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Poster Session II: Health Services

(P191) TRENDS IN SCHOOL-BASED SEXUAL HEALTH SERVICES: NATIONWIDE ESTIMATES, 2020-2022

Wednesday, September 18, 2024
4:15 PM - 5:15 PM EST
Background:
Schools play a critical role in providing school-based sexual health services (SHS) to adolescents, a population at disproportionate risk for STI and HIV infection. Little is known, however, about current availability of SHS in schools or how that availability changes over time in the United States.

Methods:
We used data from the 2020 and 2022 cycles of School Health Profiles, which assessed school health policies and practices in representative samples of secondary schools in 44 states for 2020 and 45 states for 2022. Nationwide prevalence and 95% confidence intervals (CI) were estimated for 18 SHS outcomes. Eight outcomes measure the direct provision of SHS in schools, including HIV and STI testing and treatment, HPV vaccination, and provision of condoms and contraceptives. The remaining 10 outcomes assess referrals for SHS, including referrals for STI and HIV testing and treatment, HPV vaccination, HIV post-exposure prophylaxis (PEP), and pre-exposure prophylaxis (PrEP). We compared 2022 with 2020 estimates using non-overlapping CI.

Results:
The prevalence of HIV testing, STI testing, and HPV vaccination did not change between 2020 and 2022; however, provision of condoms significantly increased from 5.2% to 7.5%. Trends for SHS referrals from 2020 to 2022 were inconsistent. Although there were significant increases in referrals for HIV testing (29.0% to 31.6%), STI testing (30.6% to 33.3%), and STI treatment (30.1% to 32.5%), there were significant declines in referrals for HIV treatment (34.2% to 30.5%), PEP (31.7% to 28.6%), PrEP (31.8% to 28.4%), and HPV vaccination (35.1% to 32.2%).

Conclusion:
The increase in referrals for STI testing and treatment in schools aligns with the uptick in STI incidence among adolescents. The decreases in referrals for HIV prevention and treatment, however, warrant further investigation. The findings underscore a critical need to enhance school-based SHS and ensure continued monitoring.