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A College Student's Guide to Sexual Health

This safe sex guide will provide you with resources and knowledge to stay safe and fully enjoy your college experience.

Last Updated: May 16, 2022
College Student’s Guide to Sexual Health

For many, college is a time of burgeoning sexual self-actualization, exploration, and experimentation. A recent report from the National College Health Association found that more than half of college students report having sex in the 12 months preceding the survey.¹ Most students are keenly aware of this going into college, which can add a lot of pressure on students regardless of their experience level. And that pressure can lead to poor judgment and a cascade of unpleasant consequences.

Knowing all you can about collegiate sexual activity, expectations, and best practices to maximize your safety without dampening that pioneering spirit can ensure that your memories are the only things from college that follow you for life.

This guide will give you useful information to keep you safe and let you have experiences that can positively shape your time in college.

Jump to:

Normal sexual activity among college students
STDs on college campuses
Protecting yourself from STDs
How to know if you have an STI
When to get tested for an STI
STD treatment resources
Accessing birth control
Importance of consent
Sexual assault on college campuses
Assistance and reporting resources
Best practices for safe sex in college
References

Normal sexual activity among college students

Questions of normalcy abound in sexual health both on and off college campuses. But for students who may have minimal or no experience with sex, it’s hard to know how your activity compares to the average.

We want to stress that there is no “normal” when it comes to sex and that you shouldn’t compare your experiences to another’s in a way that diminishes either party. That said, there are statistical realities about recurrent behaviors among college students that may give you some comfort if you’re worried that you don’t measure up.

According to a CDC report from 2017, the mean age people are having sex for the first time is a little over 17.² That gives them less than a year’s sexual experience before they reach a college campus.

Here are the most prevalent sexual behaviors among college students:³

  • Solo masturbation: 88.6%
  • Oral sex (received): 79.4%
  • Oral sex (performed): 78.4%
  • Penile-vaginal intercourse: 73.5%
  • Partnered masturbation: 71.1%
  • Anal intercourse (received): 16.8%
  • Anal intercourse: (performed): 25.3%
  • Choking (received): 43.0%
  • Choking (performed): 47.3%
  • Spanking (received): 59.1%
  • Facial slapping (received): 12.1%

The prevalence of choking⁴ may surprise some, but it’s backed up by additional studies that come to similar conclusions.

Alcohol and sex in college

According to the NIH, at least 53% of college students drink alcohol at least once monthly, with 33% binge drinking.⁵ The real numbers are likely higher since these are self-reported survey statistics. So, there’s not much point in proclaiming the dangers of alcohol abuse, however valid those proclamations are. College students are more likely to drink than not.

We encourage you not to engage in sex when intoxicated — especially with new partners. You might neglect to use protection or effectively communicate consent. You might even miss signs of active STDs like genital warts that might send you running in the other direction if you were sober.

None of this is to shame anyone for mistakes made at college under the influence of drugs or alcohol. Frankly, shame is unhealthy and unhelpful in this context.⁶ The above only serves to illustrate undeniable risks.

But if you or a fellow student are among the 20% of college students who meet the criteria for alcohol use disorder, there are some excellent resources for you, including:

STDs on college campuses

One of the biggest risks you take engaging in sex on a college campus is contracting a sexually transmitted disease. In fact, one in four college students has an active STI,⁷ meaning there’s a 25% chance that someone you sleep with in college could potentially transmit something to you. And by age 25, one in two people will have had an STI at some point.

This is despite data that illustrate a slowdown in sexual behaviors among college students — a so-called sexual recession.⁸

The most common STDs on college campuses greatly resemble the most common STDs in the general populace. The big difference is that those aged 15-24 consistently make up the majority of new cases. And with the CDC reporting a yearly uptick in STDs, the concentration of infected students only stands to grow.

