Publications

The Sex Lives of College Students: Pleasure, Precaution and Sexual Health Decisions

Gabriella Snow, Joni Roberts (DrPH), Anusha Sampath

Harvard Public Health Review | https://doi.org/10.54111/0001/DDDD4

Comprehensive Sexual Health Educational Learning Modules for College Students

Alexa Asson and Joni Roberts (DrPH)

Health Promotion Practice | https://journals.sagepub.com/doi/10.1177/15248399241227172

The Effect of Perceived Weight Gain on Hormonal Contraception Choice for Women: A Review

Joni Roberts (DrPH), Madelin Skinner, Arie To, Diane Cho

McGill Journal of Medicine | https://doi.org/10.26443/mjm.v20i2.886

Conference presentations

Oral

Internal conferences

External conferences

  • Bella Mualem, Autumn Becker, Arie To, Madellin Skinner, Joni Roberts (DrPH)

    Virtual | 9/2021

    Abstract: Sexual exploration is a common occurrence on college campuses, with around 60% of students reporting being sexually active. According to the CDC, 15-24-year-olds have the highest rates of STIs. While there is information on condom and contraceptive usage for college students, limited data exists on the usage and beliefs surrounding condoms and sexual health practices among Cal Poly students. This multi-method study utilized both surveys and focus group discussions to assess condom use, knowledge, and sexual health practices among Cal Poly students. Analysis was completed using SPSS for frequency and multinomial logistic regressions and NVIVO for the qualitative data. 580 participants completed the survey; 65% identified as female, 28% as male, and 1.3% non-binary and other. Of these participants, 69% are sexually active, almost 10% higher than previously recorded data. 73% of participants have used an external/ male condom at some time. 92% of participants have never used an internal condom. Most participants had between 1 and 5 partners in the past year. Almost 40% of participants reported using alcohol/drugs before/during sex 1-3 times a month. A total of 64 participants attended the focus groups. Primary themes included gender-based differences with condom usage with a sub-theme of partners asking about birth control instead of condoms, “cleanliness” a recurring theme was used to describe the presence or absence of STIs, trust, effectiveness related to condoms, and different brands. Finally, condoms are only being used for vaginal sex. The results are alarming given the pandemic period during which the study occurred.

  • Advaitha Bhavana, Amanda Burke, Sakina Nurruddin, Stephanie Nemet, Joni Roberts (DrPH)

    Virtual | 9/2021

    Almost two-thirds of Ugandan girls miss school at least once a year; reasons include lack of access to menstrual products and limited menstrual education. We conducted a comprehensive literature review and focus group discussions on determining the best communication & messaging form to educate girls in Jinja, Uganda, about menstruation. UNICEF defines menstrual health management as having access to menstrual hygiene products, privacy to change the materials, and access to facilities to dispose of used menstrual management materials. It can also include the "broader systemic factors that link menstruation with health, well-being, gender equality, education, equity, empowerment, and rights." Through four focus group discussions with students residing in Uganda and the results from our literature review, we developed a storybook educating students on menstruation in ways that aren't covered in the traditional classroom. The project began with the development of our focus group questions about menstrual experiences. Secondly, we conducted a literature review to identify the best mode of communication to our target audience. Thirdly, we compiled the focus group discussions and literature review to create the storybook. After creating the story, we tested it with our Ugandan students for data interpretation, comprehension, literacy, and cultural relevance. After our focus group, we revised the story to include relevant information from the participants and re-phrased many sections to decrease comprehension difficulty. Once more, we met with the participants to verify that our revisions aligned and then formatted our story to create a digital book published on ISSU.

NVIVO Virtual Conference

  • Quinn Casey, Chloe Redican, Ellie Kidd, Joni Roberts (DrPH)

    Atlanta, GA | 11/14/2023

    Introduction: Menstrual stigma is a cross cultural experience that exploits individuals with a menstrual cycle at varying levels. To demonstrate the experiences of global menstruators and address the stigma we decided to collect stories about their first period. Storytelling allows us to compare the individual effects of menstrual stigma to promote positive attitudes regarding menstrual health and hygiene. Find Your Flow is a global 5-year campaign; the objective of Year 1 is to look at first menstrual experiences in a storytelling format.

