STD Awareness and Prevention

at Texas State University - San Marcos

Team MIKY:

Maddie Mason

Isabel Escobedo

Katie Silguero

Yessica Zamarron

Spring 2018

MC3360 Section 258

Texas State University

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 TABLE OF CONTENTS
Page

COVER PAGE……………………………………………………………………………….....1

TABLE OF CONTENTS…………………………………………………………………….....2

EXECUTIVE SUMMARY, METHODS, RESULTS………………………………………….3-5

INTRODUCTION……………………………………………………………………………....5

PURPOSE AND BACKGROUND…………………………………………………………..…6

SECONDARY RESEARCH…………...………………………………………………….....7-8

LITERATURE

REVIEW………………………………………………....................................8-11

METHODOLOGY……………………………………………………………………….11-16

RESULTS…………………………………………………………………………………….16-29

ROBERSON AND GREGORCZYK INTERVIEWS………………………………………......30

RYBARSKI AND LOEFFLER INTERVIEWS……………………………………………..….31

DR. PINO INTERVIEW……………………………………………………………………......32

GROSS AND ANONYMOUS INTERVIEWS………………..…………..…....…………..32-35

INFOGRAPHICS…………………………………………………………………………….36-39

CONCLUSION………………………………………………………………………………40-41

BIBLIOGRAPHY…………………………………………………………………………....42-43

SOURCE BREAKDOWN……………………………………………………………………....44

APPENDIX…………………………………………………………………………..………45-57

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EXECUTIVE SUMMARY
Sexual transmitted diseases are a rising health problem among 18-to 24-year old college

students. As researchers, we conducted a systematic review to learn the current awareness and

knowledge of Texas State students. The results of the research allowed Team MIKY to grasp a

better understanding of college students’ knowledge towards STDs.

Methods

The team distributed an online survey through various social media outlets which was

administered for a period of 13 days. Team MIKY also conducted a large amount of interviews

consisting of professionals and a STD-positive interviewee. A content analysis was ​conducted ​on

the Texas State Health Centers’ social media platforms: Facebook and Twitter from October

2017 to the last day of March 2018.

Results

We found that students may not be as educated regarding STDs as they may think. Some

of their information regarding STDs may be outdated as new information and strains are

constantly changing throughout the years. The results found that nearly 57.14% of Texas State

students felt they were moderately knowledgeable abouts STDs, whereas 25% of students stated

that they were very knowledgeable on the subject, and 5.36% of students stated they were

extremely knowledgeable on the subject of STDs.

Results concluded that students knowledge on STDs were acquired 25.58% from high

school, 20.35% acquired their knowledge from friends, 18.02% from sexual education courses,

13.37% from a university, 12.21% from their parents, and 10.47% from other sources. These

results reveal that the after high school, students are not continuing to get educated with facts,

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but are simple relying on their friends for information over sexual health. Only half of the

respondents have seen sexual health promotion ads on Texas State campus revealing that not

enough students are being reached by the Texas State Student Health Center campaigns. This

lead Team MIKY to conclude that with further research and a situation analysis, a detailed media

kit could be developed to fully utilize the campus resources to reach more students. Through the

content analysis performed on the Student Health Center’s Facebook and Twitter pages, our team

found that there is an insufficient amount of posts that contain an STD/STI message within the

social media pages.

We found that most students are using some sort of preventative measure when engaging

in sexual activities, however 43% of the respondents stated they used birth control as their

preventative measure. Birth control does not protect against STDs so this implies that students

are not well informed over the preventive measure that protects against STDs. This is alarming

as most may believe they are protecting themselves from contracting a STD, but in reality they

are leaving them self to be fully exposed.

Nearly three-fourth of respondents felt students did not get tested as much as they should.

Therefore students are well aware that they should get tested yearly, when they have a new

partner or engage in risky behavior. However, Team MIKY found that only 60.71% of students

get tested at all. This is a alarming percentage of people at risk of contracting a disease. We

found that the top three reason why people do not get tested is because they feel that monogamy

is a reason to not get tested as they are only involved with one partner. We found that most

students are talking about STDs with their partner so the awareness is there to some extent. Other

reasonings why young college students are not getting tested are the negative stigma and cost.

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We should shine the light on the importance of STD awareness and remove the negative stigma

to allow people to feel comfortable when talking about it. This will create a safe haven to talk

and ask questions. Texas State has many resources that are available to students, many which

offer student discounts for those that feel cost is an issue.

In conclusion Team MIKY found that there is a lack of knowledge regarding STDs

among the The Texas State Campus. Students may know they are engaging in risky behavior, but

do not consider their sexual health when doing so. We must educate our college students and

promote the resources available to them on campus. Let’s not be afraid to talk about sex!

INTRODUCTION

This study will be conducted by students at Texas State University - San Marcos for the

group project of class MC3360, Section 258: Public Relations Research. The group (Team

MIKY) consist of Maddie Mason, Isabel Escobedo, Katie Silguero, and Yessica Zamarron.

The objective of the research is to measure the awareness levels of sexually transmitted

diseases among students on campus at Texas State University - San Marcos. This study will

include prior research identified in regards to sexual health and STD prevention on campus. It is

important to examine studies done to test student’s knowledge about STDs. Using these sources

the team will be able to conduct analysis of the students on Texas State's campus.

RQ1: What is the knowledge surrounding STDs at Texas State University?

RQ2: How do students know about preventative health measures on campus? (Student

Health Center, other resources, ect.)

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 RQ3: How likely are students to participate in preventative measures? (ex. Screening,

condoms, etc.)

PURPOSE

The purpose of the study is to bring awareness to Texas State and encourage frequent

STD screenings among students. This study further examines a variety of studies conducted by

researchers, aiming to assess the awareness and effectiveness of STD screening among young

adults. The ultimate objective is to decrease the overall STD cases among students at Texas State

University. In order for Team MIKY to achieve this objective, the research group conducted

quantitative research by developing survey questions focusing on the general knowledge of

STDs and preventative measures.

