I found it interesting that in the article “Univ. falls in sexual health rankings” (10/02), the drop in Yale’s ranking on the “Trojan Sexual Health Report Card” is at least partially attributed to issues of trust in health-care providers.

Few who participate in our health system deny the importance of provider/patient trust, especially when it comes to sexual health care, but it is as important to focus on improving accessibility, affordability and choice.

Several of the schools ranked higher than Yale on the report card provide cheap or free emergency contraception to both male and female students. Other universities provide the new HPV vaccine at deeply discounted prices. Though Yale students have easy access to free condoms, the Yale Health Plan does nothing to absorb the cost paid by students, even as the price of prescription oral contraceptives has more than quadrupled over the past three years.

Students should have the choice of what type of provider they see and what services they receive. Studies report that patient satisfaction is related to the degree of match between patients’ desired and actual level of involvement. Tests that are done routinely but are unrelated to the immediate needs of the student should be made optional.

Without reserve Yale is to be commended on the campuswide efforts to promote sexual health. That said, improving sexual health at Yale may come down to more than lingerie fashion shows and free condoms.

Sara Baldauf-Wagner, R.B.

MSN, Certified Nurse Midwife Candidate ’09

Yale School of Nursing