    Methods: A survey was created to collect individual’s first period stories across the globe. The survey was distributed through Qualtrics and Pollfish using a survey panel, our global partners, and recruitment posts via social media. The 683 survey responses were then organized and analyzed for qualitative coding in Nvivo. Each of the responses were summarized into a “first period story” for our social media pages while maintaining the individual’s original wording.

    Results: Emerging themes from the qualitative coding include differences and similarities with menstrual education, menstrual conversations, and societal response to menstruation which provided a deeper understanding of the roots of menstrual stigma. Most menstruators from the survey found that storytelling is effective in fighting menstrual stigma.

    Discussion: Experimental differences exist due to culture, geographic location, and menstrual education. Nonetheless, participants reported synonymous sentiments regarding their first menstrual experience. The campaign proved that storytelling provided a deeper understanding of the central attitudes towards menstruating, allowing for the campaign to continue reducing menstrual stigma on a global level.

APHA Conference

  • Gabriella Snow, Anusha Sampath, Kate Higashi, Joni Roberts (DrPH) 

    St. Louis, MO | 3/2/2023

    Introduction: Sexuality is an important facet of every individual’s identity and overall wellbeing; despite this, gender-based discrepancies exist in relation to expectations of and experiences with sexual activity. In a longitudinal study conducted in 2013, 62% of boys reported expecting sexual pleasure from intercourse, compared with only 30% of girls (Missari, 2013). Furthermore, a 2007 study discovered that women generally prioritize their male partners’ pleasure instead of their own (Tolman, et. al).

    Objective: Given an understanding of these existing trends, this study was developed to analyze contrasting attitudes about condoms and experiences with condom usage between men and women on a college campus.

    Methods: A mixed-methodology approach was utilized, consisting of a survey (n=580), focus group discussions with select survey participants (n=16), and one-on-one interviews (n=30). Each element aimed to ascertain predominating student perceptions surrounding condoms and their role in sexual intercourse and to determine if these varied between men and women.

    Results: Survey data revealed that 51.8% of men vs. 45.7% of women reported that they had never refused to engage in sexual activity when their partner refused to use a condom. Furthermore, women in 56.3% of focus group discussions reported that they believed men found condoms to be “uncool” or make sex “less enjoyable”, with 18.8% of focus groups involving statements that women felt guilty for diminishing their male partner’s experience. In no focus group conversations did men report feeling guilt related to their female partner’s experience. Interview data revealed that 47.8% of women reported a sense of individual responsibility to get STI tested and initiate condom use conversations, compared to only 28.6% of male respondents.

    Conclusions: These data reveal discrepancies in reported self-efficacy between men and women, as well as a general tendency for women to view condoms more positively and consequently advocate for their use more often. Usage in heterosexual relationships, however, appears to be influenced by women’s deference to their male partners’ preferences. This indicates a power differential between men and women that dictates the practices adhered to within sexual relationships. Subsequent interventions should look to examine how these differing perceptions are developed, and which factors can combat the prioritization of male sexual preferences, as well as promote the comfort and pleasure of all partners during sexual intercourse.  

  • Arie To, Bella Mualem, Tisha Tehranchi, Joni Roberts (DrPH)

    Virtual | 3/2021

    Introduction: Menstrual hygiene management (MHM) is an under-recognized topic in low resource, rural environments such as Uganda due to cultural taboos, access, lack of education, and sanitation issues. Poor MHM practices have been linked to higher absenteeism rates for young girls at school and greater stress and anxiety surrounding changing the menstrual products. This issue is prevalent in Uganda, where high rates of vaginal infections appear to be linked to poor MHM.

