What Works In Schools: Sexual Health Services

CDC’s What Works In Schools Program improves the health and well-being of middle and high school students by:

  • Improving health education,
  • Connecting young people to the health services they need, and
  • Making school environments safer and more supportive.

What are sexual health services?

As young people grow and potentially become sexually active, they require health care services, including information, contraception, and STD and HIV prevention tools (e.g., testing and treatment) to help them prevent HIV, STDs, and unintended pregnancy. These sexual health services (SHS) help ensure that young people remain safe and healthy.

Schools can play a critical role in raising awareness about the importance of SHS, providing SHS in schools and connecting students to these  services in their communities. When schools help connect young people to sexual health services, they are more likely to receive services.

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Examples of SHS include:

  • HIV testing and treatment
  • STD testing and treatment
  • Contraceptive services
  • Health guidance and counseling

Sexual health services can include taking a sexual history or risk assessment; counseling and educating students; as well as testing and treatment.

What are the benefits of increasing access to sexual health services to adolescents?

  • School-based health centers are associated with increased contraceptive use and sexual health care visits, and declines in unintended pregnancy.
  • A referral program that helps school nurses connect students to youth-friendly, community health providers increases students’ use of contraception services, STD testing, and counseling.
  • Other school programs, such as condom availability programs, school-based STD screening events, and sexual health awareness campaigns, can improve students’ beliefs and attitudes about condom use and STD testing, and their use of SHS.

How can schools increase access to sexual health services?

Schools can provide students with access to sexual health services on site or in their community.

  • Schools can offer on-site SHS through their own healthcare infrastructure, such as school-based health centers (SBHCs) and school nurses. Schools may also bring in community partners to provide services, such as periodic school-wide STD screening events or mobile clinics.
  • Schools that cannot provide ongoing SHS on school grounds may link students to youth-friendly providers in the community through referrals. To create a successful referral system, schools need to build strong relationships with community providers, such as health departments, community-based organizations, and primary care providers. The cornerstone of a referral system is a referral guide—a list of local youth-friendly SHS providers along with their locations, phone numbers or websites, and other information.

In addition to linking students to services, schools can help improve staff, parent, and student knowledge, awareness, and comfort with adolescent needs for sexual health information and services. For example:

  • Hosting quarterly or yearly meetings with healthcare providers can give school staff the opportunity to meet providers, learn about the services they offer, and create ways for students to connect with them.
  • Professional development to build staff comfort, capacity, and expertise in adolescent sexual health can improve clinical services in a variety of settings, including SBHCs.
  • Sharing information with parents and families on SHS-related topics—such as recommendations for routine, preventive care and how to create a trusting relationship with a provider—may help support student use of SHS.
  • Marketing campaigns for students can raise their awareness of SHS, encourage positive attitudes about getting services, and improve healthy behaviors.

What does increasing access to sexual health services look like in action?

Here’s how schools can improve student access to sexual health services:

  • Provide annual training and professional development to school and health service staff to support SHS activities.
  • Teach students how to access school-based and community SHS as part of their sexual health education curriculum.
  • Improve student use and quality of SHS provided by school-based health centers.
  • Establish or improve use of a referral system to link sexually active students to community healthcare providers.
  • Raise student awareness of SHS programs by implementing school-wide, student-planned marketing campaigns.
  • Organize field trips for students and key school staff to visit community-based, provider organizations.
  • Conduct school-based HIV and STD screening events.
  • Implement or improve a condom availability program.
  • Distribute SHS-related materials to parents and families.

Key to Success

  • Incorporate information about SHS into your school’s sexual health education curriculum. This leverages your healthcare team’s efforts.
  • Increasing access to and awareness of sexual health services has positive impacts on student health.

You can find more ways to improve student access to SHS in our program guidance.

  • Dittus, P. J., De Rosa, C. J., Jeffries, R. A., Afifi, A. A., Cumberland, W. G., Chung, E. Q., … & Ethier, K. A. (2014). The project connect health systems intervention: linking sexually experienced youth to sexual and reproductive health care. Journal of Adolescent Health, 55(4), 528-534.
  • Dittus, P. J., Harper, C. R., Becasen, J. S., Donatello, R. A., & Ethier, K. A. (2018). Structural intervention with school nurses increases receipt of sexual health care among male high school students. Journal of Adolescent Health, 62(1), 52-58.
  • Ethier, K. A., Dittus, P. J., DeRosa, C. J., Chung, E. Q., Martinez, E., & Kerndt, P. R. (2011). School-based health center access, reproductive health care, and contraceptive use among sexually experienced high school students. Journal of Adolescent Health, 48(6), 562-565.
  • Wang, L. Y., Vernon-Smiley, M., Gapinski, M. A., Desisto, M., Maughan, E., & Sheetz, A. (2014). Cost-benefit study of school nursing services. JAMA pediatrics, 168(7), 642-648.