Running

Head: STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 1

Student Awareness of Sexual Health Services Provided at Texas State University

Group Name: Spice PR

Members: Lauren Guzman, Valerie Lara, Yadira Ortiz, Quincy Standa, Kaitlyn Watson

Texas State University

MC3360.255

Spring 2019
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 2

Table of Contents

Executive Summary…………………………………………………………………………….....3

Introduction……………………..……………………..……………………..……………………6

Background………………………………………………………………………………………..6

Purpose…………………………………………………………………………….………………7

Literature Review……………………..……………………..………………………….…………7

Research Questions………………………………………………………………………………12

Methodology……………………..……………………..……………………..…………………12

Results…………………….……………………..……………………..…………………….…..12

Analysis………………………………………………………………………………………..…15

Limitations……………………..……………………..……………………..…………………...16

Managerial Implications……………………..……………………..……………………..……..17

Objectives………………………………………………………………………………………..18

Conclusion and Future Studies……………………..……………………..…………………..…18

References……………………..……………………..……………………..……………………20

Appendix A…………………..……………………..……………………..……………………..22

Appendix B………………………………………………………………………………………30
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 3

Executive Summary

The Student Health Center (hereafter referred to as SHC) offers convenient and helpful

services on campus to Texas State University students. Spice PR surveyed students at Texas

State University to gauge their knowledge on the services provided by the SHC. We arranged

questions that referred to specific services provided at the SHC for statistics and data collection.

Figure 22 Average Awareness of Services

The results show that, in general, respondents are not very aware of the extent of services

offered at the SHC. We asked respondents to check all of the services that they were aware of

and took an average score to gauge how informed they were with a specific measurement. By

analyzing the answers from all respondents, we found that the average score was 53%, which

shows that many respondents are only aware of about half of the sexual health services provided

by the SHC (Fig. 22). Currently, the knowledge most respondents have about sexual health

services is primarily learned from student orientation. Student orientation is required for all

freshmen who attend Texas State University where a PowerPoint presentation is given regarding

the services the SHC offers. Students cannot avoid attending the student orientation unless they

take an online course that depicts the same information that was given at the orientation. This

shows there is minimal effort put forth by students past the information being handed to them.

They do not seek information regarding these services on their own time.
 STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 4

Figure 17 Q17 - How do you think the Student Health Center could most effectively promote their services? (Write your response.)

Most respondents recommend either improving social media presence by posting more

(20%) or by sending out emails specifically about sexual health services (12.8%). Other

suggestions included flyers, hosting more events, and talking in classrooms (Fig. 17).

Figure 10 Q10 - If you choose not to access sexual health services provided by the Student Health Center, what are some of the reasons why?

Check all that apply.

If students have chosen not to access sexual health services provided by the SHC, they

were asked to give a reason why. The most popular answers were “I prefer an outside physician,”

(20.97%) and the “other” category (20.97%). When prompted to give a written response to the

answer instead, the most common response was that the respondent has not needed to access

these services (Fig. 10).

 STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 5

Figure 9 Q9 - If you have accessed the Student Health Center for any reason, how did you hear about their services? Check all that apply.

Texas State University currently has a multitude of sources to provide information about

sexual health services. Along with information provided on the SHC website, the university’s

biggest way to promote sexual health services currently is at New Student Orientation. Most

respondents (24.55%) said that student orientation was how they heard about sexual health

services provided by the SHC. The second most common way that people gained information

was through a friend (17.27%). Only a small percentage of respondents (13.64%) say they got

their information through the website (Fig. 9). Among the other ways of posting information

such as posters, pamphlets, and advertising in the Quad, these were not highly selected as a way

that students got their information regarding sexual health services.

As stated in our managerial implications, we suggest the SHC improve their social media

pages, change their advertising methods, and highlight all of their contraceptive services more

equally.
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 6

Introduction

Our group decided to research the awareness amongst our peers of college students at

Texas State University concerning the different resources that students have in order to access

contraceptives and anonymous sexual health checkups. Partial reasoning for researching this

topic is due to the political climate and the current state of women’s rights in the sense of

reproductive health. The public’s heightened interest in the topic at hand was attributed to this.

The business of sexual health is brimming with advocacy and campaigns to invoke safe sex

practices such as open conversation and less stigmatization of sexual history, contraceptive use,

and the normalization of regular sexually transmitted infection (STI) checkups. Our study

focused on awareness of sexual health services including contraceptives and sexual health

screening at Texas State University. Our goal was to increase the awareness in Texas State

students about the services offered by the SHC. All questions were formulated based on

information gathered and confirmed from the SHC website.