    Objectives: This study aimed to create and test prototypes of menstrual products using locally available Ugandan materials. Products aimed to be comfortable, easy to wash, and easy to replicate for local Ugandan women.

    Methods: This study is a multi-phase project consisting of three phases. 1) Prototype development. After conducting a thorough literature review of 35 articles on reusable products already available and the success of their implementation in our population of interest, three prototypes were created using locally available Ugandan materials. The materials included Ankara fabric, gauze, cotton, and snaps; due to the accessibility and affordability. 2) Testing of prototypes with college students. Students will receive a menstrual hygiene kit of materials to test during their next menstrual cycle. Participants will reveal their experiences with the product during a focus group discussion. The purpose of this phase is to test the product and get feedback for improvement before sending the items to Uganda, where women will be trained in creating, marketing, and distributing the product after a similar product testing locally. 3) Assessing attitudes and experiences of reusable menstrual products. Due to the impact of the current pandemic and limitations on assessing local Ugandan women, this phase will use college students to provide some baseline information before adapting the tool for the Ugandan community. An anonymous survey will be distributed online to college students that focuses closely on participants' general knowledge surrounding menstruation, personal perceptions regarding menstrual hygiene management, and their various experiences with reusable menstrual products.

    Results: Results of this first phase included the design and testing of three prototypes. The first was a period underwear. The underwear and reusable pad inserts were both constructed out of the traditional Ankara fabric. The absorbent material used within this design was a combination of gauze and cotton. The second included a holder and reusable pad inserts. In this design, the holder mimics many disposable pads' shape, with the wings that wrap around and snap underneath the underwear. The third was an all-in-one product. This design had half circle wings that fold underneath the underwear and snap to hold the pad in place. The circular design provides privacy and discreteness when hanging outside on a wash line.

    Conclusions: Reusable menstrual products have proven effective at improving young girls' lives, reducing infection rates, and contributing to a woman's self- esteem. The prototypes created and tested will be sent to women in Uganda to be recreated and distributed. Through the training and education of correct use of the product, we hope to decrease vaginal infection rates as women learn the importance of maintaining MHM and gain better access to discrete products.

ISSWSH Conference

  • Alexa Asson, Matthew Gutierrez, Dillan Chiewpanich, Joni Roberts (DrPH)

    Atlanta, GA | 3/22/2023

    Abstract: Sexual health education in primary and secondary schools in the US is currently required in only 29 of the 50 states, with substantial variation in topics covered and grades taught (SIECUS, 2022). When students enter college, they enter with differing levels of sexual health knowledge. Due to this, increased STI rates, unintended pregnancies, and incorrect contraception usage is often observed (Kovarik, 2012). Upon observing the current state of sexual health knowledge at California Polytechnic State University (Cal Poly), inconsistencies and gaps in knowledge were found. The 2021 ACHA-NCHAIII survey revealed that less than half (42.1%) of Cal Poly students reported using a barrier method during vaginal sex, and a mere 5.1% of students regularly utilized a barrier method during oral sex, statistics that were in line with national averages. These findings make it clear that students are engaging in sexual activity with insufficient education to take care of their sexual health. Currently, the only training required for incoming Cal Poly students is an online program titled Not Anymore, which focuses on Sexual Violence Prevention and Alcohol/Other Drugs. However, there is no discussion of sexual health topics including barrier methods, STIs, and testing within this training, nor among optional additional training courses. Some sex ed specific efforts on campus include peer education, classroom presentations, and social media posts. However, these are not required nor are all students aware of these resources. Based on the apparent lack of sex ed knowledge and limited education efforts in place, the Cal Poly SRH Lab decided to design an interactive sex ed resource. This resource is being built on Canvas; the online course management system already used by Cal Poly students. Extensive background research was done to determine the topics of focus, including a literature review, review of past SRH data, social media polls, and collaborative meetings with various campus organizations. Input from campus organizations representing minority populations has ensured the educational topics of focus are applicable to all gender identities, sexualities, and cultural backgrounds. The course will begin by focusing on consent, healthy sexual relationships and pleasure. Then, move into barrier methods, contraception, STIs, and finish with specific instructions for scheduling appointments and obtaining resources on and off campus. Reliable information, diagrams, and videos will be compiled into an easy-to-use online format that students are already familiar with. The goal is to create an easily accessible page for any student to add to their Canvas Dashboard that will provide them with important and wanted sexual health information. Ultimately, this course will increase the number of students regularly using barrier methods in all types of intercourse, promote regular STI testing, and encourage normalized conversations among students about sexual health.  