Here are the most prevalent STDs on college campuses:⁹

STDs vs. STIs

You’ll often hear the terms STD and STI bandied about somewhat loosely, but the difference is simple. STI stands for sexually transmitted infection, and it applies to anyone who contracts enough viral or bacterial cells from a partner to become infected. The medical community doesn’t consider an STI to be an STD until a patient presents symptoms.¹²

This may seem like splitting hairs, but it serves a medical purpose in maintaining clarity in a diagnosis. For a college student, either term is acceptable, and you want to avoid encounters with both.

Protecting yourself from STDs

There are several ways you can protect yourself from STDs. Each has their own success rate, and it’s ultimately up to you how much of a risk you’re willing to take with your health. But from physical discomfort to mortal peril, there is a wide range of reasons to avoid STIs.

Here are the best ways to protect yourself from infection:

Condoms

We often think of condoms as a reliable protector against pregnancy and STIs. They are highly effective (up to 98%) against pregnancy and STIs like chlamydia, gonorrhea, trichomoniasis, and HIV.¹³ However, condoms don’t cover the entire genital area, so they can fail to stop the skin-to-skin spread of diseases like syphilis, genital warts, and herpes.

Dental dams

Dental dams are probably among the least popular safe sex tools in existence. Unlike condoms, which have been around since the 1600s, dental dams have only been part of the STD prevention landscape since the late 1980s. And one study out of Australia indicates that less than 10% of women ever use them.¹⁴ They are likely more effective against transmission in cases of fellatio than cunnilingus. The one upside is that you can DIY some for cheap that are just as effective: just cut a piece of plastic wrap to an appropriate size.

Latex Underwear

While latex underwear has been around in the BDSM world and elsewhere for some time, the FDA recently approved two styles of latex panties for STI prevention during cunnilingus and analingus. The panties come from a company called Lorals, and they’re available in bikini and shortie styles.

Mutual monogamy

Mutual monogamy is all about trust. If you trust your partner is faithful to you, you have less to worry about in the STD department. That said, you should always get tested at the outset of a new relationship and insist any new partners do, as well. That ensures that you aren’t carrying anything asymptomatically.

Vaccination

There aren’t many STDs against which you can be vaccinated, but HPV is one of them. The HPV vaccine has evolved to include additional dangerous variants in the past few years. So even if you got the vaccine in your youth, you may be eligible for the updated vaccine, as there is no conflict between the two.

Abstinence

This is one of the less realistic strategies for college students, but it’s the most reliable. Still, it isn’t perfect. Even abstinent individuals can contract STIs in some unexpected ways. The Epstein-Barr virus, which often leads to mononucleosis,¹⁵ spreads via saliva. Deep kissing is often a major cause of its transmission.

Testing

Regular testing can help you identify an STD before you spread it to anyone else. This is a bit less about protecting yourself and more about creating a community where we can all minimize the spread of STDs. If you’re worried about being seen at a campus clinic, you should investigate many of the available at-home STD tests on the market.

Suppose you need a little more inspiration to take active steps to protect yourself from STDs. In that case, the CDC maintains a set of relatively gruesome picture cards showing various unpleasant physical symptoms of various STDS. Feel free to look at them if you ever need a boost.

How to know if you have an STI

There are various signs that you may have been infected with an STI. What’s more worrisome is that just about every STD can be asymptomatic for its lifespan. That means you could unknowingly spread a potentially deadly disease or experience late-term symptoms years down the line.

Here’s a look at some common symptoms to watch out for, as well as whether a given infection may be asymptomatic.

  Common symptoms May be asymptomatic
Chlamydia Painful urination, genital discharge
Yes
Gonorrhea Genital discharge, persistent sore throat
Yes
Trichomoniasis Genital itching, burning, or redness
Yes
HPV Genital warts, cervical lesions
Yes
Herpes Genital, oral, or anal sores
Yes
Syphilis Rash, hair loss, muscle aches
Yes
HIV Fever, swollen lymph nodes
Yes

When to get tested for an STI

Testing is one of the essential tools for identifying STIs and limiting their spread. It might seem scary, but the methods used today are a lot less invasive than those used in the past, so there’s little to worry about in terms of the testing experience.

