College health centers across the United States are missing a critical opportunity to stop chlamydia transmission among young adults. A new analysis of sexual health services at 115 college health centers reveals that most are not offering expedited partner therapy (EPT), a proven strategy that allows infected patients to give medication directly to their sexual partners without requiring those partners to visit a clinic first. This gap in care is particularly concerning because college-age students represent a population at disproportionately high risk for sexually transmitted infections (STIs).

What Is Expedited Partner Therapy and Why Does It Matter?

Expedited partner therapy is a straightforward approach to breaking the cycle of STI transmission. When someone tests positive for chlamydia, they receive not only their own treatment but also medication or a prescription they can give directly to their sexual partner. This eliminates the delay that often occurs when partners need to schedule their own clinic visits, which frequently leads to partners going untreated and continuing to spread the infection. The strategy is especially valuable in college settings, where students may have multiple partners or transient relationships that make traditional partner notification difficult.

The research team analyzed data from the 2023 American College Health Association Sexual Health Services Survey, which included responses from college health centers nationwide. They examined whether these centers offered EPT for chlamydia and investigated whether certain institutional characteristics, such as school size, location, and whether the school serves minority populations, were associated with EPT availability.

How Many College Health Centers Actually Offer This Service?

The findings paint a sobering picture of sexual health infrastructure on campuses. The study examined institutional characteristics to understand which types of colleges were more or less likely to provide EPT, including factors such as:

• School Locale: Whether the college is located in an urban, suburban, or rural area, which can affect access to pharmacy services and healthcare infrastructure
• Enrollment Size: The total number of students at the institution, which may correlate with funding and staffing for health services
• Geographic Region: Different U.S. regions may have varying STI prevalence rates and public health priorities
• Public or Private Status: Funding models and institutional resources differ between public and private institutions
• Minority Serving Institution Status: Schools designated as serving predominantly minority student populations may face different resource constraints
• Chlamydia Positivity Rate: The actual burden of infection at each campus, which should theoretically drive adoption of prevention strategies

The researchers also conducted qualitative analysis of open-ended responses to identify common themes about why some centers do or do not offer EPT.

Why Aren't More Colleges Offering This Prevention Tool?

The gap between the evidence supporting EPT and its actual implementation at college health centers suggests multiple barriers exist. College health centers serve a uniquely important role because they reach a major segment of young adults during their most sexually active years, yet many lack the resources, training, or institutional support to implement EPT programs. Some centers may face regulatory uncertainty, pharmacy coordination challenges, or simply lack awareness of the strategy's effectiveness. Others may struggle with staffing limitations that prevent them from adding new clinical protocols.

The disparity in EPT availability across different types of institutions also raises equity concerns. If colleges serving minority populations or those in rural areas are less likely to offer EPT, students at those schools face higher risks of untreated infections and ongoing transmission within their communities.

What Do Experts Say About Closing This Gap?

The research underscores the urgent need for college health centers to prioritize chlamydia prevention as part of their sexual health mission. Young adults deserve access to the most effective tools available to protect their reproductive health and prevent long-term complications of untreated STIs, including pelvic inflammatory disease, infertility, and ectopic pregnancy. Implementing EPT requires coordination between clinical staff, pharmacy services, and public health departments, but the effort is worthwhile given the high burden of chlamydia on college campuses and the simplicity of the intervention.

The findings suggest that targeted efforts to increase EPT adoption at college health centers could significantly reduce STI transmission among young adults. This might include providing training to health center staff, clarifying regulatory pathways for EPT implementation, and allocating dedicated funding for sexual health services. College health centers that have successfully implemented EPT programs can serve as models for others, demonstrating that the strategy is feasible even in resource-limited settings.

As STI rates continue to climb among young adults in the United States, college health centers must recognize their critical role in prevention. Expedited partner therapy is not a new or experimental approach; it is an evidence-based strategy that works. The question is no longer whether EPT should be offered at college health centers, but how quickly institutions can overcome barriers to implementation and ensure that all students have access to this life-changing prevention tool.