BACKGROUND

Sexual transmitted diseases are defined as infections – caused by bacteria, parasites,

yeast, or viruses – that pass from one person to another through direct sexual contact. According

to the Center for Disease Control and Prevention (CDC) a person with an STD is more likely to

get HIV when continuing to participate in activities such as having: anal, vaginal, and oral sex

without protection; having multiple or anonymous partners; or by having sex while under the

influence. These activities will result in a higher risk of contracting a disease. Therefore, the only

true way to avoid STDs is abstinence; however, the CDC suggest the following: choose less

risky behaviors; use condoms; reduce number of partners; limit alcohol and drug use; do not be

afraid to ask your health provider questions (​HIV/AIDS & STDs, 2017)​.

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SECONDARY RESEARCH

For young adults, their college years are a time where they are more prone to engage in

high-risk sexual behaviors, which will increase their risk for sexually transmitted diseases. The

three most common types of STDs are Herpes, HPV and Chlamydia. Texas ranked third among

the United States for having the highest number of diagnoses in sexually transmitted diseases.

(Koumans, 2005) One out of five people with HIV have not been diagnosed. Americans ages

12-to-24 make up 27% of the sexually active population. One out of four people will get an STD

in their lifetime. According to the Centers for Disease Control and Prevention (CDC), young

adults ranging from 15-24, account for nearly 50% of the 20 million new cases of sexually

transmitted diseases in the United States (Goldsberry, 2017). Everyday 12,000 are infected, yet

only 3% of college students reported being treated for at least one sexually transmitted disease in

the past year (Griner, 2017). When students from a Mid-Atlantic university were asked to rate

their sexual knowledge, 1% stated their sexual knowledge as being very poor, 29.9% of students

considered their sexual knowledge as average, 51.2% as good, and 16.4% as excellent (Martin,

2013). In fact, most students assume that sex education would come from parents. However, the

source of students’ sexual knowledge is obtained 39.8% from friends, 36.3% from experience,

23.9% from school education, 14.4% from parents, and 6% from other sources, such as T.V.,

movies, books, or magazines (Martin, 2013). Therefore, misconceptions among college students

regarding STDs have been identified to influence sexual behavior and include: being unaware

that STDs can be transmitted through oral sex; believing that STDs can only be transmitted when

symptoms are present; and believing only those who have multiple partners should be concerned

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about contracting STDs (Goldsberry, 2016). For this reason, knowledge of sexual behavior is

essential in order to understand the transmission of sexually transmitted diseases.

In today’s society, STDs are perceived as less of a threat, due to effective treatments. As

a result, there are many practices that society can participate in to keep the disease under control,

the most common method being contraception in the form of birth control or male condoms.

Additionally, medical practitioners suggest getting tested for sexually transmitted diseases at

least once a year to educate one’s self and their partners.

LITERATURE REVIEW

Statistics

The college experience is a time when newfound freedom comes with an increase in a

variety of risks factors, especially regarding sexual health. With 55% of males and females

reporting having had sex by the age of 18 (Amba, Martinez 2017); college aged students stand at

a high risk to contracting a sexually transmitted disease. In 2016; 61,780 cases of Chlamydia,

Gonorrhea and Syphilis were reported from people between the ages of 20-to 24 years old in

Texas alone (HHS 2016). The risk of contracting an STD is increased through unprotected sex,

engaging in sexual activity with multiple partners, as well as participating in risky behaviors

such as drinking and drug use.

Knowledge and Prevention

Aside from the inherent risk college students have of contracting an STD, there are

preventative measures that one can practice. As stated above, the CDC recommends practices

including: abstinence, reducing your number of sexual partners, and the use of condoms.

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However, even with alternative prevention methods known, a majority of Texas schools continue

to teach abstinence only in education (Wiley, Wilson 2009). The knowledge of STDs and STD

prevention plays a key role into the sexual health of college aged students. In a study conducted

to test the knowledge of condom usage among college students in Texas, 67% of students failed

to apply a condom correctly during a demonstration (Clifton, etc.).

There are many forms of quantitative research that has been done regarding STD cases,

specifically among the 15-to 24-year-old age group. Along with the statistical data, researchers

have conducted qualitative research to further understand the human behavior. One of the studies

conducted among college students attending a university in southwest Georgia used an evidence

approach to evaluate if the use of video education helped increase the knowledge of STDs

among students. The study found that using an educational video did indeed help bring

awareness of the social and health problems that accompany the increase of STD. Although the

benefits of the implementation of the study far outweigh the cost (Allen, 2017), one of the major

limitations of the study was the amount of money spent to conduct the study.

Another reason STD rates are so high for young adults is because it is not a topic that is

often discussed, due to its negative stigma. According to a study conducted by New Pittsburgh

Courier on STD prevention counseling, health education needs to not only be taught in schools

and homes, but also between doctors and their young adult patients. The study concluded that

teens were not given enough information and counseling in order to understand the consequences

of STDs. In the article from the Michigan Chronicle, “New data shows heavy impact of

Chlamydia in U.S. men and women, Dr. John Douglas states that STDs often go unnoticed due

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to the lack of symptoms. This is an example of what knowledge needs to be instilled in sexually

active teens.”

Due to the lack of knowledge surrounding STDs, the importance of college health

services plays a vital role to the sexual health of students. Universities often provide some form

of health resources for their students, but the extent of these resources vary from campus to

campus. Student health centers not only play a role in the treatment of STDs, but as well as the

prevention methods that can be taken. In a study assessing STD education among greek life, it

was suggested that college health centers educate their students during every visit (Goldsberry,

2016). Although student health centers exist, the extent to which they try to educate students on

STDs have not been thoroughly researched. One study conducted by the American Journal of

College Health aimed to capture the involvement of student health centers in the the prevention

and treatment of STDs on campus. The data revealed that out of the schools sampled, 85% of

campuses used at least one form of written media, and less than one-third of the schools provided

STD information at student orientation (ACHA). Another study conducted by the Population

Health and Research Institute at St George’s University of London aimed to explore the

approaches and attitudes towards STDs screening, focusing on young female college students.