SOPHE Conference

Poster

Internal conferences

  • Caroline Swanson, Siena Fisk, Olivia Roth, Laura Ruby, Kara Samaniego, Christine Hackman, Joni Roberts (DrPH)

    Cal Poly, San Luis Obispo | 5/19/23

    Background: There has been minimal research regarding medication abortion (MAB) on college campuses. SB 24 (College Student Right to Access) is a law that ensures that students attending California public universities have access to on-campus MAB. After implementation of SB24 on Cal Poly's Campus, this study works to comprehend Campus Health and Wellbeing (CH&W) staff and Cal Poly student knowledge and perceptions of MAB. Methods: In Winter and early Spring of 2023, CH&W staff were recruited via email or snowball sampling to complete an in-person qualitative interview. The qualitative interviews explored personal and professional knowledge, values, and perceptions of MAB on campus, as well as their experiences of providing MAB at Cal Poly. In Summer and Fall 2023, Cal Poly students will be recruited to participate in qualitative interviews to understand their perceptions and experiences with MAB on campus. Results: Once data collection is finished, thematic analysis will be employed to develop a codebook highlighting major themes and codes. Based on this codebook, a list of recommendations will be developed that aim to improve MAB provision and student experience with MAB at CH&W. Discussion: It is important to hear the stories and perspectives of professionals providing such a stigmatized service as MAB. Further, student narratives will be helpful in understanding the lived student experience regarding reproductive health and healthcare needs. These results will be translated into real, concrete improvements for MAB provision at Cal Poly.

  • Sydney Carolan, Anoushka Samuel, Kaylee Hyatt, Emily Joyce, Joni Roberts (DrPH)

    Cal Poly, San Luis Obispo | 5/19/23 | View Poster

    Abstract: Reusable menstrual products (RMPs) foster sustainability, reduce period poverty, promote menstrual hygiene, and have long-term cost benefits (Hait & Powers, 2018). Despite these advantages, disposable menstrual products are predominantly used and preferred among younger populations while RMPs are negatively misconceived and scarcely used (Harrison & Tyson, 2022). Consequently, college students' attitudes and perceived barriers to RMPs are vastly under-researched. Students in Cal Poly's Sexual and Reproductive Health Lab conducted a study among students assessing education and potential barriers to RMPs. Four hundred twenty-one students responded to a survey and 32 participated in 7 focus group discussions during the academic year 2020-21. Students who participated in the focus group discussions were offered free menstrual cups which aligned with Campus Health & Wellbeing's distribution of menstrual cups to the student community during the same time. Seventy-five percent of respondents reported using disposable products, while 12% used reusable, and 13% used both disposable and reusable products. Students were less likely to use RMPs due to the initial cost of these products (<0.001), satisfaction of product cleanliness (0.03), and education of RMPs (<0.001). One menstruator stated, "I think it has to do with education and just letting more menstruators know RMPs are a good option". Regarding using RMPs on campus students discussed concerns with changing RMPs in public bathrooms (<0.001). Participants also discussed discomfort using RMPs due to communal living situations, "I remember trying out the menstrual cup, but I was in the dorm, so it was a really horrible experience". Students showed interest in RMPs but lacked education and knowledge around the utilization of RMPs. College campuses should focus on providing education regarding RMPs and provide instructions on using RMPs in communal living spaces to advance their use among the student population. 