Background

There have been many studies done concerning opinions on accessibility of sexual health

screenings and contraceptives. Several studies were done specifically on access to STD

screenings on college campuses and some looked at the knowledge of students at specific

campuses. Research has found that more effective measures can be implemented to assist

students on college campuses with monitoring their sexual health. There have been no previous

studies done on Texas State University students relating to their knowledge of access to STD

screening and contraceptives.

STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 7

Purpose of Study

Spice PR is aware of the many benefits the SHC has, and we wanted to gauge the awareness the

students at Texas State University had. We aimed to research the awareness of sexual health

services on Texas State University’s campus in specific because it has not been covered before in

the materials we accessed throughout formative research. Participants who completed this survey

were also referred to the SHC website at the end of the survey to expand students’ knowledge of

the services available to them.

Literature Review

College aged women are among the highest numbers of women who seek abortions or

have unintended pregnancies (Sawyer & Thompson, 2003). Emergency contraceptive pills

(ECPs) would lower the need for abortions or unwanted pregnancies. Two associate professors at

the Department of Public and Community Health at the University of Maryland conducted

research on why this was the case and gauged college women’s awareness to ECPs (Sawyer &

Thompson, 2003). A sample was drawn from students at a public university in three kinesiology

classes, and the students were given surveys that included questions regarding sexual activity,

knowledge of ECPs availability and use, and demographics (Sawyer & Thompson, 2003). In a

sum of 693 surveys, the researchers found that 80% of the participants had penis/vagina

intercourse and 53.9% of those participants thought at some point they or their partner could be

pregnant (Sawyer & Thompson, 2003). About 86% of the participants stated they “heard of

ECP” but had little knowledge of it and the results confirmed the average score of knowledge of

ECPs was 40% correct. Additionally, over half of the students surveyed did not know about the

availability of ECPs on campus (Sawyer & Thompson, 2003).

STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 8

Sawyer, Fong, Stankus, and McKellar (1996) conducted a study to gauge how college

campuses distribute ECPs and the attitudes surrounding it. The researchers conducted a follow

up study in 2006 to see the updates in the college health centers regarding ECPs (Sawyer et al.,

2006). The 119 college campuses surveyed were located in the mid-Atlantic region of the US. It

was noted that 48% of the institutions surveyed advertised their services regarding ECPs through

brochures and 26% by flyers. Only 34% of the institutions utilized a website to advertise ECP

distribution. Additionally, they felt that student health services must do more to advertise their

ECP availability. In their 2003 survey of 700 college campuses, the surveyors found “over half”

of the students were not aware that ECPs were available at their own university health center.

The surveyors hope that over time ECPs can be more heavily discussed and become more

normalized (Sawyer et al., 2006).

Normansell, Drennan, and Oakeshott (2016) did research in London on women’s

attitudes toward STI screening and its accessibility. Sexually transmitted disease testing in the

young women demographic was very low, and the researchers wanted to discover why that was

the case. The researchers posed questions such as what women are looking for when seeking

access to STD testing and how much information women know about the process (Normansell et

al., 2016). By surveying 17 random women, Normansell et al. (2016) found that most women

want testing to be easily accessible, well advertised, and remain extremely confidential. Many of

the surveyed women did not know enough information about access to STD screening in their

nearby clinics and those who did, did not know the complete facts about when and where to go

for screening. Many women stated that they want more formal education on sexual health in

general and for the information to be clear and easily accessible, and that screening for young

women who live with their families must be more confidential (Normansell et al., 2016). The
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 9

research showed that young women are looking for more education, better reminders about ways

to have sexual screening, and confidentiality in having testing done (Normansell et al., 2016).

A recent survey done at the University of Texas (UT) stated that students do not receive

enough information regarding sexual health importance and resources (Zaksek, 2019). Zaksek

(2019) noted that 63% of students are sexually active but only half of them use a form of

contraception. UT does not have any mandatory presentation on available healthcare, including

birth control, but students would benefit highly from this information being provided (Zaksek,

2019). Many students do not know that UT offers birth control, and most do not know how to

access it or make an appointment for screenings (Zaksek, 2019). UT provides a website in which

students can learn about how to access birth control and other contraceptives, but it is not widely

announced. Zaksek (2019) suggested that open discussion would help encourage students to

learn more about access to contraceptives and help students become more educated and aware.