The study administered semi-structured interviews with 17 women ranging from 16-to 25-years

of age. The study found that the women wanted convenient and regular testing, but did not

believe the testing would be done in complete confidentiality. The study concluded that

providing the women with the certainty of complete confidentiality and trust in the health

provider will encourage women to participate in screenings. One limitation that the study faced

was that all participants were young women attending a inner-city college, therefore not proving

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a reliable sample (​Normansell, 2016​). The number of Americans affected by STDs has continued

to rise throughout the years, reaching an all-time high in reported cases in 2015. Young adults

ranging 15-to 24-year-old account for half of the annual cases. To help encourage frequent

screenings it is important for college students to know the screening and practices student health

centers offer. A research study was conducted by the department of Kinesiology, Health, and

Nutrition at the University of Texas at San Antonio in which they examined what student health

centers practice in regards to Chlamydia and Gonorrhea screening and treatment. The study

analyzed the American College Health Association (ACHA) Annual Pap and STI Survey

between 2010-2014 with a estimated 170 institution participation.The survey helped gather

information about the testing practices and results at college health centers in the United States.

The results showed that the Chlamydia screening of women under 25 years old were well

practiced, but almost one-third of health centers did not report screening practices for men with

the same sex partner to be reliable. Overall most student health centers follow current best

practices. However the screening of men to men partners need to improve their practice so the

can serve a more diverse college student population (Oswalt, 2017).

METHODOLOGY

Primary research will be gathered by using both qualitative and quantitative methods.

The objective of our research is to gather information that will provide us with insight that will

be beneficial to our research questions:

RQ1: What is the knowledge surrounding STDs at Texas State University?

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 RQ2: How do students know about preventative health measures on campus? (Student

Health center & resources)

RQ3: How likely are students to participate in preventative measures? (ex. Screening,

condoms, etc)

QUANTITATIVE METHOD

To conduct our quantitative research, the researchers will be conducting an online survey

hosted by Qualtrix1, once we obtain the instructor’s approval; which was secured on March 29,

2018. The survey will be distributed through social media by all four team members in effort to

receive feedback from a young demographic, primarily focusing on Texas State students of ages

18 to 25 including all genders, and several ethnicities: White, Hispanic, African-American and

all other. Because social media is very popular among college students, we decided the most

effective way to reach participants would be through our social media platforms. We aim to

collect a survey sample of at least 50 Texas State students in order to collect a accurate sample of

the student body.

The survey will help to better assess the perception and knowledge of STDs throughout

the student body. The survey consists of a combination of likert scale, purchase intent scales,

open-ended questions and multiple-choice questions. The questions will be well written and will

avoid biasing the respondents. All written questions take into consideration the respondents

ability and willingness to answer the question. We established a questionnaire flow and lay out

that allow the reader to go through the survey quickly and efficiently, allowing them to get a

clear understanding on what the questions asked. The survey begins with the screener questions

1
See ​Survey

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that allows us to identify our targeted respondents. The first questions after the screener

questions are our warm-up questions which allow us to ease the respondent into the survey by

asking simple questions. The second third of the questions are aimed to relate to the respondents

knowledge and require a little more effort. The last third of the questions require the respondent

to answer more personal questions regarding their personal sex life. The survey will use a skip

pattern to direct the respondent to different question in the survey based on their answer. Below

we have provided a chart providing the flowchart and lay out of the survey.

Location Type of Q’s Examples Description

Screener Qualifying ● What is your age? ● Ordinal Scale

● What is your major? ● Open-ended

1st few Q’s Warm-ups ● On a scale of 1-10, ● 5-Point Likert-type

How much would scale
you say is your
general knowledge
over STDs is?

● Where have you

learned about STDs
and prevention ● Nominal Scale; All that
options? apply.

⅓ of Q’s Transition ● Have you seen ● Ordinal Scale (skip

secual health pattern if yes)
resources ○ Open-ended
promotions/awarene
ss on campus?
○ (Answer yes,
skip to: if so,
where?)

● Do you feel like ● 5-Point Likert Scale

Texas State

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 students, including
yourself get tested
frequently enough?

⅔ of Q’s Difficult & ● How likely are you ● 7-Point Likert Scale
Complicated to ask your partner
about STDs/ Their
prior screening?

● How many times

have you been ● Ordinal Scale
screened for STDs
in the past year?

● What prevents you ● Nominal Scale; All that

from getting tested apply.
for STDs? ○ Skip pattern if
○ (Skip if other is selected;
other is Open-ended
selected,
Explain
other? )

Last third of Classifying & ● What gender do you ● Ordinal Scale

Q’s demographic identify with the
most?
● What race/ethnicity ● Nominal Scale; All that
do you identify with apply.
the most?
● What is your ● Ordinal Scale
relationship status?

We are aware that there are some disadvantages that come with conducting an online

survey such as the concern with the lack of confidentiality that comes with using the internet.

Another disadvantage that comes with internet surveys is the low response rates as online

surveys become more popular. However, the advantages of using an online survey tends to

outweigh the disadvantages, as the online method seems to be a great fit for the type of data we

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are collecting and the population sample we are trying to reach. Internet surveys allow

questionnaires to be sent and returned quickly. The data is also directly inputted into statistical

data collection system where it is easily stored and accessible for data analysis.

QUALITATIVE METHODS

We will gather qualitative research by conducting in-depth interviews. The interviews

will consist of professionals in the medical field with knowledge on STD prevention and

awareness, as well as other professionals on campus including professors and faculty.

The interview questions will be carefully written in a way that will allow us to gather

in-depth information regarding our study. Conducting in-depth interviews will provide us with

rich details and the ability to understand the perception of the individual being interview and not

only the problem being researched. Another advantage of in-depth interviews is the freedom and

control that the interviewer has regarding the questions. However, conducting an in-depth

interview can be quite costly and require time commitment. The method cannot be used for a

generalization of a large sample.