Knowing when to get tested can be confusing, especially if you’re not that active and don’t show any STI symptoms.

  • Get tested immediately if you show signs or experience symptoms of an STI.
  • Get tested at least every 3-6 months if you’re sexually active but not in a monogamous relationship.
  • Get tested at least once per year if you’re sexually active and in a monogamous relationship.
  • Get tested within an appropriate window period if you know you’ve been exposed to a particular STD. Refrain from intercourse until your results come in.
  • Get tested quickly after having unprotected sex. You may want to take more than one test to cover various window periods. Refrain from intercourse until you get your results.

What are window periods?

Not all STIs are detectable within the same amount of time from exposure. A window period is the amount of time between exposure and detectable infection. For example, you could have unprotected sex with someone infected with gonorrhea and want to take a test immediately after finding out they’re infected.

It could take between five days and two weeks for a test to be positive, even if you are infected. That means you should wait two weeks from the exposure to take a test. It also means you’ll have to refrain from sex until those results come back, including sex with the infected partner. You may not have contracted it the first time, and there’s no reason to increase the odds that you will.

Here are the different window periods for common STIs:

  • HPV: 2-3 months
  • Chlamydia: Five days to two weeks
  • Gonorrhea: Five days to two weeks
  • Syphilis: 1-3 months
  • Herpes (HSV-I): 4-6 weeks
  • Herpes(HSV-II): 4-6 weeks
  • Trichomoniasis: 3-7 days
  • HIV: 23-90 weeks

STD treatment resources

College campuses generally take their STD rates seriously and invest heavily in their on-campus health clinics. You can get tested for most STIs and receive treatment through on-campus clinics at most colleges.

Some non-secular colleges and universities may have restrictions regarding sexual health and safety,¹⁶ preferring instead to push abstinence. If you attend such a school and still need help, there are likely local resources that can help. Tools like the National Association of Free and Charitable Clinics’ clinic finder can help you find resources within a reasonable distance.

You should take any potential exposure seriously, even if the infection is bacterial and especially if you’re asymptomatic after exposure. Left untreated, many STDs can result in infertility or worse. Here’s a look at some potential long-term side effects of untreated STDs:

  Curable? Treatment Risk if left untreated
Chlamydia
Yes
Antibiotics Pelvic inflammatory disease, infertility
Gonorrhea
Yes
Antibiotics Infertility
Trichomoniasis
Yes
Antibiotics Infertility
HPV   Vaccination, wart creams Cervical, genital, or oral cancer
Herpes   Prescriptions to limit outbreaks Increased risk of other STDs
Syphilis
Yes
Penicillin and antibiotics Dementia, internal bleeding, death
HIV   Anti-virals AIDS, death

Accessing birth control

Depending on where you go to school, access to birth control may be as simple as walking over to your campus clinic or so complicated that you’re tempted to give up the search. As with STD resources, the best place to start is at your campus clinic. If that fails, Planned Parenthood has local clinics and resources to help you access birth control.

Planned Parenthood also offers advice and resources for obtaining emergency contraception after unprotected sex. Telemedicine has made it exceedingly simple to acquire a prescription for and free delivery of birth control pills. You can also use a helpful clinic finder and appointment tool from Options for Sexual Health.

Some online services will ship birth control to you in discreet packaging, which is especially useful if you live in a contraceptive desert. These companies include Favor (previously Pill Club), Simple Health, and Nurx. Different organizations may also carry other sexual health goods that are hard to come by like emergency contraception (Plan B or Ella), internal condoms, and herpes medication.

There may be nothing more important in a sexual relationship than consent. This is as true off-campus as it is on-campus. There shouldn’t be any gray area here, either. That doesn’t mean that you need to get written permission from each other to have sex, but it does mean that verbal consent is the gold standard.

