Wisconsin State Representative Stephen Nass (R-Whitewater) has taken issue with the state University’s Health Services for its decision to distribute free lip balm, sunscreen, and condoms to students before spring break. As reported in The Badger Herald, Representative Nass’s office uses the ever popular (but unfounded) argument that distributing condoms sends a mixed message giving students license to have sex and accuses the health center of poorly prioritizing expenditures.
As a college health educator and public health professional, I am professionally insulted by these arguments. First, because they are based on the shaky foundation of circular reasoning, and second, because I am tired of hearing the same arguments over and over again. (Seriously, it’s been decades.)
Representative Nass believes that distributing condoms before spring break is sending UW-Madison students a mixed message that ultimately encourages them to have sex while on spring break. I do not believe there is any mixed message at all if one understands the premise behind condom distribution to college students. The most basic tenet of health education is to meet your priority population where they are. Not all college students are sexually active and not all students will have sex on spring break. Distributing condoms before the break isn’t encouraging them to have sex but to think. To think about sex before they do it. To think about safer sex and ways to protect themselves and their partner(s). And, to think about being prepared with protection if they do indeed decide to have sex. (You’ll note that Nass did not worry that the sunscreen and lip balm will encourage students to bathe in the sun.) Sexual activity is not limited to Caribbean destinations in the months of March and April. Students may have sex while away on spring break, back home with their high school boyfriend/girlfriend, on weekends, over the summer, or during finals. This is why many college health services distribute free condoms to students all year long.
The idea that condom distribution is akin to granting permission to have sex (actually Nass said sex with strangers) is an argument that has been used against condom distribution since the AIDS crisis bloomed in the mid-1980s and health educators began advocating condom distribution in schools and, well, just about everywhere. I find this particular argument to be most insulting. It underestimates college students’ ability to make informed decisions about their own sexual behaviors. This is not “if you build it they will come.” The decision to have sex is complex at best and being on the receiving end of a free condom will not send a student straight into a sexual encounter. If college students were that susceptible to the power of suggestion, I would have been out of a job several years ago as all of my objectives and goals would have been accomplished. Just as the sunscreen is not permission to spend unlimited time in the sun or a fire extinguisher in every hallway is not permission to light the dorm room on fire, a free condom is not permission to have sex. That said, if a student decides to have sex on spring break or at any other time, having a condom readily available removes at least one barrier to condom usage.
Which brings us to Nass’ final argument which suggests the University needs “…to prioritize expenditures to better reflect the economic times.” The first thought that comes into my mind is that is exactly what UW-Madison Health Services is doing! The second is to quote Benjamin Franklin’s wise words—an ounce of prevention is worth a pound of cure. The cost of condoms, even in mass distribution into the tens of thousands, is dwarfed by the estimated costs of treating the sexually transmitted infections (STIs) those same condoms could prevent.
The Centers for Disease Control and Prevention states that each year STIs are responsible for $17 billion in health care costs. These costs are generated by the estimated 19 million new STI infections each year. Guess who accounts for 50 percent of those new infections? That’s right—young people ages 15 to 24. Who is the priority population that college health professionals serve? Young people ages 17 to 25.
The CDC also states that condom distribution programs:
“…are efficacious in increasing condom use, increasing condom acquisition or condom carrying, promoting delayed sexual initiation or abstinence among youth, and reducing incident STIs” and have been shown to be “cost-effective and cost saving.”
When implementing interventions for college-age populations, we college health professionals work to maximize limited budgets. Condoms are a cost-effective, scientifically- proven method for preventing the transmission of STIs, including HIV.
Nass’s arguments insult students and the work of college health professionals. We strive to provide students with the tools they need to make the best possible decisions about health and wellness, including sexual health, alcohol and other drugs, nutrition, physical activity, and coping with stress in healthy ways. These tools can include education, prevention, and at times, intervention. Our efforts are based upon scientific research and evidence-informed interventions. To question our use of condom distribution as a preventive measure in the fight against STIs is to question our motives in providing quality health and wellness services to students.