We will also be performing a content analysis on the Texas State Health Centers social

media platforms. The content analysis will be performed by looking at the Student Health

Center’s Facebook page, ​https://www.facebook.com/txstatehealthcenter​, as well as their Twitter

profile, ​https://twitter.com/TXSTHealthCentr​. The analysis will evaluate the number of posts

that contain an STD or STI message over the span of October 2​nd​ 2017 to March 31​st ​2018. This

information will be useful in further evaluating the health center's role in the education of

students on campus.

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INTERVIEW OVERVIEWS2

In order to further understand the knowledge and awareness of sexually transmitted

diseases on the Texas State campus, our research group chose to conduct qualitative research

with the following interviewees:

● Q’Anteria Roberson, a Marketing and Promotions Coordinator with the Texas

State Student Health Center

● Katie Gregorczyk, a Registered Nurse working with the Texas State Student

Health Center.

● Emily Rybarski, an English professor on Texas State campus

● Maddie Loeffler, the Vice President of the​ Not On My Campus

● Dr. Nathan Pino from the Sociology department at Texas State University.

● Judy Gros, head nurse practitioner at the Community Action Inc. of Central Texas

of San Marcos

● STD positive anonymous interviewee

RESULTS

SURVEY

Quantitative research was conducted through an online survey hosted by Qualtrics. The

survey used nonprobability sampling as we did not have access to every student at Texas State

and relied solely on volunteers to complete our survey. The survey was first administered on

April 3, 2018 and remained open until April 16, 2018. Since our research group did not have

2
See ​Appendix

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access to the entire population of Texas State students, we chose a clustered sampling strategy.

Our participant recruiting strategy was to reach out to every Texas State student through various

platforms as in: Facebook, Group Me, text messaging, etc.; each team member posting on their

own personal accounts.

The results and summary below are based on the responses of 57 anonymous

respondents.

The demographic sample characteristics of our respondents consisted of mostly females,

making up 77.19% of our sample, followed by 21.05% male, and 1.75% identifying as other.

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The age groups 18-to 20-years and 21-to 24-years of age accounted for nearly 87.72% of the

sample, with the other age groups 25-to 29-years of age, and over 30 years making up the

remaining percentage.

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The respondents consisted of five different ethnicities: Caucasians, African-American, Hispanic,

Asian, and other. 52.38% of the respondents identified as Caucasian, followed by 36.51%

Hispanic, 4.76% African-American, 4.76 % Asian, and 1.59% identified as other.

Nearly 94.86% of our respondent reported to be single or in a relationship, the rest of the

respondents identified as being married or in a complicated relationship.

The findings of our survey introduced our research group to information that was needed

in order to further analyze and understand STD awareness and prevention among Texas State

students.

RQ1: What is the knowledge surrounding STDs at Texas State University?

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 The survey found that a majority of students feel as if they have a moderate amount of

knowledge regarding STDs. Only 5.36% felt like they were extremely knowledgeable and no

respondent felt as if they were not knowledgeable at all.

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25.58% respondents were educated about STDs and prevention options from their high school,

followed by 20.35% in sex-ed classes, and 18.02% from friends. The results show that many

students have not acquired new information on STDs or are up to date with the new development

and preventive measurements available. Nurse practitioner, Judy Gross believes this is a

contributing factor to the lack of awareness as young adults believe, it’s a quick fix; as simple as

getting a shot or a pill to be cured.

RQ2: How do students know about preventative health measures on campus?

As stated above, students that participated in our survey answered that they acquired STD

knowledge from high school. However, it is interesting to note that during our initial research we

found that sexual education in Texas high schools are not comprehensive, with most schools

teaching only abstinence. Only 13% of respondents reported that the university they attended has

helped them learn about preventative options. In addition, only around half of survey

respondents report having seen sexual health promotions on campus from the Texas State

Student Health Center. Due to these results, our research team can conclude that students at

Texas State are not fully informed about the available health measures on campus, and find that

the Student Health Center is not reaching its audience appropriately in regards to STD

awareness.

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 The Student Health Center previously ran a campaign entitled, ​“It’s Worth Knowing.”

Respondents to our survey answered that they have not previously seen the campaign posted in

areas around campus; for this reason, roughly half of the respondents reported not being aware of

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the campaign at all.

Our research team decided to further study the role that the Student Health Center plays

in the sexual education of Texas State students. As additional qualitative research, our team

chose to conduct a content analysis on the Health Center’s social media pages. The Student

Health Center has active pages on both Twitter, ​https://twitter.com/TXSTHealthCentr​, and

Facebook, ​https://www.facebook.com/txstatehealthcenter/​. Our content analysis studied posts

from October 2, 2017 through March 31, 2018; and during this time frame, researchers recorded

the amount of posts/ tweets that contained a message regarding STDs or STIs on each social

media platform. The results came back lower than expected, with 10.88% of tweets containing a

message, and only 5.6% of the Facebook posts containing a message in regards to sexually

transmitted diseases. During the time frame, the Health Center posted a total of 106 posts on

Facebook and only six of them contained an STD message. Additionally, the Health Center had a

total of 147 tweets with 16 of them containing a message. This data was surprising due to the

fact that the Student Health Center serves as a source of information for a lot of health issues,

including STD screening. Aside from advisories on campus, our research team believes that it

would be beneficial for the Student Health Center to reconsider their social media plan and to

integrate more posts regarding the sexual health of students.

RQ3: How likely are students to participate in preventative measures?

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 Although neither method prevents STDs, almost 30% of students answered that they use

condoms; whereas 43% of students answered that they use birth control in order to practice safe

sex against sexually transmitted diseases. We can conclude that based off the survey a good

number of students are misinformed on preventative methods that are available for STD

prevention. It is interesting to see a majority of students report that they have a moderate amount

of knowledge regarding STDs yet report birth control being their preventive measure of choice.

