Letter to the Editor: Access to UHS sexual health and wellness services| Apr 24, 2018
Sexual Health and Wellness Services are a major and valued component of Medical Services at University Health Services, located in the McCosh Health Center. An opinion column published by The Daily Princetonian on April 23, 2018 drew my attention. As the Director of Medical Services, I agree wholeheartedly with two of the primary points, that “the failure to disseminate knowledge about how such services work only heightens fear and apprehension in the student body,” and that there is always room for improving access to services. Therefore, I felt it important to respond by clearly communicating information about our approach to ensuring ready access to health care and a few of the specific services we offer.
Sexual Health and Wellness (SHAW) appointments are designed to provide confidential exams and counseling for the sexual and reproductive health needs of the patients we serve. We strive to be inclusive and non-judgmental in providing information and services. To meet this objective, we engage in frequent staff trainings, case discussions, and offer support for individual professional development.
During SHAW appointments, we do not make assumptions, but instead ask questions about past history and future plans. While this may feel invasive or judgmental to some, answers to these questions are the key to providing the best information for each student. I feel it is important here to convey specific information about some of the many SHAW services available at the McCosh Health Center:
- Emergency contraception (ECP) is available 24/7 during the academic year. This includes Plan B© (or its generic forms currently available at $13.00) and Ella©, a prescription-only emergency contraceptive pill (currently available at $33.00). ParaGard©, a copper intrauterine device, can also be used for ECP; however, it is only available during regular business hours. UHS has all of these options in stock and available for students, as one may be more effective than another depending on each person and circumstance.
- Unlike a pharmacy, we anticipate that some patients who request emergency contraception may have been involved in a non-consensual sexual encounter. Therefore, we ask personal questions that may be perceived as probing and judgmental, although that is not the intent. While we have heard concerns from a few students that asking about consensual encounters feels uncomfortable, we have also heard from many students that the benefits of asking this question far outweigh these concerns.
- Long acting, reversible contraceptives (LARC), including intra-uterine devices and hormonal implants, involve invasive procedures that require informed decision-making and consent. LARC procedures are planned when possible to meet the unique needs of each patient and to minimize physical discomfort. No initial consultation is required; however, we find that most patients choose to take information and consider their options before scheduling a LARC procedure.
- Condoms are available at no cost at UHS, or 24/7 in a vending machine located in the McCosh entryway. Non-latex condoms are also available for anyone with latex sensitivity.
- Maintaining same-day availability for testing for STIs is a priority. Any student with symptoms or knowledge that they may have been exposed can be counseled and seen that day. We have tracking systems that ensure students are notified as soon as possible (including weekends) when a test result is reported as positive. If any student requests results, we will contact them with negative results. If there is any doubt, we encourage students to contact their clinician, whether that is by phone, through the secure MyUHS patient portal, or through email, although we will not send test results through regular email.
- To help ensure that we achieve the highest standards possible, we at UHS take student feedback seriously. To that end, we have processes and procedures in place to take immediate action when a concern is reported. Recently, a group of student leaders, working collaboratively with us, developed a guide to the comprehensive sexual health services available at UHS, which can be found online. We recently expanded our sexual health services based on feedback from students, and will continue to do so.
- Not addressed in this response is current information regarding the effectiveness and other factors that may play into individual decision-making related to contraceptive options. I encourage anyone seeking evidence-based information on contraceptive options to explore the Bedsider website at https://www.bedsider.org/.
UHS is a student health service with a primary mission to enhance learning and student success by advancing the health and well-being of our diverse University community. Our staff is dedicated to serving students, and we continually stretch ourselves in providing high quality and accessible comprehensive services. We appreciate hearing about students’ perceptions of our services, and I am available to discuss this or any concerns.
Jonathan R. Pletcher, MD
Director, Medical Services