A fact sheet created by the Centers for Disease Control and Prevention (CDC) provided

information about the scope, distribution, and trends in STD diagnoses in the United States

(2017). The fact sheet reported on STDs such as chlamydia, gonorrhea, and syphilis. It was

found that young people ages 15–24 years acquire half of all new STDs (Satterwhite et al., 2013)

and that one in four sexually active adolescent females has an STD, such as chlamydia or human

papillomavirus (HPV). Kovacs discussed the CDC’s fact sheet and the connection that the 15-24

age range has with college students. Traditionally, college students fell into this age range, and it

is was noted as vital that colleges are proactive in educating students about health services and

prevention resources (Kovacs, 2016).

Coor et al. (2018) conducted research concerning the differences visible from 2001 to

2014 in reference to access to STI diagnosis and treatment, contraception, STI education,
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 10

condom distribution and availability of health insurance in universities in the United States. The

compared data in question was collected from nationally representative surveys administered by

the CDC (Coor et al., 2018). The purpose of this study was to research the change in sexual

health services on US college campuses from 2001 to 2014, and the conclusion drawn was that

there has been an improvement in sexual health services including an increase in HIV and

gonorrhea testing and contraceptive services, while others declined (Coor et al., 2018). This was

seen in the number of schools offering health plans and STI education, and the advice given was

for schools to conduct regular assessments of this nature to promote sexual health services on

campuses (Coor et al., 2018).

Korn and West (2018) reported on the use of vending machines as a medium to

administer emergency contraception pill such as Plan B on US college campuses. The vending

machine aspect of the ECP was meant to be an extension of already existing sexual health

services that are offered to students on the campuses in question, and served as a convenience

during times when the health offices are closed (Korn & West, 2018). The research referencing

the American College Health Association estimation of 17% of sexually active undergraduates

having used ECPs in the prior year shows that the initiative works to provide students with even

more discretion when accessing a resource that is already being utilized in other ways (Korn &

West, 2018).

McCarthy (2002) conducted research to determine how willing student health centers

were to make ECPs available to students. The study found that, of the 358 centers that were

surveyed, 52.2% offered ECPs and 47.8% did not (McCarthy, 2002). Of the universities that did

not offer ECPs, there were many private institutions and, based on the research, specific
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 11

institutions and their characteristics such as being a private school, determine the availability of

ECPs at their student health centers (McCarthy, 2002).

Grasgreen (2012) discussed opinions on the availability of Plan B or other ECPs.

Grasgreen’s (2012) opinion is that Plan B is not as easily accessible as it should be. A college in

Pennsylvania offered ECPs for $25 in vending machines (Grasgreen, 2012). Grasgreen (2012)

also mentioned that 17% of schools did not respond to wanting to make contraceptives available,

which showed that many schools might not see the pill as something of importance. There is an

opportunity to raise awareness on this subject that can help increase the attention of the

importance of the morning-after pill as awareness of political climate and the current state of

women’s rights in reproductive health is essential to the body of knowledge on this topic such as

our proposed study. Surveys and petitions have been used as research methods on the birth

control debate (Grasgreen, 2012).

Tanriverdi and Ersay (2010) conducted a study on college students in Turkey from the

age range of 16-to-38 years old which measured the result between genders on sexual behavior,

the knowledge of STDs, and the different methods of contraceptives used by students. The study

was conducted through a 41 item questionnaire that was taken by 322 students in a university

school for Health College and Occupational School for health sciences (Tanriverdi & Ersay,

2010). The questionnaire asked students about their demographic characteristics, sexual

behaviors, and whether they know the STDs are and whether they use contraceptive methods

(Tanriverdi & Ersay, 2010). The authors discovered that even though the students knew that

AIDS is a form of STD, there was still strong evidence in determining that the students have

insufficient knowledge about other STDs. The research also showed that condoms were the most

common method of contraception, along with oral contraceptives, and withdrawal. Overall, the
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 12

research demonstrated the lack of knowledge about sexual health, STDs and contraceptive

among the college students in health related fields in Turkey (Tanriverdi & Ersay, 2010).

Research Questions

RQ1: What mediums does Texas State University currently use to promote information about

sexual health services offered at the Student Health Center?

RQ2: How aware are current Texas State students about the sexual health services offered at the

Student Health Center?

RQ3: How could Texas State improve how they promote awareness about their sexual health

services?

