The School Counselor and Prevention of Sexually Transmitted Infections

(Adopted 1988; revised 1993, 1999, 2001, 2006, 2012, 2018)

ASCA Position

The school counselor supports educational efforts related to the prevention of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS), through engagement with students, families, school staff and the community to prevent infection and the spread of these infections. The school counselor collaborates with other school health personnel in these efforts, while recognizing the importance of student/family confidentiality. The school counselor provides support, counseling and referral services to students and their families affected by these infections.

The Rationale

Current research suggests that formal sex education addressing topics such as the prevention of STIs has been in decline since 2011 (Lindberg, Maddow-Zimet, & Boonstra, 2016); yet, we know that lack of information about STIs may put adolescents’ health at risk as they explore multiple facets of their identities. As a part of a student support services team, school counselors have the opportunity and responsibility to provide students with developmentally appropriate, accurate and current health information regarding STIs and to help them develop healthy attitudes and habits. Risk can be reduced when adolescents understand the causes and potential consequences of sexual behaviors and experimentation and learn multiple ways to prevent acquiring and spreading of STIs (Chin et al., 2012). School counselors are poised within the schools to provide this education and prevention information to students and their families. Students and families affected by STIs have a right to confidentiality and equitable treatment in schools (ASCA, 2022).

The School Counselor's Role

School counselors collaborate with school health personnel (e.g., school nurse, health instructors, physical education instructors and life science instructors) to provide counseling, support and educational programs for students, staff and families. As a part of the school counseling program, the school counselor addresses STIs not as a moral issue but through prevention and nonbiased support efforts. The school counselor strives through professional development to maintain a current understanding of the recommendations and resources regarding the nature of STIs and appropriate means of prevention.

The school counselor is familiar with and complies with school policy and federal, state and local laws as well as the ASCA Ethical Standards for School Counselors (2022) regarding STIs. The school counselor understands and upholds HIPAA and FERPA laws protecting confidentiality of students and families affected by STIs. The school counselor is alert to any form of discrimination on the basis of a student’s STI status. The school counselor advocates on behalf of students and families affected by STIs for equity and access to educational opportunities and health care, maintenance of confidentiality and referrals to available resources to assist them.

As a part of the school counseling program, the school counselor is an advocate and direct service provider for the implementation of an STI education curriculum in collaboration with the school’s other health curriculum providers. The STI education curriculum includes instruction for students, families and staff promoting healthy living and responsibility to self, family and society. Preventive education is recommended for populations currently less likely to receive adequate STI education: males (Donaldson, Lindberg, Ellen, & Marcell, 2013), rural students (Lindberg et al., 2016) and LGBTQ groups (Gowen & Winges-Yanez, 2014).

Specific elements may include general information about STIs, including knowledge of:
  • behaviors that put people at risk
  • methods of transmission
  • health risks to self and others
  • related nondiscrimination and confidentiality policies
  • prevention efforts
  • accurate information dispelling myths and stereotypes
  • referral information for health clinics providing testing and treatment

Summary

The school counselor promotes educational efforts related to STIs while providing support and counseling to students and families affected by these infections. The school counselor’s approach to STI-related issues is through education and prevention efforts, by keeping abreast of current recommendations and resources in collaboration with health care professionals in the school and community.

References

American School Counselor Association. (2022). ASCA ethical standards for school counselors. Alexandria, VA: Author.

Chin, H. B., Sipe, T. A., Elder, R., Mercer, S. L., Chattopadhyay, S. K., Jacob, V., & ... Santelli, J. (2012). The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: Two systematic reviews for the guide to community preventive services. American Journal of Preventive Medicine, 42(3), 272-294. doi:10.1016/j.amepre.2011.11.006

Donaldson, A. A., Lindberg, L. D., Ellen, J. M. & Marcell, A. V. (2013). Receipt of sexual health information from parents, teachers, and healthcare providers by sexually experienced U.S. adolescents. Journal of Adolescent Health, 53, 235-240.

Gowen, L. K., & Winges-Yanez, N. (2014). Lesbian, gay, bisexual, transgender, queer, and questioning youths’ perspectives of inclusive school-based sexuality education. Journal of Sex Research, 51(7), 788-800. doi:10.1080/00224499.2013.806648

Harris, G.E., & Jeffrey, G. (2010). School counsellors’ perceptions on working with student high- risk behavior. Canadian Journal of Counselling, 44(2), Article 531.

Lindberg, L. D., Maddow-Zimet, I., & Boonstra, H. (2016). Changes in adolescents’ receipt of sex education, Journal of Adolescent Health, 58, 621-627.

Resources
Center for Disease Control and Prevention: Division of Adolescent and School Health (DASH) http://www.cdc.gov/healthyyouth/about/hivstd_prevention.htm

Family Educational Rights & Privacy Act (FERPA): http://www2.ed.gov/policy/gen/reg/ferpa/index.html

Gay, Lesbian & Straight Education Network (GLSEN): https://www.glsen.org/article/call-action-youth-parents-community-members-educators-and-policymakers

Guttmacher Institute State Laws and Policies: https://www.guttmacher.org/state-policy/laws-policies

Health Insurance Portability & Accountability Act (HIPAA) Privacy Rule: http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/index.html

National Coalition of STD Directors Promoting Sex Healthy through STD Prevention Adolescent Sexual Health: http://www.ncsddc.org/resources/

Sexually Transmitted Diseases – Prevention https://www.cdc.gov/std/prevention/default.htm

​*Note this position statement includes minor updates to reflect the revisions to the 2022 ASCA Ethical Standards for School Counselors.