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AIDS is not the only sexual di$ease risk to students

While AIDS gets the lion' s share of


publicity and research dollars, other Sexu-
ally Transmitted Diseases (STDs) may
represent a much graver threat to most
sexually active college students.
About three of every thousand stu-
dents-mostly males- across the country
have tested positive for the HIV virus
which causes AIDS. Some of these sbl-
dents are undoubtedly aware that they are
infected and have modified their sexual
behavior or intravenous drug usage to avoid
infecting others. But many are probably
unaware of their condition, and they are
at substantial risk of infecting another per-
son with each sexual encounter.
At the end of 1990, surveyors reported
that only one of every 5000 female college
students across the U.S. is infected with
AIDS, demonstrating that these young
women are at much higher risk of being
infected by STDs other than AIDS.
These other diseases represent a much
greater to the health of students be-
cause of their easy transmission and their
already high incidence among adolescents
and young adults. Some of these STDs
have consequences which are every bit as
horrific and deadly as AIDS.
Cervical cancer
Six thousand woman will die in 1989
from cancer of the cervix, and hundreds
of thousands more will contract infections
strongly associated with development of
the disease, or have abnormal Pap tests
indicating cervical changes possibly
ing to cancer. To illustrate, 17 percent of
the female students at the University of
Akron show such abnormal smears.
Women who begin sex at a young age
or who have multiple sexual partners are
at increased risk for cervical cancer. In
large part, certain infections obtained in
these sexual encounters may be respon-
sible for increased cancer risk. Several of
these infections are common on campuses.
Warts (HPV)
A strong association has been estab-
lished between cervical cancer and some
of the more than 40 herpes viruses which
cause genital warts (HPV). Physician and
clinic visits for treatment of HPV in the
U.S. increased by 500 percent between
19(>6 and 1981, to more than one million
per year. Eighty-five percent of those ex-
posed to sexual partners with HPV will
be infected with these incurable viruses.
HPV is the major cause of abnormal
Pap smears in women of college age. At
the University of Washington, 11.4 per-
cent of the female students examined had
cervical infection by HPV even though
they had no visible warts. Nearly half
of these students had pre-cancerous cell
changes. Researchers emphasize, "all cer-
vical HPV must be treated as having ma-
lignant potential." HPV can also invade
the bladder, eyes and other areas with
mucous membranes. Another herpes vi-
rus, known as Epstein-Barr Virus (EBV),
is also a potential cause of cervical cancer.
Ominously, one swdy detected HPV
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infection in 72 percent of male partners
of infected females even though the men
had no symptoms.
Chlamydia trachomatis
The most common STD, Chlamydia
has also been found to be associated with
cervical cancer. Four million new cases
of the Chlamydia infection are estimated
to occur annually in the U.S. One-half to
two-thirds of all involuntary blbal infertility
is due to this infection. Up to 62 percent
of women with Pelvic Inflammatory
Disease (PID) have been infected with
Chlamydia.
At the University of South Florida, 6.9
percent of female students with no
symptoms were infected with Chlamydia.
Forty-eight percent of the females with
vaginal symptoms (itching, discharge, etc.)
tested positive, and 50 percent of the males
with non-specific urethritis had Chlamydia.
In 1988, 20 percent of the sexually ac-
tive males at Bowling Green State Uni-
versity tested positive for Chlamydia, and
7 percent of the males with no symptoms
were infected. Up to one-third of all sexu-
ally active male adolescents are estimated
to have the disease. Since few of them
are treated, many bring Chlamydia with
them to college to share with their female
partners. More bad news: Perhaps 30 per-
cent of infected (and infectious) people
have no symptoms.
In 1990, a urine test for Chlamydia
was approved, allowing for easier testing
and the first practical test for males.
Gonorrhea
Gonorrhea is the most reported STD
among college sbldents, probably because
it usually produces distinct symptoms.
High school and College-aged Americans
have the highest rate of gonorrhea infec-
tion. Sixty percent of cases are reported
in people under 20 years of age. While
gonorrhea is fairly readily treated, it is not
a wholly innocuous disease. A substantial
percentage of women with (PID) previ-
ously had gonorrhea.
Herpes
As with other STDs, genital herpes
(HSV-2) is epidemic among college sw-
dents, and easily transmitted to an unin-
fected partner. Less widely known, a study
of students at Pennsylvania State showed
that common oral herpes (HSV-1) "is
readily transmitted to the genitalia" during
oral sex. It is also transmitted by kissing.
While the drug acyclovir is of tremen-
dous importance in treating herpes, it does
not reduce the infected person's ability to
infect a sexual partner. Viral shedding (and
spreading) can occur even when no sore
is visible.