Methodology

Spice PR conducted an online survey in which participants were students enrolled in

classes at Texas State University. This online survey method was chosen for the convenience of

data collection. It prevented interview bias and allowed for more privacy so participants could

respond with the least amount of apprehension. The survey was composed using the Qualtrics

survey system, which best formatted our multiple choice, Likert-type, and “check all that apply”

questions. The questions were crafted with the intention of gathering data for our three research

questions. Spice PR distributed the survey using personal contacts, class GroupMe chats, and

organization leaders at Texas State who were able to send it to their members.

Results

A total of 70 survey responses were gathered and analyzed. Female participants made up 78% of

the gender demographic while the remaining 22% were males (Fig. 18). Eighty-four percent of

participants identified as heterosexual, while the remaining participants identified as homosexual

(5.17%), bisexual (6.9%), pansexual (1.72%), or asexual (1.72%) (Fig. 21). Out of all the
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 13

participants, 8% are classified as freshmen, 27% as sophomores, 39% as juniors, and 24% as

seniors. Additionally, 2% of participants classified themselves as a “super senior,” or someone

who has been attending a university for more than 4 years (Fig. 20). The participants’ ages

ranged from 18-25, with the highest percentage of participants being 20 years old (25%) (Fig.

19).

RQ1: What mediums does Texas State University currently use to promote information

about sexual health services offered at the Student Health Center?

Texas State University currently has a multitude of sources to provide information about

sexual health services. Along with information provided on the SHC website, the university’s

most prominent way of promoting sexual health services currently is at New Student Orientation.

Most respondents (24.55%) said that student orientation was how they heard about sexual health

services provided by the SHC. The second most common way that people gained information

was through a friend (17.27%). Only a small percentage of respondents (13.64%) said they got

their information through the website (Fig. 9). Among the other ways of posting information

such as posters, pamphlets, and advertising in the Quad, these were not highly selected as a way

that students got their information regarding sexual health services.

RQ2: How aware are current Texas State students about the sexual health services offered

at the Student Health Center?

The SHC offers over 10 different services regarding sexual health. These services

include: Intrauterine devices (IUDs), birth control implants, birth control pills, birth control

counseling, syphilis testing, chlamydia testing, HIV testing, gonorrhea testing, emergency

contraceptives, herpes testing, HPV testing and condoms. Most respondents were overall

unaware of the extent of sexual health services provided by the SHC. Fifty-eight percent of
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 14

respondents were unaware of the payment plans available at the SHC (Fig 2). More significantly,

68.33% of respondents were not aware of the free condom packet given out upon the first STI

screening (Fig. 3). Of all the services that are provided by the SHC, most respondents (61.14%)

knew that HIV screening was provided and 64.29% of respondents knew that condoms are

available (Fig. 11).

RQ3: How could Texas State improve how they promote awareness about their sexual

health services?

Most respondents recommended either improving social media or posting more on social

media (20%) or by sending out emails specifically about sexual health services (12.8%). Other

suggestions included flyers, hosting more events, and talking in classrooms (Fig. 17).

Overall, participants were surveyed on the services provided by the SHC at Texas State

University, and significant patterns became evident when results were reviewed. When asked if

participants were aware that the SHC has payment plans available, the results showed that

41.67% of the students were aware, while the remaining 58.33% of participants were not (Fig.

2).

When participants were asked if they have been tested for STIs or STDs at the SHC, an

overwhelming majority (83.33%) claimed that they have not been tested, while only 16.67% of

participants have (Fig. 4).

Respondents showed that the majority pays attention to campus advertisements in general

with 68.33% of them responding “yes” when asked if they read flyers posted on bulletins around

campus (Fig. 5).

If students have chosen not to access sexual health services provided by the SHC, they

were asked to give a reason why. The most popular answers were “I prefer an outside physician,”
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 15

(20.97%) and the “other” category (20.97%). When prompted to give a written response to the

answer instead, the most common response was that the respondent has not needed to access

these services (Fig. 10).

The most popular answer concerning comfort levels when accessing contraceptives at the

SHC was neutral (35.59%), while 27.12% claimed that they are comfortable with doing so. Only

6.78% of respondents said that they would feel uncomfortable (Fig. 12).

