No one likes thinking about STIs.
They have spelling–bee winning names (see: gonorrhea), result in unnecessarily terrifying WebMD searches, and may prompt flashbacks to your 10th grade sex ed teacher’s fanatical sermons on the virtues of abstinence.
But sexually transmitted infection (STI) testing remains one of the most important issues on college campuses. Studies indicate that around one in four college students have an STI, and many may not even be aware of their status. One study found that fewer than 7% of male college students and approximately 17% of female students reported getting an STI test over a 12–month period. These low numbers may result from various factors, including a lack of effective sexual health education, cost barriers, and the stigma surrounding STIs. As a result, many feel it is critical to have accessible, affordable, and anonymous STI services on campus.
Penn has made strides in improving access to sexual health services on campus. Students can make an appointment with Wellness at Penn anytime, either online through its wellness portal or by calling a provider at (215) 746–3535. The cost of testing is entirely covered for any student on the Penn Student Insurance Plan. Wellness at Penn will also waive any fees for lab charges related to sexual assaults.
But for students on private insurance, which represents the majority of students at Penn, there are still costs associated with STI testing. Tests can range from between $10–$30 a test, with an HIV test costing $22 and single–site tests for gonorrhea and chlamydia costing $10 each. Wellness at Penn prioritizes making costs for STI tests clear before providing them.
“One of the things we hear a lot from students is that they never know what the cost is going to be until they get a bill,” says Erika Gross, Chief Operating Officer for Wellness at Penn. “What students really want is to know what the costs are going to be for the care that they do receive.”
Some students say the cost of testing might pose a barrier to getting tested. “I know that $10–$30 might not be that bad for some, but I do know that when you’re thinking about individual tests—depending on how much you’re exploring and how much you feel comfortable getting testing—that can add up,” says Mari Andrzejewski (N '24), who also works with Penn Violence Prevention.
The Centers for Disease Control and Prevention recommends that people with more than one sexual partner get tested for HIV at least once a year. Wellness at Penn follows this guidance, advising that students get tested for STIs annually—or even more frequently depending on a doctor’s recommendation.
As a result, the cost of STI testing could accumulate if students are getting tested regularly, such as each time after changing sexual partners. A full panel STI test through Wellness at Penn—which includes HIV, gonorrhea (urogenital, throat, and rectal), chlamydia (urogenital, throat, and rectal), syphilis, and hepatitis C—would cost $99. Most students might not require all of these tests, but especially at Penn—where hookup culture is prevalent—the cost of frequent testing might discourage students from getting tested.
“I’ve generally heard through the anti–violence community and through other students who partake in hookup culture at Penn that they’re not particularly enthused about going to get tested just because of the cost,” Mari says.
Layla Murphy (C '23), co–founder of Quake Magazine, which focuses on appreciating bodies, relationships, sex, and love, agrees with Mari’s concerns about the cost of testing. Layla believes that Wellness at Penn should eliminate the cost of testing entirely, along with placing a greater emphasis on publicizing STI testing services on campus. “At minimum, people are paying too much money to get STI tested. But at worst, they’re not getting STI tested at all,” Layla says.
Some universities have instituted free testing to alleviate costs and encourage students to get tested. Cornell University has made preventative STI screenings free for all students, regardless of their insurance plan. At Harvard, all students who have paid the Student Health Fee are eligible for testing without out–of–pocket charges. Closer to campus, Temple University offers testing “at low cost based on your ability to pay.”
According to Gross, discussions about implementing free STI screenings at Penn are ongoing. “We always look at ways to reduce the cost to students, so we continue to evaluate options to eliminate the cost for asymptomatic STI testing that would meet the general recommendations,” she says.
If students are unable to pay the costs associated with STI testing, there may still be ways to access testing through Penn. According to Gross, Wellness at Penn handles any requests for fee waivers on a case–by–case basis. But as of now, Penn has no concrete plans to establish a universal free testing policy. “We haven’t been able to accomplish that yet,” Gross says.
According to Mary Kate Coghlan, Director of Communications for Wellness at Penn, the university assessed the cost of implementing free testing prior to the COVID–19 pandemic, but has not done so since. Gross notes that establishing free testing would likely lead to an increase in the Penn Clinical Fee, which was $332 per semester in the 2022/2023 academic year.
Some students have also raised concerns about the privacy of STI testing at Penn. Previously, STI testing charges would show up on a policyholder’s insurance plan, potentially allowing parents to discover a student’s testing habits, which is uncomfortable for some students. Now, the charges show up as a “healthcare assessment” on a student’s financial account, without any identifying information about the test.
There is not currently an option for students to take the charge off their account altogether. Gross says that the university phased out a cash–payment option for appointments, as most students don’t carry cash. At this time, she says, there is no option for students to pay directly by credit card to prevent any charge from appearing.
Students are able to get tested for STIs outside of Penn. Some students may be able to access cheaper STI testing through their primary care physicians. There are also many free STI testing services throughout Philadelphia that are available to students. These include rapid HIV testing at the Mazzoni Center in Center City and walk–in STI testing at Philadelphia Health Center 1 in South Philadelphia.
For students who don’t want to commute to an appointment, the Philadelphia Department of Health offers a convenient alternative. By filling out a short online request form, students can request free at–home tests for HIV, chlamydia, gonorrhea to be mailed to their address. Students can also request free condoms and other sexual health resources.
Not every student is aware of these off–campus testing options, though. Layla notes that these resources may pose other challenges to Penn students, including being far from campus and underpublicized. “There are a lot of places that you can get free STI testing in Philly. I just think it’s not front of mind for people,” she says.