If you have any reason to suspect your partner isn’t enthusiastically on board with the direction your interaction is taking, you should simply ask. If you’re worried it will ruin the mood, it won’t. If it does, then that’s not someone with whom you want to have a sexual relationship.

Of course, explicit consent becomes even more critical when you consider the rates of drug and alcohol use among college students. According to a National Institutes of Health report from 2019, nearly 55% of survey respondents 18-22 admitted to consuming alcohol within the past month.¹⁷ These are self-reported statistics; the real percentage may be higher.

Whether cold sober, slightly buzzed, or blackout drunk, sexual consent is an absolute must. The problem here is that alcohol commonly reduces inhibitions and impairs judgment.

Here are some signs¹⁸ to look for that might indicate your potential partner is not in a sober enough position to give consent:

  • Slurred speech
  • Trouble walking
  • Poor coordination
  • Heavy eyes
  • Confusion
  • Sweating
  • Vomiting
  • Slow reaction time

There are many more indications that someone may be too intoxicated for consent. There are also instances in which someone is too intoxicated for consent but otherwise seems normal. This is why clear consent is so important. Never assume that your partner is equally enthusiastic, especially when drugs or alcohol are present.

Sexual assault on college campuses

Unfortunately, consent is not something everyone holds dear. There are far more sexual acts performed without consent — or with a crystal clear refusal of consent — than most people would assume. Women on college campuses have three times the risk of sexual assault as women in general. And a shocking 13% of college students experience rape or sexual assault (including assault during periods of incapacitation).¹⁹

It’s not just women who face the threat of sexual violence, either. Male-identifying college students are 78% more likely to endure rape or sexual assault than their peers outside of college.

Here are some other important RAINN (Rape, Abuse, and Incest National Network) statistics to consider:

  • Nearly a quarter of trans, genderqueer, and nonconforming students have been sexually assaulted.
  • Nearly 6% of students experience stalking during their time at college.
  • Only one out of five female survivors have had assistance through a victims services agency.
  • Only about 20% of female survivors file a report of sexual assault with law enforcement.

Assistance and reporting resources

Part of getting survivors the assistance they need — including access to justice — is expanding the knowledge of available resources. If you’ve endured any form of sexual violence, there are various resources at your disposal. Some provide physical and psychological support, while others can help you file charges against assailants within criminal and collegiate justice systems.

RAINN

RAINN’s National Sexual Assault Hotline offers support for survivors of sexual assault anywhere in the nation — on college campuses and beyond.

RAINN’s contact resources include:

RAINN also has a local service provider tool to help you find help centers in your immediate vicinity.

1in6

The name 1in6 is a direct reference to the portion of men who experience sexual assault. The organization offers various resources for men, not least of which involves busting myths and resolving the stigma around male victimhood.

1in6’s resources include:

National Sexual Violence Resource Center

This invaluable resource provides a wide range of information on sexual assault for victims, family members, and more. They also host advocacy and education events around the country.

Some of their most important resources include:

Best practices for safe sex in college

There are many new things to learn when you get to college, not least of all what your classes have to teach you: a new landscape, new friends and neighbors, and new responsibilities for starters. We’ve put together this set of best practices you can follow to make the safe sex side of the equation a bit easier to take in. The list is by no means exhaustive, but it’s a great place to start. Hopefully, it contains some valuable information you didn’t have before

Learn your limits

You’ll try a lot of new things when you get to college, and learning where your personal limits lie is critical. What might you be willing to do drunk that you wouldn’t do sober? If you consume alcohol, how quickly do you become drunk? If you do drugs, how do they affect you? You can put all of this information together to help you realize when you’re about to make a decision that’s not in line with your sober thinking. It can also keep you from overindulging in any substance that could impair your judgment beyond safety.

If you’re having a hard time keeping within your limits, you may want to speak to someone about your alcohol and drug use. The College Alcohol Intervention Matrix has a handful of excellent resources that can help you identify issues and provide you with treatment.