When tested on knowledge pertaining to which sexual health services are provided by the

SHC, the most commonly known service was the distribution of condoms (61.29%). The second

most popular answer was HIV testing with a 61.14% awareness rate. We calculated these

percentages by looking at the total number of people who selected each option as being known

and dividing it by the total number of respondents. The most unknown service was the

Nexplanon birth control implant with only 12.86% of the participants responding with this

answer (Fig. 11).

A majority of the respondents, 73.33%, reported that they never go to the SHC in regards

to contraceptives (Fig. 15).

Analysis

The results show that, in general, respondents are not very aware of the extent of services

offered at SHC. We asked respondents to check all of the services that they were aware of and

took an average score to gauge how informed they were with a specific measurement. By

analyzing the answers from all respondents, we found that the average score was 53%, which

shows that respondents were only aware of about half of the sexual health services provided by

the SHC. Currently, the knowledge most respondents have about sexual health services is

primarily learned from student orientation. Student orientation is required for all freshmen who
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 16

attend Texas State University where a PowerPoint presentation is given regarding the services

the SHC offers. Students cannot avoid attending the student orientation unless they take an

online course that depicts the same information that was given at the orientation. This shows

there is not much of an effort put forth by students unless information is handed to them. They

do not seek information regarding these services on their own time.

When we asked respondents how they would prefer to get information about sexual

health services, most answered with either social media or email. The SHC currently only has a

Facebook and Twitter account and many suggested that the Twitter account become more lively

and informative. Looking at how respondents currently get their information versus how they

prefer to get information, we can better understand what method would work best to give

students the information that they want or need.

While respondents showed a general middle-ground knowledge of the sexual health

services provided by the SHC, 73.33% of respondents claim that they never go to the SHC in

regards to contraceptives (Fig. 15). This shows that, despite the awareness of the services

available, a majority of participants still do not utilize them.

Limitations

There were a few limitations that arose throughout the research. The first limitation is that this is

an incomplete representation of the Texas State student population as a whole (random

sampling) due to falling under non-random convenience sampling when distributing the survey.

Another limitation was that the sensitivity of the topic could have created false reports from

people despite the survey being conducted online. The method of online survey also limited the

diversity in sexual orientation and gender, with heterosexual being 84.48% and females being
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 17

77.59% of the total survey population. The use of open ended questions led to 34% of people not

giving suggestions as to how the SHC could better promote their services.

Finally, we had a few respondents that did not answer every question, which slightly

skewed the data and resulted in false measurements.

Managerial Implications

Based on the responses by participants and our knowledge of services provided by the SHC,

Spice PR has a few suggestions for the SHC as to how they can better advertise their services to

reach a larger audience.

Firstly, we recommend that the SHC become more active on social media. The research

demonstrated that 20% of students believe that the most effective way to promote the SHC is

through social media engagement. The SHC currently has a Twitter and a Facebook, but we

suggest that they engage more with students and post more statuses or tweets that promote

specific services that would benefit a wide variety of students. Expanding their social media

would help as well, such as creating an Instagram, where they could post graphic advertisements

promoting services such as STD testing, or what free services they have.

Second, Spice PR suggests that the SHC spend less time posting flyers around campus

and devote more time to advertising in the Quad or post large signs in high-traffic locations on

campus. When we surveyed the students about how often they look at flyers and how they gain

information about sexual health services, 68.33% said they read flyers on campus, but only 10%

say they have often seen flyers promoting sexual health services. Spending more time on

effective advertising would be more beneficial to the SHC rather than dedicating resources to

more ineffective advertising.

STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 18

Thirdly, we suggest that the SHC assures all of their contraceptive services are promoted

more equally so that students have a more well-rounded awareness of all services offered. Our

results showed 29 out of the 70 respondents were aware that birth control pills can be provided at

the SHC, but only 9 out of 70 respondents knew that Nexplanon is provided and 14 out of 70

knew that IUDs were provided. This suggestion can increase students’ knowledge over the

awareness of all the birth control options that they have.

Objectives

1. Increase social media engagement on Facebook and Twitter by 50% by January 2020.

2. Increase overall awareness of students regarding sexual health services provided by the

SHC by 25% by January 2020.

3. Increase the promotion of all birth control methods by 50% by January 2020.

Conclusion and Future Studies

Most students responded that they utilize the SHC at least once a year. Unfortunately, the

overall awareness of the sexual health services provided by the SHC was very low. Our study

reflected that most respondents knew only about half of the sexual health services provided.

