Far fewer students have sought STI tests since Chico State implemented a fee
Chico State’s Student Health Center saw a huge decrease in the number of students seeking screenings for sexually transmitted infections during the 2009-10 academic year. That drop coincided with a new fee for certain tests, though officials aren’t convinced that cost is the reason for the fewer visits.
Last school year (between July 1, 2009, and June 30, 2010) the health center logged 1,597 visits for chlamydia and gonorrhea screenings. That’s compared to 2,657 the previous academic year—a difference of 1,060 students who were tested for these common STIs.
“It is a big drop,” acknowledged Student Health Services Director Cathy Felix. “Last year was a very unique fall semester. It could be based on a lot of reasons.”
Felix said she thinks the outbreak of H1N1 (swine flu) last fall may have diverted students’ attention from getting tested. She said another possible cause for the drop could have been increased difficulty in getting an appointment due to three practitioners retiring last year.
But then there’s the new fee policy.
Previously, students weren’t charged for any lab tests that cost the center less than $20. That changed about a year ago. Felix said that students are never charged for lab tests that are done in-house (and a variety are done there), but starting last August they have been charged for all tests sent to an outside lab.
It just happens that several common STI screenings require outside testing.
When the health center implemented the lab fees, it notified students through its website by posting a pricing list for the most common lab tests. The list includes STI screenings such as chlamydia and gonorrhea ($10), herpes types I and II ($14 and $13, respectively) and human papilloma virus-typing ($31). Students are assessed by clinicians to avoid unnecessary testing, and it’s the practitioner’s job to tell a student about a fee before a test is conducted, Felix said.
Nearly all out-of-house tests are sent to Quest Diagnostics Inc., a national lab and pathology corporation with locations in Chico. Felix said the health center negotiates low-cost lab fees.
Whatever the reason for the sharp drop in STI screenings, Jillian Ruddell, director of the Associated Students Women’s Center at Chico State, said it’s something to be worried about.
The 2,657 who sought testing two years ago comprised a significant portion of the student body, and the drop in the number of students being tested could pose a risk to the public’s health, Ruddell said.
“It’s dangerous because STIs are probably spreading throughout the community more quickly because people aren’t being checked for them and don’t know if they have them,” she said.
Ruddell may be on to something.
For example, instead of the number of positive chlamydia tests decreasing with the drop in students seeking screening, the number remained about the same (84 positives last year compared with 81 positives during the 2008-09 school year, according to health center stats). This apparent rise in percentages is reflected countywide. The number of positive chlamydia tests in Butte County rose from 601 in 2008 to 729 in 2009, according to provisional stats from the California Department of Public Health.
“It’s absolutely concerning,” Ruddell summed up.
She and her staff regularly promote safe sex by offering free literature and condoms at the center in the basement of the Bell Memorial Union. When men and women come in with STI-related questions, staff refer them to clinics such as Women’s Health Specialists, where the staff is friendly and screenings are free, Ruddell said.
Chico State’s health center also has options for cash-strapped students.
Felix has recently implemented Family PACT, a government program that assists low-income men and women with “family planning, access, care and treatment,” according to the California Department of Public Health’s website. Many students qualify for the program and can sign up for it before their lab test, Felix said.
Felix noted that the health center has seen a number of changes, including a reduction in staff, since she took over 2 1/2 years ago. Most have been related to financial stressors. But one thing that hasn’t changed—for nearly 20 years, she said—is the $120 university fee students pay each semester for access to the health center. To avoid raising that fee, she decided to begin charging students for tests done outside the Chico State lab.
She also noted that the costs of laboratory materials and employee salaries and benefits have gone up.
“We’re depleting our staffing because there aren’t enough budget resources to support it,” Felix said. “But [the drop in testing] could be for a million reasons. The purpose of me tracking stats is to project, strategize and plan ahead. But I don’t hold those stats as consistent.”