  • Anusha Sampath, Kate Higashi, Gabriella Snow, Joni Roberts (DrPH)

    Cal Poly, San Luis Obispo | 5/19/23 | View Poster

    Abstract: Beginning in the 1980s, HIV and AIDS gained considerable, negative public attention that contributed to the "pervasive use of language" to describe individuals with the virus as "undesirable and even dangerous" (Joe & Parkin). One primary example of stigmatized verbiage that was born of this era is the term "clean" to describe STI status. The consistent use of this terminology in the media and everyday dialogue means that "such metaphors are encoded in the ways we talk about STIs" (Hutchinson & Dhairyawan). This study was therefore developed to identify predominating student perceptions of the word "clean" in a sexual context, as well as gauge the use of such terminology in STI status conversations between partners. One-on-one interviews (n=31) were conducted with students, which were subsequently analyzed using NVIVO coding software. Student interviews revealed that personal definitions of the word "clean" varied considerably and there was no universally recognized understanding of sexual "cleanliness". Rather, "clean" was used to describe STI status, social stigma, overall bodily hygiene, and the environment within which activity took place. Furthermore, 14 out of the 31 students expressed that they did not like using this term, with one female participant citing that "it implies someone with an STD or STI is like dirty, or used, or things like that." In practice, only 19.3% (6/31) of respondents specifically asked their partners if they were "clean" during STI status conversations. Differences were also noted between heterosexual respondents and students identifying as members of the LGBTQIA+ community. This inconsistency in personal definition, recognized connotation, and reaction to the term "clean" reveals that students may associate varying degrees of stigma with this terminology, dependent upon their lived experiences and sex education backgrounds. To further understand these discrepancies, additional interviews will be conducted with those who identify as men and/or sexual minorities. 

  • Alexa Asson, Dillan Chiewpanich, Amanda Hodges, Tanya Patil, Joni Roberts (DrPH)

    Cal Poly, San Luis Obispo | 5/19/23 | View Poster

    Introduction: Learn by Doing allows Cal Poly students to learn through active engagement and hands on activities to better prepare for the real world (California Polytechnic State University, 2023). An independent senior project allows students to bridge their undergraduate education with their future career by applying what they have learned to their specific area of interest. Students must critically analyze data, demonstrate professional communication skills, and synthesize what they learned throughout undergrad (California Polytechnic State University, 2023). The Sexual and Reproductive Health Lab found gaps in student sexual health knowledge and a lack of adherence to safer sex practices. For example, 22.9% of cis female students reported using the pull-out method as their only form of contraception the last time they had vaginal intercourse (ACHA-NCHAIII, 2021). Therefore, a set of comprehensive Sexual Health Educational Canvas modules was proposed, as a senior project, to address these issues. Methods: Biology (1), kinesiology (1), public health (2), and graphic communications (1) students came together to complete this project through an interdisciplinary lens. The team performed extensive background research to determine what aspects of sexual health needed focus, held collaborative meetings with campus organizations to ensure this resource was inclusive to all students, and hired a graphic communications major to create graphics to accompany written educational material and increase student engagement. Results: Upon launching this Canvas page in June 2023, all students will have access to vital sexual health information that will help to improve safer sex practices across campus. Ten modules will cover information on healthy sexual relationships, barrier methods, contraception, pregnancy options, STIs and access to resources. Conclusion: The completion of this senior project through Learn by Doing allowed this team to gain hands-on professional experience that will put us at an advantage as we enter professional careers. 

