1.80 .81-4.02
Type of Institution
Public (reference)
Private 1.25 .60-2.61
Setting
Urban (reference)
Suburban .99 .51-1.91
Small town .75 .38-1.50
Rural 1.10 .50-2.43
Student Population
<5,000 (reference)
5,000-9,999 2.13 * 1.03-4.34
10,000-24,999 4.44 *** 2.06-9.56
[greater than or equal to] 25,000 5.39 ** 1.85-15.69
Residential Characteristic
Primarily Residential (reference)
Primarily Commuter .66 .34-1.30
Equal Residential/Commuter .70 .36-1.36
Non-faith-based (reference)
Faith-based .39 * .19-.83
* p < .05. ** p < .01.*** p < .001.
Table 13
Demographic Predictors of HPV Vaccine (n = 346).
VARIABLE OR 95%CI
Region
South (reference)
Northeast 1.09 .56-2.13
Midwest 1.21 .60-2.45
West 2.85 * 1.15-7.02
Type of Institution
Public (reference)
Private .54 .25-1.16
Setting
Urban (reference)
Suburban 1.14 .56-2.33
Small town .76 .37-1.58
Rural .81 .36-1.81
Student Population
<5,000 (reference)
5,000-9,999 1.40 .67-2.90
10,000-24,999 3.70 ** 1.67-8.23
[greater than or equal to] 25,000 27.00 ** 3.33-218.00
Residential Characteristic
Primarily Residential (reference)
Primarily Commuter .60 .29-1.18
Equal Residential/Commuter 1.07 .53-2.19
Non-faith-based (reference)
Faith-based .29 ** .13-.64
* p < .05. ** p < .01.