There seems to be a disconnect between what students report knowing, and their actually

knowledge of the presence of STDs on campus.

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 Our research team found that 37.50% of students get tested at least one to two times a

year, followed by 60.71% of students who do not get tested at all. When researchers asked what

prevented students from getting tested 22.73% respondents stated it was due to the negative

stigma surrounding the subject, 25.76% respondents selected cost, 19.70% selected that they

were restricted to resources, and 31.82% selected other. Those who selected other were asked to

list their preventive measures; which included a variety of reasons, from being in a relationship

to not being sexual active.

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 Additionally, 41% of our sample answered that they are extremely likely to ask their

partner about STD screening and their sexual history.

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 A large amount of respondents report that they feel that students do not get tested as

much as they should. We can draw the conclusion that students do not place STD screening high

on their list of preventative measures. Although students are engaging in condom use and

abstinence, there is still a lack of regular STD screening. This can stem from inadequate

knowledge about STDs and how they are contracted, or a lack of concern from students.

The finding shows that only half of the respondents do not get tested due to cost or lack

of resources. The respondents that chose others were ask to explain their answer with a open

response. Most responded that being in a relationship is a reason not to get tested, we found that

is not always they case when we interviewed our anonymous interviewee. We must hold

ourselves and our partner more accountable for our sexual health. It’s often viewed as having a

trust issue with your partner, but it not about trust and being accused of cheating, just simply

wanted to have accurate results. Another finding that was mention in our interview with Judy

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Gross, nurse practitioner of community clinics-San Marcos is that a lot of young adult have the

mindset of being invincible. When one has this mindset often believe “this won’t happen to me.”

Our result show that indeed some respondents gave this mind as some responded “I don’t feel

like I need too” and “ I don’t have time.” This type of responses emphasize the fact the young

adults do not view their sexual health as a priority. However, a further evaluation and a more

in-depth responded would allows to know more about the reason behind the mindset which

shows that this survey has limitation and in the future a focus group should be conducted to

further analyze the true psychological reason behind the lack of health awareness.

Included in our survey was a question regarding the major of the respondents. Our survey

respondents consisted of a majority of Mass Communication students due to our team

administering the survey to our fellow classmates. The other two top majors were education and

business.

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 We also gathered results by conducting in-depth interviews. The interviews consisted of

professionals in the medical field with knowledge on STD prevention and awareness, as well as

other professionals on campus including professors and faculty. Below is a brief summary and

finding of the interviews.

ROBERSON’S & GREGORCZYK’S INTERVIEWS

Q’Anteria Roberson, a Marketing and Promotions Coordinator with the Texas State

Student Health Center; as well as Katie Gregorczyk, a Registered Nurse working with the Texas

State Student Health Center. The interviews were conducted mid-day on March 23​rd​, at the

Student Health Center, in each of our interviewees’ offices.

During the interviews the researchers asked each participant a series of questions that

pertained to their area of expertise. The respondents were encouraged to speak freely and in great

detail on the subject matter. With this in mind, researchers chose to ask Roberson questions that

applied to the marketing and promotion aspect of sexually transmitted diseases on the Texas

State campus. Furthermore, researchers chose to ask Gregorczyk questions that applied to the

knowledge and awareness of sexually transmitted diseases of patients that frequent the Texas

State Student Health Center. Since both our interviewees are employed by the Texas State

Student Health Center, they are working for the same mission of their organization: “To support

the academic and personal success of all Texas State students by providing high-quality,

accessible and inclusive health and wellness services.” The interviewees also work towards the

same vision, which is to “be recognized in promoting a healthy campus and lifelong health and

well-being.”

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 Provided that, the main purpose of the interviews were to further understand the

knowledge that students at Texas State University have on sexually transmitted diseases, as well

as to identify what campaigns are being used to bring awareness to the subject. Therefore, the

main theme and focus of both interviews was sexually transmitted diseases, specifically on the

Texas State campus.

RYBARSKI & LOEFFLER INTERVIEWS

The interview was conducted with Emily Rybarski, an English professor on Texas State

campus. The professor was knowledgeable on the topic and had insight on her student’s level of

awareness on campus. Professor Emily Rybarski said, “From what my students write about

they’re pretty vocal and I can tell they are up to date and aware of serious things such as STDs. I

feel like they all get it as 19 year olds.”

The next interview was conducted with Maddie Loeffler, the Vice President of the Not on

my Campus organization here at Texas State. Not on my campus had a successful campaign to

spread awareness about sexual assault so when asked about how to make a successful campaign,

she responded, “College students use their phone the most so I feel like a majority of them are up

to date with social media.” She also suggested that ​Healthy Cats​ could take measures to fix it. “I

think organizations like Healthy Cats should do more STD education around campus or figure

out a way to make the topic more known and talked about,” Loeffler said.

Overall, from both interviews, the main themes that emerged were that leaders around

campus believe that not enough STD awareness campaigns take place. I found out that it is not a

topic among professors or something that they necessarily think about. For the organization Not

on my Campus, that is focused on raising awareness on sexual assault, they do not talk about

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STDs among them either. Not on my campus did mention that they think the two topics, sexual

assault and STDs do correlate. With that being said, I think both parties are aware that it is a

problem on college campuses but never thought to take actions to fix it or spread awareness. I

learned that leaders on campus don’t see campaigns along with regular students so something

needs to be done to promote and spread awareness.

DR. PINO INTERVIEW

An interview was conducted with Dr. Nathan Pino from the Sociology department

at Texas State University. The interview was conducted on March 27th in the UAC building on

campus. Throughout the interview Dr. Pino provided further insight into the attitudes of college

students and the risky behaviors that they engage in. Having studied the behaviors of college

aged students, Dr. Pino noted that both drinking and hook-up culture contribute to the lack of

preventative measures being taken by students. He also brought attention to the fact that there is

a pressure on women to become sexually active once they get to college. Another important topic

discussed during the interview was the sexual education that students receive prior to college. Dr.