Students suggested better ways for the services to be promoted and gave insight to which

promotion tactics are not as effective. Spice PR believes that if our managerial implications are

implemented, overall awareness can be raised. As we learned about all of the services that were

provided, we wish for all students to have the information that we do about everything the SHC

has to offer. With the correct promotional tactics, students should be able to fully utilize the SHC

to its full potential.

Future studies of sexual health services at Texas State University should feature random

samplings so that it can applied to the entire population of the university. Having a discussion
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 19

with the SHC would also be beneficial so as to be clear on what the SHC wants students to be

more aware of. A relationship with the staff at the SHC would give an inside view to how the

SHC already works to promote their services and what they believe is working. We also suggest

that future studies incorporate more “other” options so more suggestions can be added where

needed. Spice PR believes that if more studies are conducted and analyzed, the student body will

become more aware of the sexual health services provided by the SHC at Texas State because

the SHC will have more knowledge as to how to best promote the services.
 STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 20

References

Coor, A., Esie, P., Dittus, P. J., Koumans, E. H., Kang, J., & Habel, M. A. (2018). Assessment of sexual

health services at US colleges and universities, 2001 and 2014. Sexual Health.

doi:10.3200/JACH.54.5.249-256

Grasgreen, A. (2012, February 20). The other birth control debate. Retrieved from

http://www.insidehighered.com/news/2012/02/20/student-access-plan-b-varies-college-campuses

Korn, M., & West, M. G. (2018, December 16). To expand access to emergency contraception, some

colleges try vending machines. Retrieved from https://www.wsj.com/ar

ticles/to-expand-access-to-emergency-contraception-some-colleges-try-vending-machines-

11544961601

Kovacs, K. (2016, November 3). Colleges vs. STDs. Retrieved from https://ww

w.insidehighered.com/news/2016/11/03/cdc-finds-sharp-growth-stds-college-age-population

McCarthy, Susan K. “Availability of emergency contraceptive pills at university and college student

health center.” Journal of American College Health, 2002. doi: 10.1080/07448480209596323

Normansell, R., Drennan, V. M., & Oakeshott, P. (2016). Exploring access and attitudes to regular

sexually transmitted infection screening: the views of young, multi-ethnic, inner-city, female

students. Health Expectations, 19(2), 322–330. doi: 10.1111/hex.12354

Satterwhite, C. L., Torrone, E., Meites, E., Dunne, E. F., Mahajan, R., Ocfemia, M. C., . . . Weinstock,

H. (2013, March). Sexually transmitted infections among US women and men: Prevalence and

incidence estimates, 2008. doi: 10.1097/OLQ.0b013e318286bb53.

Sawyer R.G., Fong D., Stankus L.R., & McKellar, L. (1996) Emergency contraceptive pills: a survey of

utilization and experiences at college health centers in the mid-Atlantic United States. Journal of

American College Health, 44:139-144. doi:10.3200/JACH.54.5.249-256.

 STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 21

Sawyer, R. G., & Thompson, E. (2003). Knowledge and attitudes about emergency contraception in

university students. College Student Journal, 37(4), 523–531. doi:10.1089/jwh.2007.0391

Student-Health-Center. (2019, April 09). Texas State Student Health Center. Retrieved from

https://www.healthcenter.txstate.edu/

Tanriverdi, G., & Ersay, A. R. (2010). The effect of gender on sexual behavior, knowledge of sexually

transmitted diseases and contraceptive methods in college students in Turkey. Türkiye Klinikleri

Tp Bilimleri Dergisi, 30(3), 1039–1045. doi: 10.5336/medsci.2008-9898

Zaksek, J. (2019, January 29). UT should give a mandatory presentation on birth control options at

orientation. Retrieved from http://www.dailytexanonline.com/2019/01/29/ut-sh

ould-give-a-mandatory-presentation-on-birth-control-options-at-orientation
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 22

Appendix A

Figure 1
Q1 - Have you ever visited the Student Health Center for any reason?

42%
Yes
No
58%

Figure 2
Q2 - Were you aware that the Student Health Center has payment plans available to pay for
services?

42%
Yes

58% No

Figure 3
Q3 -Were you aware that you will receive a free condom packet at your first STI screening?

37%
Yes
No
63%
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 23

Figure 4
Q4 - Have you ever been tested for an STI or STD at the Student Health Center?

17%

Yes
No

83%

Figure 5
Q5 - Do you read flyers posted on bulletins around campus?