  • Quinn Casey, Chloe Redican, Joni Roberts (DrPH)

    Cal Poly, San Luis Obispo | 5/19/23 | View Poster

    Abstract: Access to sanitary menstrual products is inconsistent globally. The UNICEF guide to menstrual hygiene materials found that available high-quality and appropriate hygiene materials to manage menstruation are not accessible for most menstruators in UNICEF program countries (Guide 2023). Find Your Flow is a global, 5-year campaign focusing on menstruation; the objective of Year 1 is to look at first menstrual experiences and compare regional differences pertaining to menstrual health and hygiene. A survey was created to collect individuals first period stories across the globe. The survey was distributed through Qualtrics and Pollfish using a survey panel, our global partners, and recruitment posts via social media. The 683 survey responses were analyzed for qualitative coding in Nvivo. Emerging themes from qualitative coding include the type and use of specific menstrual products across countries. From analyzing the responses of 55 countries, the regional differences include increased use of certain types of menstrual products including tampons and disposable sanitary pads in regions like the United States and United Kingdom compared to regions of the world where menstrual cloth is more utilized. One key finding was higher tampon use in the United States compared to India with higher sanitary pad use. By revealing these global inconsistencies in sanitary menstrual products for menstruators, the campaign brings awareness to the regional differences in menstrual health and hygiene. The campaign works to eliminate stigma and promote equal access to sanitary menstrual products around the globe. 

  • Sarah Blankespoor, Erika Dorwart, Sydney Anselmo, Ella Ramirez, Christine Hackman, Joni Roberts, Kara Samaniego 

    Cal Poly, San Luis Obispo | 5/19/23

    Background: State Bill 24 (SB 24) requires University of California and California State University campus health centers to provide medication abortion (MAB) by 1/1/2023. This study explores abortion perceptions among staff at Cal Poly Campus Health and Wellbeing (CH&W), which may affect staff comfort and standards of care. Methods: An online survey was sent out to CH&W staff in September 2022, prior to SB 24 fall training, which evaluated staff experiences of and attitudes towards legality of abortions, availability of reproductive care, and perceptions of working in a facility providing abortion. For legality of abortion in different scenarios, a scale was developed (range from 1-4), with a score of 4 strongly endorsing abortion. For reproductive care availability, a scale was developed (range from 1-5), with a score of 5 strongly endorsing availability of reproductive care. Results: Survey respondents (n=43) were aged 20-69, with a mean CH&W employment of 3.77 years. Only 7% of respondents had previously assisted in an abortion procedure, and 37.2% of respondents indicated at least some discomfort working in a setting that offers MAB; the most common reason for discomfort was concern for staff safety. Legality of abortion observed a mean of 3.35 and a standard deviation of 0.89, while reproductive care availability observed a mean of 4.47 and a standard deviation of 0.76. Discussion: To support CH&W staff regarding SB24 implementation and provide high-quality care to students, understanding the perceptions of the staff is essential. Overall, CH&W staff show moderate to strong support for both reproductive care and abortion; however, CH&W staff also expressed concerns regarding MAB provision on campus. Results from this study can help identify further MAB training needs for staff at CH&W. 

BCSM Research Symposium

  • Gabriella Snow & Joni Roberts (DrPH)

    San Juan, Puerto Rico | 10/28/2022 | View poster

    Abstract: Sexual scripts influence the interpretation of behavior and guide interactions within romantic and sexual contexts, including conversations about STI status and condom usage (Hill & Andrews, 2017). Exposure to sexual scripts begins in school, with messages about sex and sexual behavior (Hauck, 2015). These scripts may include terminology such as “clean” or “clean status” when describing negative STI status (Hill & Andrews, 2017). With a desire to identify predominating student sexual scripts, including the use of the word “clean” on a college campus, this study was developed to ascertain whether college students adhere to the clean status sexual script when deciding to engage in sexual activity. One-on-one interviews (n=30) were conducted with college students, which were subsequently analyzed using NVIVO coding software. Students had different responses about their perceptions of and adherence to sexual scripts. While 86.7% of participants understood the concept of “cleanliness” within a sexual context, many recognized this verbiage’s flawed and stigmatized nature throughout their interview. 14 out of 30 participants stated that they did not prefer using the word ‘clean’ in a sexual health context, given its perpetuation of a negative stigma surrounding sexual activity and STIs. These preliminary findings reveal that college students understand the negative implications of some sexual scripts. Subsequent interventions should therefore explore the formation of such sexual scripts and potential alternatives which can be employed to foster more open communication while addressing STI status stigma.