Get tested often

Testing is the best way to ensure that you and your fellow campus-mates are safe. Knowing you have a clean bill of health will also keep you from getting to the point where you’re ready to enjoy the company of a classmate, only for them to ask you about your sexual health status and derail the whole relationship. And since so many potentially deadly STDs can exist inside you asymptomatically, knowing you have an infection could save your life.

Everyone wins when you test regularly.

Talk to your partners

It’s not easy to stop in the middle of foreplay and ask a potential partner if they’ve been tested lately, but that’s no reason not to do it. Talking to your partners before and after sex ensures that you’re always on the same page about sexual health and consent.

Planned Parenthood offers some great advice on talking to your partner about sexual health.

Investigate your campus's resources

Most college campuses has a litany of resources dedicated to safe sex and sexual security. You may learn about these during your orientation, and your college’s website likely has a section devoted to them. If you’re sexually active on your campus or thinking of increasing your sexual activity, you should familiarize yourself with these resources as much as possible.

Use the right condoms, and use them correctly

The condom industry largely takes a one-size-fits-all approach to its products, resulting in unintentional misuse and even embarrassment. Some companies offer custom-sized condoms through online interfaces, which can help if you land in a size between specialty small, standard, and magnum sizes.

And please use your condoms correctly. That doesn’t just mean putting them on correctly, either. It means storing them correctly.

Where not to store your condoms:

  • Back pockets
  • Wallet
  • Car (glovebox, center console, etc.)
  • Fridge or freezer
  • Outdoors

Where to safely store your condoms:

  • Uncluttered drawers (ideally bedside)
  • Empty tin
  • Toiletry or cosmetic bag (without sharp objects in it)
  • Front pocket for no more than a few hours

Use the right lube in for the situation at hand

Lubrication can make an incredibly positive difference in the bedroom, but it can also cause some unintended complications. Certain lubes will fail under specific circumstances, and some can even make sex less safe.

Here are the main types of lubricants and their best uses:

  Ideal for Not ideal for Noteworthy characteristics
Water-based Simple sex acts Water or shower sex Easy to clean up, may require frequent reapplication
Oil-based Water play, masturbation Use with latex condoms Degrades latex
Silicone-based Long sex sessions, water or shower sex Use with silicone-based sex toys Long-lasting, can be a pain to clean up

There are also hybrid lubricants available, many of which combine water-based and silicone-based materials.

If you use toys, keep them clean

For many people expanding their sexual repertoire, sex toys will enter the picture at some point. If you’re new to using sex toys, you may fail to clean them properly. That can result in a handful of unpleasant consequences, including dangerous infections. Fortunately, there are plenty of reputable sex toy cleaners on the market. Invest in one and use it regularly.

References

[1] American College Health Association. (2019). National College Health Assessment. https://www.acha.org/documents/ncha/NCHA-II_SPRING_2019_US_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf

[2] Centers for Disease Control and Prevention. (2015). Key Statistics from the National Survey of Family Growth. Department of Health and Human Services. https://www.cdc.gov/nchs/nsfg/key_statistics/s.htm#sexualactivity

[3] Herbenick, D., Patterson, C., Beckmeyer, J., Gonzalez, Y.R.R., Luetke, M., Guerra-Reyes, L., Eastman-Mueller, H., Valdivia, D.S., Rosenberg, M. (2021, June). Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey. Journal of Sexual Medicine. https://doi.org/10.1016/j.jsxm.2021.03.006. Retrieved May 9, 2022 from: https://www.sciencedirect.com/science/article/abs/pii/S1743609521003106

[4] Herbenick, D., Patterson, C., Fu, T., Gonzalez, Y.R.R., Luetke, M., Guerra-Reyes, L., Eastman-Mueller, H., Valdivia, D.S., Rosenberg, M. (2021, July 9). Prevalence and characteristics of choking/strangulation during sex: Findings from a probability survey of undergraduate students. Journal of American College Health. https://doi.org/10.1080/07448481.2021.1920599. Retrieved May 9, 2022 from https://www.tandfonline.com/doi/abs/10.1080/07448481.2021.1920599