31.67%

Yes
No

68.33%

Figure 6
Q6 - How many times in the last year did you access sexual health services at the Student Health
Center?
50
40
Number of 30
Participants 20
10
0
0 1 2 3 4 5+
Number of Visits
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 24

Figure 7
Q7 - Have you gone to any activities that the Student Health Center has hosted?
6.67%

Yes
No

93.3%

Figure 8
Q8 - Do you follow the Student Health Center on any social media platforms?
11.67%
1.67%

Twitter
Facebook
Neither

86.67%

Figure 9
Q9 - If you have accessed the Student Health Center for any reason, how did you hear about their
services? Check all that apply.

4.55% 9.09%
5.45% Poster

7.27% Social Media

6.36%
Newspaper
2.73%
Student Orientation
Student Health Service Event
Website
17.27% A friend
24.55%
Brochure
Student Health Center Lobby
The Quad Advertising
13.64% 3.64%
Other (please elaborate)
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 25

Figure 10
Q10 - If you choose not to access sexual health services provided by the Student Health Center,
what are some of the reasons why? Check all that apply.

Someone I know had a negative experience 4.84%

Services are too expensive 9.68%
Other (please elaborate) 20.97%
I prefer an outside physician 20.97%
I feel that the staff might judge me 3.23%
I feel embarrassed 8.06%
I do not know how to set an appointment 3.23%
I do not feel comfortable 12.90%
I did not know they had these services 16.13%
0.00% 5.00% 10.00% 15.00% 20.00% 25.00%
Percentage of Participants

Figure11
Q11 - To your knowledge, which services are provided? Check all that apply.

50 43 45
45
40 35
35 29 31 31 30
26 28
30 24
25
20 14
9
Number of 15
10
Participants 5
0
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 26

Figure 12
Q12 - How comfortable are you to accessing contraceptives at the Student Health Center?
7%
Not comfortable
27% 15%
Somewhat
uncomfortable
Neutral

15%
Somewhat
36% comfortable

Figure 13
Q13 - How trustworthy do you consider the Student Health Center overall?
2% 0%
Not trustworthy
27%
Somewhat
untrustworthy
48%
Neutral

Somewhat
23% trustworthy

Figure 14
Q14 - How willing would you be to get tested for an STI or STD at the Student Health Center?
3% 5% Not willing

23% Somewhat
unwilling
49%
Neutral

Somewhat willing
20%
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 27

Figure 15
Q15 - How frequently do you go to the Student Health Center in regard to contraceptives?
0% 3%
12%
Never

12% Rarely
Occasionally
Often

73% Always

Figure 16
Q16 - How often do you see a Texas State promotional flyer about the Health Center?
10% 17%

Never
Rarely
Occasionally
25%
48% Often

Figure 17
Q17 - How do you think the Student Health Center could most effectively promote their
services? (Write your response.)

20% SOCIAL MEDIA

HOSTING EVENTS
34%
EMAILS
ADVERTISING
19% FLYERS
OTHER
4%
4% NO COMMENT
7% 12%
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 28

Figure 18
Q18 - What gender do you identify as?

22%

Female
Male

78%

Figure 19
Q19 - How old are you?
20 18

15 13
Number of 8 9
10
Participants
5 3 2 2 2
0
18 19 20 21 22 23 24 25
Age

Figure 20
Q20 - What is your classification in school?
2% 8%
24% Freshmen
Sophomore
27%
Junior
Senior
Super Senior
39%
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 29

Figure 21
Q21 - What is your sexual orientation?

Asexual 1.72
Pansexual 1.72
Bisexual 6.9
Homosexual 5.17
Heterosexual 84.48

0 20 40 60 80 100
Percentage of Participants

Figure 22
Average Awareness of Services
15

10
Number of
Participants
5

0
0-20% 21-40% 41-60% 61-80% 81-100%
Scores
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 30

Appendix B

Texas State University Sexual Health Services

We are PR Research students doing a research project for class. We are conducting a study about

Texas State students’ awareness of the services provided by the Student Health Center regarding

sexual health. You were selected as a participant because you are currently attending Texas State

University. The purpose of this survey is to help us understand sexual health services on campus.

Procedures

If you agree to participate in this study, you will be answering a series of questions. You do not

need to participate in this survey. If you choose to participate, you may skip any questions you

are not comfortable with answering.

This survey will take approximately 15 minutes.

Confidentiality

We will protect the confidentiality of your answers. The results will be presented in summary

form so no individual can be identified.