NDiSTEM Conference

External conferences

  • Sydney Carolan, Kaylee Hyatt, Anoushka Samuel, Emily Joyce, Joni Roberts (DrPH)

    Atlanta, GA | 3/22/2023 | View Poster

    Introduction: Menstruation is a ubiquitously uncomfortable and taboo topic that is rarely discussed casually. As a result of this secrecy, there is generally a negative stigma surrounding periods and nearly half of all menstruators in the United States experience period shame (Seibert, 2018). The effects of period shame are often unnoticed as menstruators accept these feelings as normal. However, the impact on their daily lives results in disparities leading to gender discrimination, violence, and untreated health issues (UNFPA, 2018). To understand the root of this shame and its impact on college students, the researchers collected data from 32 menstruators through 7 focus group discussions. Of the participants, 81% experienced period shame at least once since first menstruating, such as being seen as inferior, weaker, and treated differently when others know they are on their period. One menstruator stated, “I always felt people would treat you differently if they knew you’re on your period, like she's probably going to be extra irritable today". As a result, 47% of participants reported feeling uncomfortable discussing menstruation with individuals who do not menstruate. One participant revealed, “Sometimes I worry about making men uncomfortable. I don't know their comfort level with it (menstruation), I think it's something they shouldn't be uncomfortable discussing, but there is that taboo in society”. Thirty-four percent of participants fear being perceived as “dirty” while menstruating and 84% hide that they are on their period by unwrapping period products quietly when using public restrooms, “even in college, I would slip a tampon or pad in my pocket and then go to the bathroom”. Lastly, 15% of participants reported hiding period products in their own home and one menstruator shared, “I grew up sharing a bathroom with my brothers and my mom would make sure I put my pads in a place where they couldn't see”. The shame associated with a normal bodily function disproportionately affects menstruators, and future efforts are needed to reduce the resulting disparities. Of the participants, 75% indicated that they believed this stigma is perpetuated by non-menstruators, revealing that inclusive menstrual health education and open conversations regarding menstruation are crucial to normalize this process and help menstruators feel comfortable with their bodies. 

APHA Conference

  • Sydney Carolan, Kaylee Hyatt, Anoushka Samuel, Emily Joyce, Joni Roberts (DrPH)

    Atlanta, GA | 3/22/2023 | View Poster

    Introduction: Menstruation is a ubiquitously uncomfortable and taboo topic that is rarely discussed casually. As a result of this secrecy, there is generally a negative stigma surrounding periods and nearly half of all menstruators in the United States experience period shame (Seibert, 2018). The effects of period shame are often unnoticed as menstruators accept these feelings as normal. However, the impact on their daily lives results in disparities leading to gender discrimination, violence, and untreated health issues (UNFPA, 2018). To understand the root of this shame and its impact on college students, the researchers collected data from 32 menstruators through 7 focus group discussions. Of the participants, 81% experienced period shame at least once since first menstruating, such as being seen as inferior, weaker, and treated differently when others know they are on their period. One menstruator stated, “I always felt people would treat you differently if they knew you’re on your period, like she's probably going to be extra irritable today". As a result, 47% of participants reported feeling uncomfortable discussing menstruation with individuals who do not menstruate. One participant revealed, “Sometimes I worry about making men uncomfortable. I don't know their comfort level with it (menstruation), I think it's something they shouldn't be uncomfortable discussing, but there is that taboo in society”. Thirty-four percent of participants fear being perceived as “dirty” while menstruating and 84% hide that they are on their period by unwrapping period products quietly when using public restrooms, “even in college, I would slip a tampon or pad in my pocket and then go to the bathroom”. Lastly, 15% of participants reported hiding period products in their own home and one menstruator shared, “I grew up sharing a bathroom with my brothers and my mom would make sure I put my pads in a place where they couldn't see”. The shame associated with a normal bodily function disproportionately affects menstruators, and future efforts are needed to reduce the resulting disparities. Of the participants, 75% indicated that they believed this stigma is perpetuated by non-menstruators, revealing that inclusive menstrual health education and open conversations regarding menstruation are crucial to normalize this process and help menstruators feel comfortable with their bodies. 