HSV may increase the risk of cervical
cancer and have unpleasant effects on the
nervous system.
Hepatitis B
According to the Centers for Disease
Control (CDC), college swdents who have
3 sexual partners within 4 months are 10
times more likely to contract hepatitis B,
a major cause of liver cancer and cirrho-
sis. Students with 2 or more episodes of
STD were 25 times as likely to be infected
than students with fewer episodes. Over
the next 20 years, the cost of treating people
with hepatitis B, which is totally prevent-
able by vaccination, is estimated to exceed
the cost of treating AIDS.
Molluscum contagiosum
Molluscum contagiosum is another in-
curable viral infection whose highest in-
cidence is among college-aged Americans.
In the general population, patient visits for
the disease increased by 1,100 percent be-
tween 1966and 1983. The long-term health
risks of molluscum infection are unknown,
but based on the harmful effects of other
STD viruses there is reason for concern.
PID
As previously mentioned, Pelvic In-
flammatory Disease (PID) is precipitated
by gonorrhea and Chlamydia infection. It
is a major cause of infertility and ectopic
pregnancy. Twenty percent of women with
PID become infertile. One of every 8 ado-
lescent women will get PID, and 7 of every
1,000 women aged 20-24 will be hospi-
talized with the disease. Interestingly, oral
contraceptives seem to reduce the risk of
developing PID.
Attitudes
Why do young people--and college
students in particular-have such a high
incidence of Sexually Transmitted Dis-
ease? Very simply because they have a
lot of sex and multiple partnl78. They also
engage in risky sexual behaviors.
Brandeis University researchl78 report
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Type-1 (oral)
herpes, is easily
transmitted to
the genitals of a
partner receiving
oral sex
C5"'!11oo..,. ______________ -t''Z5vl
that the percentage of males aged 17-19
who have had sex went up from 66 percent
in 1979 to 75 percent in 1988.
At Wake Forest, the percentage of fe-
male students having multiple sexual part-
nl78 went from 19.4 percent in 1970 to
48.8 percent in 1981, nearly the same per-
centage as males. If the national trend has
held true, the percentage is probably con-
siderably higher today. The average age
of first intercourse dropped to 17 years
for males and 17.6 for females. (By com-
parison, in a lower-middle-class com-
munity in Illinois, the age for boys was
12.5 and for girls 14.5.)
At Indiana University, 27 percent of
male and 24 percent of female swdents
report having anal intercourse, a higher
risk sexual behavior for contracting AIDS
when performed without condoms.
(Regular receptive anal intercourse with-
out condoms is also known to interfere
with a healthy immune system.)
'These are Indiana students, cheer-
leaders, basketball players, the heart of
America They are having multiple part-
nl78 at a very high rate, they have an av-
erage of four years of sexual experience
and are averaging six or seven partners
over that time. They are not using
condoms-they have a sort of a natllral
idea that if you use one a year it sort of
protects you," says the researcher who
conducted the survey.
. Other surveyors note that, although
"AIDS-specific knowledge [is] high among
adolescents/young adults," those who were
sexually active scored high on a scale of
sex risk behaviors. Two-thirds reported sex
without proper condom use. Those with
more AIDS knowledge were no more likely
to take precautions. Educational programs
are, say these researchers, "unlikely to re-
duce risk behaviors in sexually active ado-
lescents."
In a Santa Cruz, California study of
sexually active women aged 14-20, more
than 50 'percent had more than one sexual
partner in the prior year, but only 12 per-
cent used condoms consistently. Frustrat-
ingly, 20 percent of the women had used
condoms with their primary partner,
but only 12 percent used condoms with
other partners. Thirty-two percent had
a prior history of STD, 16 percent had
been pregnant
Researchers at the University of Cali-
fornia at San Francisco who examined the
women reported that "although perceptions
[among young people] that condoms pre-
vent sexually transmitted diseases and the
value and importance placed on avoiding
STDs remained high, they were neither
reflected in increased intentions to use
condoms nor in increased use."
Former Surgeon General Koop agrees
that AIDS education is not influencing
young people. "We do know that teen-
agers are not listening" to warnings against
unsafe sex." (And neither are college stu-
dents.) Dr. Koop speculates on why young
people have not modified their behavior
to combat the spread of AIDS and STDs:
"Teenagers are risk takers. They feel they
are immortal. They don't like any admo-
nition that begins with the word 'don't'."
Ninety percent of college health pro-
fessional rank sexual health problems as
the primary threat to the physical and
emotional well-being of young adults.
Solutions?