Contacts and Questions

The persons responsible for conducting this survey are Quincy Standa (qes4@txstate.edu),

Kaitlyn Watson (kbw47@txstate.edu), Yadira Ortiz (yadira.ortiz@txstate.edu), Lauren Guzman

(lag249@txstate.edu), and Valerie Lara (v_l90@txstate.edu).

Survey Design

On the following pages, you will see a series of questions and statements regarding your

knowledge and opinions of the Student Health Center’s services that you must read and then

respond to.
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 31

There are no right or wrong answers.

Please answer every question.

Thank you for taking time to respond to our survey. When you are ready, please turn to the next

page and begin.

Please read the following questions carefully and circle your answer:

1. Have you ever visited the Student Health Center for any reason? Yes / No

2. Were you aware that the Student Health Center has payment plans available to pay for

services? Yes / No

3. Were you aware that you will receive a free condom packet at your first STI screening?

(Includes: 1 Trojan Condom, 1 LifeStyles Condom, 1 Dental Dam, 1 Flavored Condom,

1 Safer Sex - Proper Condom Usage Card) Yes/ No

4. Have you ever been tested for an STI or STD at the Student Health Center? Yes / No /

Prefer not to answer

5. Do you read flyers posted on bulletins around campus? Yes / No

6. How many times in the last year did you access sexual health services at the Student

Health Center? (answer with a number) _______

7. Have you gone to any activities that the Student Health Center has hosted? Yes / No

8. Do you follow the Student Health Center on any social media platform (Facebook,

Twitter, etc.)? Yes / No

STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 32

For the following questions, please check all that apply.

10. If you have accessed the Student Health Center for any reason, how did you hear about their

services? Check all that apply.

___ Pamphlet ___ Student Orientation ___ Brochure

___ Poster ___ Student Health Service Event ___ Student Health Center Lobby

___ Social Media ___ Website ___ The Quad Advertising

___ Newspaper ___ A friend

Other (Please Elaborate) ____________________________________________________

________________________________________________________________________

11. If you choose not to access sexual health services provided by the Student Health Center,

what are some of the reasons why? Check all that apply.

___ Services are too expensive ___ Someone I know had a negative experience

___ I do not feel comfortable ___ I did not know they had these services

___ I feel embarrassed ___ I feel that the staff might judge me

___ I do not know how to set an appointment ___ I prefer an outside physician

Other (Please Elaborate) ____________________________________________________

_______________________________________________________________________

12. To your knowledge, which services are provided? Check all that apply.

___ Intrauterine Device (IUD) ___ HIV Testing

___ Nexplanon (Birth Control Implant) ___ Emergency Contraceptives

___ Birth Control Pills ___ Herpes Testing

 STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 33

___ Birth Control Counseling ___ HPV Testing

___ Syphilis Testing ___ Gonorrhea Testing

___ Chlamydia Testing ___ Condoms

For the following questions, please circle the corresponding number to your answer.

13. How comfortable are you to accessing contraceptives at the Student Health Center?

Not at all Somewhat uncomfortable Neutral Somewhat comfortable

Comfortable

1 2 3 4 5

14. How trustworthy do you consider the Student Health Center overall?

Not trustworthy Somewhat untrustworthy Neutral Somewhat trustworthy Trustworthy

1 2 3 4 5

15. How willing would you be to get tested for an STI or STD at the Student Health Center?

Not willing Somewhat unwilling Neutral Somewhat willing Willing

1 2 3 4 5

16. How frequently do you go to the Student Health Center in regard to contraceptives?

Never Rarely Occasionally Often Always

1 2 3 4 5
STUDENT SEXUAL HEALTH SERVICES AT TEXAS STATE 34

17. How often do you see a Texas State promotional flyer about the Health Center?

Never Rarely Occasionally Often Always

1 2 3 4 5

18. How do you think the Student Health Center could most effectively promote their services?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Please provide the following details. They are to help us describe the sample as a whole, and

your answers will not be used individually.

19. What gender do you identify as? Female / Male / Intersex/ Genderfluid / Non-binary / Other

(please list) ___________

20. How old are you today? ___________

21. What is your classification in school? Freshman / Sophomore / Junior / Senior / Other

______________________

22. What is your sexual orientation? Heterosexual / Homosexual / Bisexual / Pansexual / Asexual /

Other ___________________

If you would like to make an appointment at the Student Health Center, call 512-245-2161, or visit their
website at https://www.healthcenter.txstate.edu/.