Theses Doctoral

Utilization of Student Health Centers, Student Identity, and Engagement in Risky Sexual Behaviors: A Secondary Data Analysis of American College Health Association-National College Health Assessment III Data

Paikoff, Rachel Emma

There is extensive research on the prevalence of college student engagement in risky sexual behaviors and its potentiating factors in college/university settings. However, there remains limited data and study on the use of campus health centers, as well as the patterns of how students seek sexual health care, its relationship to student gender identity, and student engagement in sexual risk behaviors. Despite literature surrounding student health centers and how students seek out medical care, the minimal data in the field regarding campus health center use, if and how students specifically seek out sexual health services, and how this collectively might vary across students with different gender identities, clearly indicate a need for further research on the experiences of students on college campuses in this regard.

This dissertation is a secondary data analysis of the American College Health Association-National College Health Assessment III. This study’s specific aims were to: 1) describe key characteristics of students utilizing student health centers 2) describe if and how frequently college students are regularly seeking sexual health services; and 3) evaluate the relationship between a student’s gender identity and engagement in risky sexual behaviors. Drawing on a nationally representative sample of undergraduate students, analyses illustrated that students utilizing health services were primarily heterosexual female undergraduate students, with differing rates of utilization health services and sexual health services depending on race/ethnicity, year in school, and primary source of health insurance.The results confirmed that there are barriers to college student utilization of sexual health services, specifically for students who are non-heterosexual and transgender. Fewer students are seeking out their student health center and are seeking out care from services from other medical locations or may not be seeking out care at all.

These findings highlight the need to ensure that student health centers on college campuses are inclusive of all students, regardless of gender identity. Given the important role that campus health center services play in promoting positive health outcomes and reducing sexual risk among its students, universities should consider efforts to increase student health center utilization, as it is a primary source of college student healthcare.

Geographic Areas


  • thumnail for Paikoff_tc.columbia_0055E_11219.pdf Paikoff_tc.columbia_0055E_11219.pdf application/pdf 2.64 MB Download File

More About This Work

Academic Units
Health and Behavior Studies
Thesis Advisors
Rajan, Sonali
Ed.D., Teachers College, Columbia University
Published Here
October 27, 2021