Abstract
<p>Problem Significance:
Syphilis is a sexually transmitted infection (STI) that leads to severe adverse health outcomes when untreated. Syphilis in women is consistently increasing in the U.S. (217.4% from 2017-2021) and in California (1,139% from 2009-2019). Additionally, young adults and first-generation college students are disproportionately affected by STIs, compared to other age groups and non-first-generation students, respectively.</p>
<p>Analysis:
This project’s analysis found that factors related to STI knowledge, attitudes, and perceived risk, social and personal rewards, self-efficacy to access STI testing, and racial/ethnic disparities in health care contributed to incidence of syphilis. An intervention should address these factors to change behaviors of consistent barrier method use, decreased unprotected casual sexual activity, and increased regular STI testing.</p>
<p>Intervention (Solution) Proposal:
The First Steps to Generational Wellness is a proposed program to prevent syphilis in first-generation college student women implemented throughout California’s public higher education systems. The program consists of two intervention strategies: the First-Gen Steps to Sexual Wellness health education course and the First-Gen Steps to Access health policy. The health education is online, peer facilitated, and follows a sex-positive approach for optimal success with college students. While sexual health education increases participants STI knowledge and self-efficacy, the health policy ensures equitable sexual health care access is embedded at all systems through promotion and connection to on-campus or local community STI services.</p><p>Recommendations and Conclusions:
The First Steps to Generational Wellness program and its coalition work towards improved and accessible STI care for first-gen women, a group experiencing multiple disparities in sexual health and health overall. If successful, expansion to other areas of wellness in first-generation students is highly encouraged to ensure that students from all communities have an equal opportunity to thrive.