Pino noted that the initial education in Texas high schools is not comprehensive. The lack of

education accompanied with pressure for women to have sex creates a problem among college

students to engage in risky sexual behaviors.

GROSS & ANONYMOUS INTERVIEWS

Two one-on-one in-depth interviews were conducted consisting of one professional in the

medical field with knowledge of STD prevention and treatment and an anonymous person whom

was STD positive. Although the interviews do not necessarily represent the populations thoughts

over STD and can be quite time consuming. One-on-one interviews allow one to focus on a

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certain topic and go in-depth with the topic.We are able to gather a more accurate information

and viewpoint without any outside influences.

The first interviewee, Judy Gros is the head nurse practitioner at the Community Action

Inc of Central Texas in San Marcos. Gross earned her Master of Science in Nursing at the

University of Texas-Austin in 1998 and has been practicing for almost 20 years. She has worked

with the community clinic of San Marcos for 8 years and is dedicated ​to help her patients be the

best people they can be and to stay as healthy as they can be. I had the pleasure of interviewing

her on March 9,​ ​2018 at the Community Action Clinic. The interview lasted about 20 minutes

long which brought up for discussion many insightful themes. Community Action is dedicated to

bring STD awareness and prevention as they ​do screenings at Texas State for HIV or do a rapid

HIV event about two or three times a year. Gross encourages students to get tested, every few

months and/or any time you engage in unprotected sex. The screenings are easily administered,

results are very accurate, and everything is done in confidentiality Gross examines about 100

people a week, 5 out the 100 test positive for a STD, whom many showed no symptoms.

Although most STDs can be treated now in days and ​most treatments are not expensive,

according to Gross the problem with the treatment for at least the treatment for gonorrhea, is that

it’s becoming resistant to the antibiotics against it. “​It's very scary when I'm treating the same

person 3 to 4 times in the space of a year for the exact same thing. I'm telling them that you're

starting to worry me because I might not be able to fix this the next time you have a flare up.

They think oh I catch it I give me a shot I'm good, go on with my life, catch it again,” Gross said.

A great point that was discussed was the fact there are more prevention methods for

pregnancy than STDs, making it more likely to contract a STD than to become pregnant. Young

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adults seem to be more concerned in preventing an unplanned pregnancy than protecting

themselves from getting a STD. We are sure one values our life more and maybe be more

concern about a life threatening disease, but why aren’t they? “I think it's the mentality ​ ​it won't

happen to me, just like people used to feel that way about pregnancy and now they're able to

protect against that,” Gross said. “They just are too trusting”. This information and topics are

worth exploring and should be shared in the attempted to encourage people to get a STD

screening.

The second interviewee would like to stay anonymous, therefore for this research project

the only information that will be provided will be the gender and age: female, 26. The interview

was conducted at Café on the Square in San Marcos to provide a relaxed environment. The

interview lasted about 15 minutes and discussed the thoughts and opinions of her health history.

At the age of 21, she had tested positive for a STD. She contracted the STD from her long-time

boyfriend whom she was expecting her first child with. She talked to her partner about getting

tested and trusted him fully when he continuously stated he was clean. One thing that is

interesting as it was mentioned in the previous interview, she felt that contracting a STD was

something that would never happen to her, with the mindset that she was invincible. She felt that

she knew a lot about STDs and how to protect herself from it. A great issue to point out is that

while she was frequently engaging in unprotected sex “I was more concerned with an unplanned

pregnancy because at the time a STD wasn’t a big deal,” she said. Young adults are adopting the

“I’m invincible mentality and it is worth taking a more in-depth look into why preventing a STD

is not a bigger priority. Now that she is older her mindset has changed and she made a good

analogy, “​I think about it this way; would you trust a child with a stranger? No. Simply for the

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fact that you must ensure their safety, so a background check must be administered. I now ensure

my safety and health with a screening,” she said. It is my hope that it does not have to come

down to students contracting a STD before they value their health. Although the thoughts and

opinion are of one person, it has brought light to the idea that it may not be that students do not

have knowledge, but that cultural mindset of being invisible needs to change. Further research ,

must be done to conclude if this is indeed a issue needed to be addressed by conducting a focus

group.

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CONCLUSION

Our survey revealed useful information in assessing the knowledge that students have

about STDs at Texas State University. We can conclude that there is a need for more in-depth

sexual education in schools, as well as information regarding preventative measures. Our content

analysis combined with the survey responses indicate that the Student Health Center needs to

reevaluate their marketing strategy and focus on expanding the presence of STD screening on

their social media platforms. The limitations presented in our study include our sample of 57

respondents and majority of them being Mass Communication students.

A disadvantage of the study would be that it was mostly Mass Communication students at

Texas State. We were not able to get a variety of students with other majors to participate as

much and we were not able to get students from other schools around Texas. Another

disadvantage was that we could not ask all the questions that we would like to ask. Asking more

personal questions would have been able to give us stronger results but personal questions should

not always be asked. An advantage was that feelings were able to be revealed anonymously

through the surveys.

Based off the results we acquired, our research team believes that college students are not

educated enough on the subject of sexually transmitted diseases. A hypothetical management

team should conduct more campaigns on STDs, in order to bring more awareness to the subject.

This could be implemented through partnering up with a PR Campaigns course at Texas State.

This practice would be a cost efficient way of conducting research, that involves students’

perceptions and insight; which in return would bring awareness to the subject.

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 In future studies our team could research what forms of media students respond to best in

order to maximize the awareness of STD prevention on campus. Another area of research could

include the study of misconceptions regarding STDs and why students are so misinformed.

In regards to public relations, our research group acquired information that could be

useful to the Student Health Center and their future STD campaigns. We found that there is

disconnect between perceived knowledge and actual knowledge about STDs and preventative

measures. These misconceptions can be harmful and result in higher STD rates within our

campus. In addition, our information could be used to help the Health Center focus on areas of

weakness and assist in strategizing future campaigns.

