The authors' objectives in this study were to describe the proportion of schools providing and the percentage of students with access to HIV and sexually transmitted disease (STD) education, treatment, and prevention services at 2-year and 4-year US colleges and universities. The authors mailed self-administered questionnaires to a stratified random sample (n = 910) of the 2,755 US schools with an enrollment of more than 500 students; 736 (81%) returned the survey. Four hundred seventy-four schools (60%) had a health center, representing 73% of students. Schools with a health center or housing for students were more likely to provide STD education; 52% of the schools made condoms available to students. Sixty percent of schools with health centers could test for both Chlamydia trachomatis and Neisseria gonorrhoeae, but only 67% of these schools screened women for these infections. Although most schools provided some prevention education, access to prevention, testing, and education should be increased at schools where these services are possible but not available.