College institutional characteristics and the use of barrier methods among undergraduate students

Sexually transmitted infections (STIs) may be prevented through the use of barrier methods, but rates of use among US college students are low. Previous research focuses on individual-level factors influencing barrier method use, but few studies consider community-level influences. This study examined consistency of barrier use by college institutional characteristics including region, enrolment, control (public or private), locale, type, or religious-affiliation. Data from the Autumn 2013 US National College Health Assessment-II (n = 13,400; 57 colleges) were analysed. Prevalence ratios were calculated for consistent barrier method use during vaginal, oral and anal sex. Consistent barrier use during vaginal sex was associated with enrolment at a college in the Northeast, compared to the West (aPR: 1.16 [95%CI 1.01–1.29], p = 0.04), and enrolment at larger institutions compared to smaller colleges. Attending a private college or university was associated with more consistent barrier method use during vaginal sex and anal sex compared to those attending a public college or university. Findings demonstrate differences in barrier method use by institutional-level factors, and future research should consider the role of the college community. US college-based health promotion should include barrier method interventions at multiple levels if STIs are to be reduced.