  • Sydney Carolan, Kaylee Hyatt, Anoushka Samuel, Emily Joyce, Joni Roberts (DrPH)

    Atlanta, GA | 3/22/2023 | View Poster

    Introduction: Menstruators face a unique set of circumstances when attending college, explicitly the inability to comfortably change, utilize, and access menstrual products on campus. The lack of accessible facilities on college campuses to comfortably change menstrual products contributes to the ongoing stigma and discomfort menstruators face. The researchers aimed to investigate the barriers to menstrual hygiene faced by menstruating students, determine the impact of diminished menstrual resources on a college campus, and assess ways in which college facilities can better meet the needs of menstruators. To assess the impact of college facilities on menstrual health, the researchers distributed a campus wide Qualtrics survey addressing stigma, perceptions, and attitudes towards both reusable and disposable menstrual products. The survey generated 421 student responses. Seven focus group discussions with 32 participants were held to further elucidate the survey findings. Preliminary data analysis revealed a significant association between worrying about where to dispose menstrual products and having access to clean facilities to change products (<0.001). Of the survey participants, 28.4% expressed worries regarding the disposal of menstrual products on campus and 22.1% of students reported not always having access to clean facilities to change products. Sixty-four percent of menstruators reported feeling comfortable disposing menstrual products at home while only 31% of menstruators reported feeling comfortable disposing menstrual products at school. Menstruators expressed difficulty changing products within communal living arrangements with one menstruator stating, “college dorm living makes things hard because of fear of peer judgement” with another adding, "in the dorms I would be rinsing out my underwear in the sink as people were walking by”. Twenty-seven percent of survey respondents agreed with the statement “I worry about how I will get more menstrual products if I run out” supported by one menstruator stating, “Products are not present in every bathroom on campus”. Menstrual health and hygiene are difficult to sustain on college campuses due to barriers such as lack of facilities to purchase products, absence of free menstrual products, and privacy for changing menstrual products. Study findings address health disparities and discrimination against menstruators within university environments. Future actions include improving facilities geared towards menstruators, availability of free products within campus dorms and restrooms, and products available for purchase within university stores. Accessible menstrual products and clean facilities within universities should be made a priority to decrease health risks and inequalities associated with menstrual health. 

ISSWSH Conference

  • Kate Higashi, Anusha Sampath, Gabriella Snow, Joni Roberts (DrPH) 

    St. Louis, MO | 3/3/2023 | View Poster

    Abstract: Sexual wellbeing is a large aspect of college students’ health that continues to be minimally addressed on university campuses. Considering the topic of STIs, it is estimated that people ages 15-24 accounted for almost half of the 26 million new sexually transmitted infections that occurred in the United States in 2018 (CDC, 2018). While there is information on condom and contraceptive usage for college students, there is not much data on the usage and beliefs surrounding condoms and sexual health practices among Cal Poly students. To further explore the sexual health practices at Cal Poly, a mixed-method study was conducted by Cal Poly’s Sexual and Reproductive Health Lab during the 2020-21 school year. The study included a survey (n=580) and focus group discussions (n = 16) designed to answer the research questions 1) to what extent are condoms being used by Cal Poly students and 2) what are Cal Poly students’ knowledge, attitudes, and beliefs about condoms and sexual health? Results from the study indicated that while 69% of students engage in sexual activity, sex-based differences are apparent in the desire to use condoms, condoms are only used for vaginal sex, and barrier methods other than external condoms are not being used. Further, conversations prior to sex surrounding STI status and testing are limited. Future interventions are necessary to ensure that current limitations to best safe sex practices are improved through more inclusive sexual education and access to sexual health resources. 

SOPHE Conference

Creative works

Senior projects