Condoms: Does your clinic cover the bases?
A recent survey of 100 public and private colleges found that many facilities may not be making the grade when it comes to providing condom availability and sexual health information.1
About 75% of schools surveyed do not provide free condoms to students, the survey findings indicate.1 The report, released by Church & Dwight, of Princeton, NJ, the manufacturers of Trojan Condoms, and Sperling's Best Places, a Portland, OR research firm, looked at several criteria in ranking schools, including condom advice and availability; contraception advice and availability; HIV & sexually transmitted disease (STD) testing; sexual assault counseling and services; advice column or question and answer feature to address sexual issues or relationships; and counseling services, peer counseling, campus events, and other forms of outreach.
Oregon State University in Corvallis, which ranked in the survey's top five schools, makes condoms available through several venues, says Lora Jasman, MD, the school's director of student health services. "The cost to our health center of our condom distribution is approximately $2,100," she reports. "Many of the condoms we distribute are made available from grants or other funding sources."
Get the word out
Oregon State's Student Health Services (SHS) provides a broad range of services and programs to address condom availability and sexual health education, says Jasman.
During fall term, the university offers freshmen orientation classes where sexual health, in particular safer sex, is one of the most requested presentations during the eight-week course, she states. The presentations are conducted by health educators from SHS' health promotion department.
SHS also works in collaboration with the Benton County Health Department in Corvallis to offer Male Advocates for Responsible Sexuality (MARS), a male involvement program funded by the U.S. Office of Population Affairs. "The mission of the MARS program is to support men in taking a responsible role in promoting equality and cooperation in relationships, pregnancy, and infection prevention, and overcoming stereotypical gender roles," explains Jasman. "This program provides educational outreach as well as one-on-one educational consultations with male college students."
Reaching college-age men
MARS is comprised of two components: educational outreach and clinical services. MARS outreach workers hand out condoms as well as pens, pencils, rub-on tattoos, and wristbands with the program's "Respect Yourself" tagline, to college-age men in a variety of venues, such as bars, restaurants, dining halls, and fraternity meetings. The items promote taking an active role in sexual health and coming in for a MARS clinical educational session. Such sessions include information on correct condom use, the effectiveness of different birth control methods, STD signs and symptoms, the benefits of abstinence, and relationship issues.2
To further answer students' sexual health questions, the university offers the "Answer Spot" (studenthealth.oregonstate.edu/answerspot), an anonymous question-and-answer web site for health-related questions. The SHS web site (student health.oregonstate.edu/index.php) also provides safer sex information through its link to HealthyLife Students' Self-Care Guide, an on-line collection of guidance developed by the American Institute for Preventive Medicine.
Information about sexual health and condom availability also is readily provided to students who visit the SHS ambulatory clinic, states Jasman. Every year, thousands of students schedule individual appointments with clinicians at SHS for the purpose of STD screening, contraceptive services, or other sexual health issues. The clinic participates in the Family Planning Expansion Project ([FPEP), a program that expands Medicaid coverage for family planning services to low-income women and men, she reports. "Most students qualify for this program and can get a host of contraceptive services, including condoms, without cost," Jasman adds.
Getting the message out
Messages about condom availability are delivered through outreach at campus events, guest lectures in academic classes, presentations to student organizations, trainings provided to residence hall assistants and directors, and a variety of leadership training seminars, she says.
Condoms are distributed by a student-staffed office, the FPEP office, and by individual clinicians, notes Jasman. Condoms also are distributed on campus in the Women's Center, cultural centers, and by residence assistants who request to have condoms available. Condoms are available for those males who participate in MARS educational appointments, notes Jasman. During guest lectures on sexual health and during outreach events, condoms are available to students. Condoms are available without cost to students participating in the FPEP program at Student Health Services, she states.
Educate on correct usage
It's one thing to provide condoms, but education on correct condom usage is key, notes Richard Crosby, PhD, associate professor in the Department of Health Behavior in the College of Public Health at the University of Kentucky in Lexington. While many young men may be motivated to use condoms, they may not put that motivation into action unless they understand how to properly use a condom, says Crosby, who has conducted several studies of condom use in college-age men.
Use a "teachable moment" — and a penile model — to demonstrate correct condom use, says Crosby. Use the next two minutes to allow the patient to demonstrate use on the penile model. These three minutes will help to correct any deficit in skill that can preclude a patient's motivation from being translated into action, he states.
1. Trojan Condoms. New survey points to disparity of access to information about sexual health on college campuses nationwide. Press release. Princeton, NJ; Sept. 19, 2006. Accessed at: www.trojancondoms.com/press_articles/a20060919eng.asp.
2. Rink E, Zukoski A, Edmunds L. Working with young men. Northwest Public Health 2006; 23:10-11.
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