As Dr. Koop has observed, short of
an unlikely outbreak of abstinence,
condoms are the first line of defense against
AIDS and STDs.
If your sexual partner is infected with
AIDS, the risk of becoming infected is
about 150 times less if you use a condom.
Condoms have been shown to be effective
against herpes simplex, hepatitis B, Ch-
lamydia, gonorrhea, and cytomegalovirus
(CMV) (another herpes virus which is
sexually transmitted). Condom use reduces
the incidence of PID, ureaplasma infec-
tion, and cervical cancer. They are prob-
ably somewhat less protective but still
valuable against warts and molluscum.
If you or your partner has had prior
sexual experience it is thoroughly irre-
sponsible for you not to use a condom
with each sexual encounter, from start
to finish. This means not only during
vaginal and anal intercourse, but also oral
sex, which is now known to be a method
for transmitting and receiving SID in-
fections, including AIDS.
If you are a male, consider that several
STDs place a young woman at increased
risk of cancer, sterility, and even death.
Is that a risk you would like. her to take?
If you are a female, remember that he
might be infected and show no symptoms.
And, while they may not significantly in-
crease his risk of cancer, the effects of
STDs on males can be unpleasant, expen-
sive, and perhaps more dangerous than is
presently known.
Remember, each person you infect may
infect several others. In the future you could
be reinfected with the same or another
STD. And there may be many other
STDs.-possibly CMV or Epstein-Barr
Virus.-with effects not fully understood.
Condoms are not perfect About one
of every 100-165 breaks. They should not
be used with any lubricating product-
like baby oil-containing mineral oil,
which quickly destroys them. Their value
is increased in conjunction with a sepa-
rately applied spermicide (in addition to
the kind that comes already on the
condom). Spermicides are also indepen-
dently associated with reduced risk of
certain STDs. Use only latex condoms.
If you have had sex with someone who
previously had multiple partners you
should be examined for the spectrum of
SIDs while embarking on a safer approach
to sex. Females should have regular Pap
tests and report any prior history of STD.
Early detection of cervical cell changes
is a powerful weapon in preventing them
from developing into cancer.
Three important barriers to the spread
of AIDS and STDs are reason, prudence
and communication. Adopting the fol-
lowing approaches will dramatically re-
duce exposure to and spread of all SIDs.
. t/ Choose low risk sexual partners and
behaviors.
t/ Always use a condom, or require
that 'JOur partner use one. Avoid exchange
of body fluids. Always use a spermicide.
t/ Find out your partner's sexual his-
tory. Require that he/she be examined for
STDs and treated if necessary.
t/ Women should obtain regular Pap
tests and report STD history.
t/ Unless your partner is a virgin,
never presume that he/she is STD-free.
t/ If you have any doubts, simply
refuse to have sex.
Sexual choices are part of the moral
and intellectual fabric of life. To engage
in behavior known to be risky or harmful
is demeaning and self-destructive. A young
person who takes on the responsibility to
become educated, wear seat belts, and to
look both ways before crossing the road,
can exercise similar judgement in choos-
ing safer sex. To do otherwise makes you
a danger to yourself and a menace to others.
Choosing a condom
Which provide superior protection?*
*Best
Condoms tested wtih 1.5% failure rate:
Embrace Ultra-Thin
Excita Extra
Excita Fiesta
Gold Circle Coin
Kimono
Koromex with Nonoxynol-9
Lady Protex Ultra-Thin
Lady Protex with Spermicidal Lubricant
Lady Trojan
LifeStyles Conture
LifeStyles Extra Strength Lubricated
LifeStyles Stimula Vibra-Ribbed
Protex Arouse
Protex Contracept Plus with Spermicidal Lubricant
Protex Secure
Protex Touch
Ramses Extra with Spermicidal Lubricant
Ramses Non-Lubricated Reservoir End
Saxon Wet Lubricated
Sheik Elite
Sheik Fetherlite Snug-Fit
Sheik Non-Lubricated Reservoir End
Today with Spermicidal Lubricant
Trojan Naturalube Ribbed
Trojan Plus 2
Trojan Ribbed
Trojan-Enz
Trojan-Enz Lubricated
Trojans
Trojans Plus
Wrinkle Zero-0 2000.
Yamabuki No. 2 Lubricated
*Medium
Condoms tested with 4% failure rate:
Lifestyles Nuda
Mentor
Ramses NuFORM
Ramses Sensitol Lubricated
Saxon Ribbed Lubricated
Sheik Non-Lubricated Plain End
*Worst
Condoms tested with 10% failure rate:
LifeStyles Extra Strength with Nonoxynol-9
LifeStyles Nuda Plus
*According to testing reportsd by Consumers Union