[5] National Institute on Alcohol Abuse and Alcoholism. (2021, October). College Drinking. National Institutes of Health. Department of Health and Human Services. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/college-drinking

[6] Clark, N. (2017, May 10). The Etiology and Phenomenology of Sexual Shame: A Grounded Theory Study. Seattle Pacific University. https://digitalcommons.spu.edu/cgi/viewcontent.cgi?article=1024&context=cpy_etd

[7] Hartford Healthcare. (2021, April 20). 1 in 4 College Students Has an STD: Here Are The Facts. https://healthnewshub.org/campus-care-1-in-4-college-students-has-an-std-here-are-the-facts/

[8] Wooden, A. (2019, February 14) Why are we having less sex today than ever before? The Johns Hopkins News-Letter. https://www.jhunewsletter.com/article/2019/02/why-are-we-having-less-sex-today-than-ever-before

[9] Johnson A., and Jackson, J. (2021, January 10). Sexually Transmitted Infections Among College Students. College of Liberal Arts and Sciences. University of Iowa. https://scivisionpub.com/pdfs/sexually-transmitted-infections-among-college-students-1481.pdf

[10] Wayne State University. (n.d.). HOW COMMON ARE STI’S AMONG COLLEGE STUDENTS? WHAT ARE THE MOST COMMON STI’S IN COLLEGE STUDENTS? https://health.wayne.edu/sp_faq/common-stis-among-college-students-common-stis-college-students/

[11] Shen, J-H., Huang, K-Y.A., Chao-Yu, C., Chen, CJ., Lin, T-Y., Huang, Y-C. (2015, August 7). Seroprevalence of Herpes Simplex Virus Type 1 and 2 in Taiwan and Risk Factor Analysis, 2007. PLoS ONE 10(8): e0134178. https://doi.org/10.1371/journal.pone.0134178

[12] Planned Parenthood. (2022, April 1). STD vs STI — What’s the Difference? https://www.plannedparenthood.org/blog/std-vs-sti-whats-the-difference

[13] Centers for Disease Control and Prevention. (2021). Condom Fact Sheet In Brief. Department of Health and Human Services. https://www.cdc.gov/condomeffectiveness/brief.html

[14] Richters, J., Prestage, G., Schneider, K., Clayton, S. (2010, June). Do women use dental dams? Safer sex practices of lesbians and other women who have sex with women. Sex Health. doi: 10.1071/SH09072. Retrieved May 9, 2022 from pubmed.ncbi.nlm.nih.gov/20465981.

[15] Tosh, P.K. (2020, November 17). Mononucleosis and Epstein-Barr: What’s the connection? https://www.mayoclinic.org/diseases-conditions/mononucleosis/expert-answers/mononucleosis/faq-20058444

[16] Oswalt, S.B., Eastman-Mueller, H.P., Baldwin, A.(2019, September 9). Counseling college students after a positive pregnancy test: Trends in practice. Journal of American College Health. Retrieved May 9, 2022 from https://www.tandfonline.com/doi/abs/10.1080/07448481.2019.1657120

[17] National Institute on Alcohol Abuse and Alcoholism. (2022 March). Alcohol Facts and Statistics. National Institutes of Health. Department of Health and Human Services. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics

[18] Business Queensland. (2019, June 26). Signs that a person is unduly intoxicated. Queensland Government. https://www.business.qld.gov.au/industries/hospitality-tourism-sport/liquor-gaming/liquor/training/rsa/refresher/unduly-intoxicated/signs

[19] Rape, Abuse, and Incest National Network. (n.d.). Campus Sexual Violence: Statistics. https://www.rainn.org/statistics/campus-sexual-violence