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 Bibliography

Allen, W. (2017). ​ABNF Journal​, ​28​(3), 64-68.

Amba, J. C., & Martinez, G. M. (2017). ​Sexual Activity and Contraceptive Use Among
Teenagers in the United States, 2011–2015 (​ Rep. No. 107). CDC

Clifton, J., Penrose, L., Prien., S., & Farooqi, N. (2015). Influence of Sex Education on Condom
Knowledge and Condom Use Skills Among Texas College Students. [Abstract]. ​Texas
Medicine ,​ ​11​.

Ephrain, D. (2005, Jun). The reality of STDs on college campuses.​ ​The Jacksonville Free Press
Retrieved from
http://libproxy.txstate.edu/login?url=https://search-proquest-com.libproxy.txstate.edu/doc
view/365182688?accountid=5683

Goldsberry, J., Moore, L., MacMillan, D., & Butler, S. (2016). Assessing the effects of a
sexually transmitted disease educational intervention on fraternity and sorority
members' knowledge and attitudes toward safe sex behaviors. ​Journal Of The
American Association Of Nurse Practitioners,​ ​28(​ 4), 188-195. doi:10.1002/2327-
6924.12353

Griner, S. B., Thompson, E. L., Vamos, C. A., Logan, R., Vázquez-Otero, C., & Daley, E. M.
(2017). College institutional characteristics and the use of barrier methods among
undergraduate students. ​Sex Education,​ ​17(​ 6), 647-666.
doi:10.1080/14681811.2017.1347093

HIV/AIDS & STDs. (2017, July 10). Retrieved March 01, 2018, from
​https://www.cdc.gov/std/hiv/stdfact-std-hiv.htm

Koumans, E., Sternberg, M., Motamed, C., Kohl, K., Schillinger, J., & Markowitz, L. (2005).
Sexually transmitted disease services at US colleges and universities. ​Journal of
American College Health ,​ ​53​(5)

Martin, J. C., & Mak, J. Y. (2013). College Students' Sexual Knowledge and Attitudes.
​Kentucky Newsletter For Health, Physical Education, Recreation & Dance​, ​51​(1),
1-10.

Most teens not given STD prevention counseling: Opportunity to educate teens often overlooked.
(2001, Jun 27). ​New Pittsburgh Courier​ Retrieved from
http://libproxy.txstate.edu/login?url=https://search-proquest-com.libproxy.txstate.edu/doc
view/367951598?accountid=5683

New data show heavy impact of chlamydia on U.S. men and women. (2005, Jul). ​Michigan
Chronicle​ Retrieved from

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 http://libproxy.txstate.edu/login?url=https://search-proquest-com.libproxy.txstate.edu/doc
view/390134507?accountid=5683

Normansell, R., Drennan, V. M., & Oakeshott, P. (2016). Exploring access and attitudes to
regular sexually transmitted infection screening: the views of young, multi-ethnic,
inner-city, female students. ​Health Expectations,​ ​19(​ 2), 322-330. doi:10.1111/hex.12354

Oswalt, S. )., & Eastman-Mueller, H. ). (2017). Chlamydia and gonorrhea screening and
expedited partner therapy (EPT) practices of college student health centers.
Journal Of American College Health,​ ​65(​ 8), 542-547.

Texas STD Surveillance Report (​ Rep.). (2016). Retrieved February 22, 2018, from Texas Health
and Human Services website.

Wiley, D., & Wilson, K. (2009). ​Just Say Don’t Know: Sexuality Education in Texas Public
Schools (2009)​ (Rep.). Retrieved ​http://a.tfn.org/sex-ed/index.html#reports

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Maddie Mason:
● New data show heavy impact of chlamydia on U.S. men and women
● The Reality of STDs on college campuses
● Most teens not given STD prevention counseling: Opportunity to educate teens often
overlooked.

Isabel Escobedo:
● College Students' Sexual Knowledge and Attitudes.
● Assessing the effects of a sexually transmitted disease educational intervention on
fraternity and sorority members' knowledge and attitudes toward safe sex behaviors
● College institutional characteristics and the use of barrier methods among
undergraduate students

Kaitlin Silguero:
● Sexual Activity and Contraceptive Use Among Teenagers in the United States,
2011–2015
● Influence of Sex Education on Condom Knowledge and Condom Use Skills Among
Texas College Students
● Just Say Don’t Know: Sexuality Education in Texas Public Schools
● Sexually Transmitted Disease Services at US Colleges and Universities
● Texas STD Surveillance report

Yessica Zamarron:
● Increasing Knowledge of Preventing Sexually Transmitted Infections in Adult College
Students through Video Education: An Evidenced-based Approach.
● Chlamydia and gonorrhea screening and expedited partner therapy (EPT) practices of
college student health centers.
● Exploring access and attitudes to regular sexually transmitted infection screening: the
views of young, multi-ethnic, inner-city, female students.
● HIV/AIDS & STDs. (2017, July 10). Retrieved March 01, 2018, from
https://www.cdc.gov/std/hiv/stdfact-std-hiv.htm

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 APPENDIX

SURVEY

Link: ​https://txstate.co1.qualtrics.com/jfe/form/SV_3VJxYFkQ2LnWZLf

Texas State STD Prevention & Awareness

Start of Block: SURVEY INSTRUCTION

Start of Block: Informed Consent

Welcome!

We are interested in understanding perception and knowledge on STDs among Texas

State students. You will be presented with information relevant to STDs and asked to
answer some questions about it. Please be assured that your responses will be kept
completely confidential.

The study should take you around 15 minutes to complete as the survey questions
range from 13 to 18. Your participation in this research is voluntary. You have the right to
withdraw at any point during the study, for any reason, and without any prejudice. If you
would like to contact the Principal Investigator in the study to discuss this research,
please e-mail Yessica at ygz2@txstate.edu

By clicking the button below, you acknowledge that your participation in the study is
voluntary, you are 18 years of age, and that you are aware that you may choose to
terminate your participation in the study at any time and for any reason.

