This is a guest post by Kailah Carden. Content note: This article is about campus sexual assault, however it does not contain any descriptions of assault.
Thanks to student activists, our country is paying unprecedented attention to the epidemic of sexual assault on college campuses. Students across the country have staged protests, filed Title IX complaints, and the Office of Civil Rights in the Federal Department of Education is currently investigating over 85 schools for non-compliance. As a result, institutions of higher education across the country are currently rewriting their sexual assault policies.
While the national attention and policy work is a welcome rupture in the status quo, the dominant discourse has been almost exclusively on reforming disciplinary procedures to hold perpetrators accountable. As a result, survivor’s health needs in the wake of sexual assault have been overlooked. Biomedical interventions, specifically, emergency contraception (EC) and post-exposure prophylaxis (PEP) — both FDA approved medication, that when taken after unprotected sex can prevent pregnancy and HIV respectively – must be included in the ongoing policy discussions on college campuses to ensure unwanted pregnancy and HIV infection are never part of the burden carried by students who survive sexual assault.
Clear and enforceable protocols on sexual assault management are necessary for all college health centers. In order to adequately serve survivors of sexual assault, colleges and universities must develop sexual assault protocols that include EC and PEP and (re)train all health care providers on these updated protocols. Training should not only include basic biomedical information, such as when to prescribe EC and PEP, but also a comprehensive overview on what sexual assault is and how it may impact different communities, with specific attention to gender, sexual identity, gender identity, race, and ethnicity. In addition to developing protocols, college health centers must have mechanisms in place to measure and enforce compliance.
Structural changes are also necessary to ensure access to EC and PEP. The majority of young, female survivors of sexual assault present to emergency departments between 8pm and midnight. Health care providers must be available to students on campus on nights and weekends when the majority of assaults occur. EC — available over the counter without a prescription — should be available for sale on all campuses twenty-four hours a day, seven days a week, perhaps in existing convenience stores or stand alone vending machine.
Further structural barriers identified by researchers include high co-pays for HIV testing. All costs associated with care for a survivor should be reduced or eliminated by colleges and universities. Cost should never be a factor for a survivor making decisions about their health. Making EC accessible over the counter, reducing co-pays for HIV testing, and subsidizing all costs associated with care for survivors are feasible and cost effective steps for all colleges and universities to take as compared to the economic and psychological cost of unplanned pregnancy and HIV infection.
In addition to structural changes, colleges must invest not only in updated policies but updated health education. College students must be educated on the basics of pregnancy and HIV prevention for general sexual health. In a population where 1 in 5 women will experience sexual assault it is necessary to educate all students on EC and PEP, because they will undoubtedly know at least one person in their college career who will need these services. Proactive education on sexual health is an integral component to utilization of EC and PEP and must be comprehensively instituted on all college campuses in order for these interventions to be effective.
Biomedical interventions such as EC and PEP have the potential to tremendously reduce the burden that sexual assault survivors carry, and must be included in the ongoing conversation on sexual assault on college campuses. Students who have survived sexual assault have a federally protected right to equal access to educational opportunities under Title IX. As colleges and universities update sexual assault policies they must not overlook the importance of the physical health of sexual assault survivors as integral to complying with Title IX. Thanks to EC and PEP no survivor needs to face unwanted pregnancy or HIV infection as a consequence of their assault. It is the responsibility of all college health centers to make sure these resources are immediately available to all survivors.
Kailah Carden is a Master’s Candidate in the Educational Studies program at Tufts University. Kailah completed her undergraduate degree in Women’s, Gender, and Sexuality Studies and Community Health at Tufts. Her research interests include feminist and queer theory, knowledge production, and systems of power.