With hookup culture and discussions on sex as common themes on college campuses across the nation, it’s important to know: how is reproductive health valued at the University of Michigan?
In 2019, the University Health Services (UHS) discontinued free testing for sexual transmitted Infections (STIs) until students advocated for the need of these free and confidential services, leading to the program being reinstated months later. Since then, STI testing has increased at the University but what has changed? The Daily spoke with students and experts on the current state of STI testing and how reproductive health can continue to improve on campus.
Dr. Susan Ernst, chief of Gynecology Services at UHS, wrote in an email to The Michigan Daily that since September 2021, UHS has tested just under 2,700 students with appointments, and an additional 8,700 through asymptomatic testing, which screens for the most common STIs. Ernst also wrote that UHS has seen a 23% increase in the number of serious cases this year.
“We’re finding increased rates of STI this year compared to last year,” Dr. Ernst wrote. “Specifically we’ve noted an increase in the rate of chlamydia, gonorrhea and mycoplasma infections and in the more serious (infections) for people with a uterus – Pelvic Inflammatory Disease, or PID.”
STI testing at the University has also increased by over 40% since last year, according to Michigan Medicine health professionals. One of the students who tested positive for chlamydia in 2021 shared their experience with The Daily. The student has requested anonymity to preserve the confidentiality of their medical record and will be referred to as Sam for the rest of the story.
Sam told The Daily they tested positive for chlamydia through the asymptomatic testing offered through UHS. They said they did not have any symptoms, but wanted to get tested before seeing a sexual partner over Thanksgiving break. While Sam said they were generally satisfied with the process of getting tested through UHS, they did note that their wait time was longer than expected — in both scheduling their test and receiving guidance after the positive test result.
“When I got back to school — I kind of forgot that I was prescribed that test so I didn’t get it until like a week after I got back from Thanksgiving — and it was positive,” Sam said. “They were pretty slow in calling me. I got my test results and then they called me the next day. Because the doctor gets results the exact same time you do, they hadn’t had time to call me yet.”
Sam also expressed concern with the antibiotics they were prescribed by UHS after their diagnosis. Sam said UHS offered them the option to take an antibiotic that was a one-time dose or two pills a day for seven days of another medication. Sam said they decided to take the one-time dose before returning to their hometown for Thanksgiving Break.
Dr. Marisa Louie, director of children’s emergency services at the CS Mott Children’s Hospital, shared her experience working in the children’s emergency room with The Michigan Daily. Louie said she often sees undergraduate students affected by STIs and that there are several symptoms commonly associated with STIs that bring undergraduates into the emergency room.
“So the kind of symptoms that we see with STIs sometimes are the classic symptoms, whether that’s vaginal discharge or penile discharge, testicular pain or something along those lines,” Louie said.
The two most common forms of STIs come in the form of bacterial and viral infections. The major difference is what kind of pathogen, or disease-causing agent, is causing the illness and the treatment methods. Bacterial STIs include gonorrhea, syphilis and chlamydia while viral STIs include HPV, HIV and herpes.
Louie said chlamydia is the most common STI diagnosed among the student population who comes into the Michigan Medicine Emergency Room, followed by gonorrhea and then syphilis. Louie said the fourth most common STI causing the University community to come into the ER is HIV, but the virus is still fairly rare in the U-M community.
Louie also said UHS does not test for herpes or HPV, but both viral STIs are likely prevalent on campus as well. In 2019, UHS decided to no longer financially cover testing for sexually transmitted infections. After receiving significant community backlash, the University reversed its decision and reinstated its original policy.
Once Sam returned home and saw their primary care doctor, they underwent a second test and received another positive result for chlamydia. Sam said their doctor also mentioned the one-time antibiotic option, but said it was less effective than the week-long prescription.
Even though Louie confirmed for The Daily that the one-dose medication is less effective, Sam said they had not received that information from UHS when they were asked to make a choice. Still, Sam said they recommend UHS’s STI-testing program and plan to get tested monthly.
“I’m definitely going to get monthly tests,” Sam said. “I guess I’m also going to ask them what they’re prescribing me as they do it.”
Besides UHS, U-M students can also get STI-tested through the Spectrum Center. LSA junior Evan Hall, leads HIV/STI testing through the Spectrum Center. In an interview with The Daily, Hall explained the difference between STI-testing offered through the Spectrum Center and the testing offered by UHS.
“We really center on student-led, student-driven testing initiatives,” Hall said. “What makes … Spectrum Center testing unique is that you’re talking to people who are coming from (young adult) perspectives of sexual engagement on campus.”
Hall said conversations pertaining to sexual health can be difficult to have with strangers and doctors. The Spectrum Center aims to be a place in which students of all gender and sexual identities can comfortably enage in conversations about sexual heath, according to Hall.
“Oftentimes, when I engage in these dialogues with individuals, this may be the first time they’ve talked about safer sex practices, outside of relationships or secondary education,” Hall said. “The discussion of safer sex practices with somebody who is from your generation … can make it easier to understand certain lingo or terms. I know a lot of people may use hookup language that may not be readily understood by medical providers who aren’t specifically trained in engaging with the youth.”
No matter where the STI testing occurs, Louie, Ernst and Hall all agree that it’s important to get tested frequently if an indvidual is sexually active. Hall told The Daily testing is not only important for guiding choices related to sexual activity, but is also vital to a healthy lifestyle overall.
“If we know our (STI) status, we can be conscious and aware of the type of behaviors we can engage in,” Hall said. “Sexual health is physical health, mental health, emotional health … Getting HIV/STI tested is the opening of the door for routine healthcare initiatives that people are going to engage with for the rest of their life.”
In addition to getting tested, Louie and Ernst both suggested using protection methods such as condoms and dental dams when engaging in sexual activity.
UHS has a page dedicated to sexual protection measures, including information on how to use condoms. Students can pick up free sexual health supplies outside Wolverine Wellness on the ground floor of UHS.
“Protection is number one,” Dr. Louie said. “Using a condom, using barrier methods if you’re engaging in oral sex, those are those are certainly going to be your best bet.”
Daily Staff Reporter Isabella Kassa can be reached at ikassa@umich.edu.