Please note that this survey will be best displayed on a laptop or desktop computer.
Some features may be less compatible for use on a mobile device.

o I consent, begin the study (1)

o I do not consent, I do not wish to participate (2)

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Page Break

Q1 What is your age?

o 18-20 years old (1)

o 21-24 years old (2)
o 25-29 years old (3)
o Over 30 years old (4)

Page Break

Q2 I identify my gender as...

o Male (1)
o Female (2)
o Other (3)

Page Break

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Q3 What race/ethnicity do you identify most with?

▢ Caucasian (1)

▢ African-American (2)

▢ Hispanic (3)

▢ Asian (4)

▢ Other (5)

Page Break

Q4 What is your relationship status?

o Single (1)
o Married (2)
o In a relationship (3)
o it's complicated (4)

Page Break

Q5 What is your major?

________________________________________________________________

Page Break

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Q6 On a scale of 1-10, How much would you say is your general knowledge over STDs?

STD
Knowledg
o Extremely o Very o Moderately o Slightly o Not
e (1) knowledgeabl knowledgeabl knowledgeabl knowledgeabl knowledg
e (1) e (2) e (3) e (4) e at all (5

Page Break

Q7 Where have you learned about STDs and prevention options?

▢ High School (1)

▢ Parents (2)

▢ University (3)

▢ Sex-ed Class (4)

▢ Friends (5)

▢ Other (6)

▢ Nowhere (7)

Page Break

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Q8 How likely are you to ask your partner about STDs/their prior screening?

o Extremely likely (1)

o Moderately likely (2)
o Slightly likely (3)
o Neither likely nor unlikely (4)
o Slightly unlikely (5)
o Moderately unlikely (6)
o Extremely unlikely (7)

Page Break
Q9 How many times have you been screened for STDs in the past year?

o 0 (1)
o 1-3 times a year (2)
o 4-9 times a year (3)
o 10+ times a year (4)

Page Break

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Q10 Have you seen sexual health resources promotions/awareness on campus?

o No (1)
o Yes (2)
o I do not know (3)

Page Break
Display This Question:
If Have you seen sexual health resources promotion/awareness on campus? = Yes

Q10 If so, where

________________________________________________________________

Page Break
Q11 Do you feel Texas State students, including yourself get tested frequently enough?

o Definitely yes (1)

o Probably yes (2)
o Might or might not (3)
o Probably not (4)
o Definitely not (5)

Page Break

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Q12 What prevents you from getting tested for STDs ?

▢ Cost (1)

▢ Resources (2)

▢ Negative Stigma (3)

▢ Other (4)

Display This Question:

If What prevents you from getting tested for STDs ? = Other

Q12 Explain other?

________________________________________________________________

Page Break

Q13 What preventative measures do you engage in?

o Abstinence (1)
o Birth Control (2)
o Condom (3)
o Regular screening (4)
o Other (5)

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Page Break
Display This Question:
If What preventative measures do you engage in? = Other

Q13 Explain other?

________________________________________________________________

End of Block: Informed Consent

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INTERVIEW QUESTIONS GUIDE
First interview conducted with Q’Anteria N. Roberson, Coordinator, ​Marketing and Promotions:
1. What types of campaigns are used at Texas State to promote STD testing and/or
prevention?
2. Which type of campaign works best for the Health Center to draw patients in to get
tested?
3. How would you describe the overall mission and goals of your organization?
4. What social media platforms does the Health Center use to promote STD
screening/prevention?
5. Could you explain more on the campaign, It's Worth Knowing -Were there any
implications when conducting the research?

Second interview conducted with Katie Gregorczyk,​ Staff Nurse – Registered Nurse:
1. On average, how many patients visit the Health Center on a daily basis?
2. Are patients primarily male or female?
3. How many patients get tested for STDs on a daily basis?
4. How often do patients return to get re-tested?
5. How often do patients bring guests to their appointment?
6. Is there a fee to get tested for STDs?
7. How long does the process of getting tested take?
8. Opinion. Is there a negative stigma surrounding the subject of STDs, causing it to be
less spoken of?

Third interview conducted with Maddie Loeffler, ​Not On My Campus​ Vice President
1.​ ​What exactly is Not on my Campus?
2.​ ​ What is Not on my Campuses mission here at Texas State?
3.​ ​Does the Not on my Campus organization ever talk about STDs?
4.​ ​Do you think it is important to spread awareness about STDs through college campus like
Not on my campus spreads about sexual assault awareness? Do you think there is a correlation
between the two?
5.​ ​Do you think there is enough awareness of STDs around the Texas State Campus?
6.​ ​If not, do you have any ideas on how Texas State could spread awareness throughout
campus?
7.​ ​What type of campaign works the best for your organization?
8.​ ​Do you think that your campaign approach could work for spreading STD awareness as
well?

Fourth interview with Emily Rybarski, Texas State English Professor

1.​ ​What is your general knowledge about STDs on college campuses?
2.​ ​So far throughout your couple years of being a professor, do you feel you’ve seen/heard
STD campaigns around campus?
3.​ ​Did you see/hear of any during your undergrad?

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4.​ ​Do you feel like it is important to spread this awareness throughout the University?
5.​ ​Based on the knowledge that you have about your students; do you feel like you know
enough about serious topics such as STDs?
6.​ ​If you had to guess would you say STDs are higher in males or females on college
campuses?
7.​ ​Do you have any suggestions/ideas on campaigns or anything Texas State could do to
spread awareness on this topic?
8.​ ​Have you or any other professors thought about this topic before this interview?

Fifth interview conducted with Dr. Nathan Pino, ​Texas State Sociology Professor:
1. What are the things that contribute to risky behaviors from college students?
2. Do you think the health center does a good job at promoting preventative measures?
3. How does prior sexual education influence STD preventative measures?
4. Why do you think women feel pressure to be sexually active?

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