On February 10, 2004 health workers reported the first HIV outbreak among American college students.  Of the 84 students who tested HIV positive, 80 were from North Carolina (Altman, 2004).

Promiscuity at colleges has been a cause for concern for years, and with the recent outbreak of HIV, the sexual behavior of college students and the spread of sexually-transmitted diseases has once again become a leading concern on campuses nationwide.  Because of the frequency of sexual activity at colleges and the increased average number of sexual partners, the introduction of STDs to the population could result in an unprecedented epidemic unless suitable countermeasures are taken.

            In a 1999 study conducted by David Siegel, Debora Klein, and Klaus Roghmann, the sexual behavior of college students was analyzed with respect to contraception and avoiding sexually transmitted diseases.  Nearly 800 students at a college in upstate New York completed a 41-question survey revealing information about sexual behavior, contraceptive choice, and HIV testing.  The results revealed that HIV and other STDs could potentially be transmitted at a rate high enough to become endemic among college students.

            The study discovered that 45% of students were sexually active and 72% of college students had had sexual intercourse, which included vaginal, anal, and oral sex.  Of those, 43% reported having had three or more partners within their lifetime.  While that figure does not necessarily exhibit promiscuity among college students, it is at least indicative of serial monogamy.  The fact that a large portion of students have multiple partners within the span of their college careers is a factor in the rapid spread of STDs. 

The rise in STDs in American colleges in recent years necessitates prevention by students, and while most students used some form of contraception or STD prevention, a large number did not. Among sexually active students, 11.4% reported that they did not currently use any form of contraception, and 14.7% did not use contraception at the time of their first sexual experience.  Only 1% of students used contraception solely to prevent STDs and less than half were concerned at all with preventing STDs through contraception.

Condoms were the most common form of contraception and were used by 70% of students who had ever had sex.  Condoms were followed by oral contraception, which was used by 37% of students at the time of the survey, but by only 10% of students at the time of their first sexual encounter.  Spermicide was the only other form of contraception used regularly; its use was reported by 8% of students for current sexual activity and 5% for first-ever sexual activity.  Of the methods of contraception reported, only the use of condoms provides any protection against STDs.  Over 30% of sexually-active students do not use condoms, leaving themselves at risk.  Moreover, the increase in the use of oral contraception from first sexual encounter to present sexual activity indicates a decreasing concern of obtaining STDs.  This may be the result of increasing monogamy throughout the span of one’s sexual activity, but “while partners may be sequential, cumulative sexual contact can nevertheless be substantial, and, therefore, the risk of HIV transmission remains despite the students’ possible perception to the contrary”  (Siegel, et al., 1999).  Perhaps even more significant is the fact that only 23% of students who had ever had sex had undergone HIV testing.  Because HIV may go unnoticed for months or even years after being contracted, it is possible that it could easily be spread among college students without their realization.

The disregard for disease prevention may be the result of misinformation regarding contraception and the transmission of STDs.  The study suggests that “incorrect knowledge concerning the effectiveness of oral contraceptives … in preventing STDs and HIV infection” may, in part, be the cause of college students’ sexual behavior (Siegel, et al., 1999).  Students may develop a false sense of security with respect to STDs because to this point there has not been a major outbreak at colleges within the United States.  Only 2% of students reported ever having contracted an STD.  That is not to say, however, that students are out of danger or even that STDs are a rarity among college students.  The recent epidemic of HIV and a number of other STDs could easily spread and pose a serious health threat to students nationwide as diseases, when unchecked, spread exponentially. As Siegel, et al. noted, “without abstinence or the consistent use of an effective barrier method, college students will continue to place themselves at risk.”

            The situation among American college students is remarkably similar to that of Sub-Saharan Africa, the region most affected by HIV.  An estimated 29.4 million in Sub-Saharan Africa currently have HIV, which in some areas amounts to over 6% of the population (Tanzania Care, 2003). The sexual behavior of college students is presumably similar to inhabitants of Sub-Saharan Africa or more promiscuous, which would facilitate the spread of STDs.  A more crucial factor in the spread of HIV in Africa is the unavailability of contraception.  In Tanzania, contraception in any form is available to less than a quarter of the population (Tanzania Care, 2003).  In American colleges, the issue is not the inaccessibility of contraception, but the choice of college students to not use contraception.  While a significantly larger portion of American college students use condoms (68%) than Tanzanians (< 25%), the possibility of an epidemic is still present. Though the potential epidemic may not be as drastic as in the worst region in the world, it is certainly large enough to make a significant impact among the lives of college students.

 

References

Altman, Lawrence K. New H.I.V. Test Identifies Cases in College Students.  11 February 2004. <http://proquest.umi.com/pqdweb?index=0&did=000000543316691&SrchMode=1&sid=1&Fmt=3&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1083164162&clientId=15020#fulltext>.   [accessed 2004 March 11]

Siegel, David M., Debora I. Klein, and Klaus J. Roghmann. 1999.  Sexual Behavior, Contraception, and Risk Among College Students. J. Adolens. Health. 25: 336-343.

Tanzania Care. Aids in Tanzania. 2003.  <http://tanzaniacare.org/htmls/ AIDS_tanzania.html>.  [accessed 2004 April 27]