SEX | SEX | AND MORE SEX!!!

02. 6.10

About 1 million adolescents and young adults aged 10-24 years were reported to have chlamydia, gonorrhea, or syphilis in 2006. Nearly a quarter of females aged 15-19 years, and 45 percent of those aged 20-24 years, had a human papillomavirus (HPV) infection during 2003-2004.

College offers an opportunity for new experiences and developing one’s identity but it is also a time during which young people are faced with many new challenges and exposed to unfamiliar and sometimes unsafe environments. It is then to no surprise that about half of incoming college freshmen will have their first sexual experience in college.¹ In 2006, 14%, or 5259 individuals, of the total population diagnosed with HIV/AIDS [that year] were between the ages of 13 and 24.²Young people make up a large part of those infected with sexually transmitted diseases (STD’s) and college students greatly contribute to these statistics as in 2008, 39.6% of 18 to 24 year-olds were enrolled in college.³ It is mostly due to risky sexual behaviors such as “hooking up,” the act of taking part in any intimate behavior from kissing to having intercourse with an individual you are not in a committed relationship with, that put college students at risk for contracting HIV and other STD’s .^4,5 Early pregnancy, or becoming pregnant at a younger age, and unplanned pregnancies have been a problem in the United States for several decades. Lonczak et al. state that according to the National Center for Health Statistics, more than 900,000 teenagers become pregnant every year. In other words, about 10% of women between the ages of 15 and 19 will become pregnant.⁶ The average age of students entering college is 18 years and the college student population therefore experiences early pregnancy as well. Risky sexual behaviors and the misuse or lack of use of contraceptives continues to put college students at risk for the contraction of STD’s and unplanned pregnancies.

In his study of contraceptive use among female college students, KD. Bryant states that 80% of college women are sexually active and not seeking to become pregnant. ¹⁷ Unplanned pregnancies, along with the acquisition of STD’s, are due to risky sexual activities, in other words, due to “unsafe sex.” Scientists tend to define what risky sexual behavior is based on the type of study they are conducting. However, overall, it can be said that a risky sexual behavior is any sexual activity undertaken by the individual that puts him or her at risk for some type of health implication such as contracting a sexually transmitted disease or having an unplanned pregnancy. Risky sexual behaviors include, but are not limited to, having unprotected sex, multiple partners and one-night stands. ⁹ “Hooking up” is another type of risky sexual behavior that has become an alternative to dating and being in committed relationships, especially among the youth.

“Hooking up” can be defined as taking part in some type of intimate behavior, from kissing to intercourse, with an individual the person in question is not in a committed relationship with. The behavior is commonly chosen by college students and usually involves alcohol consumption and binge drinking. ⁴Due to its connection with alcohol, this behavior is sometimes exercised when the students are too intoxicated to understand the consequences their actions may have.

Alcohol, along with drug usage, peer pressure, social norms, and other factors, make the behavior more likely to occur. According to the National Institute of Health (NIH), risky sexual behaviors, whether they take place with or without consent, are more likely to occur among students who are heavy drinkers. Alcohol therefore increases the risk of one being involved in a sexual assault or having unplanned and unsafe sex. ¹⁰

In a particular study involving college students, it was found that only about 50% of the students who took part in a hookup involving intercourse were worried about contracting a sexually transmitted disease. The majority of students, regardless of the level of sexual interaction they had during the hookup, were not concerned at all about contracting an STD. Results showed that there were three main reasons for this: 1) they put too much trust into their partners, 2) they placed too much trust into their community, in other words, they believed that being from a Midwestern state put them at a lesser risk for STD’s, and finally 3) they were not properly educated on the risk of contracting an STD, particularly when it came to oral sex. ⁴

Another way college students partake in risky sexual behaviors is by not using or the misuse of contraceptives. In another study, 262 sexually active college students were surveyed and it was reported that three-fourths of them either did not use a condom at all or did not properly use one. Additionally, one-third of them reported having had more than one sexual partner in the past 11 weeks. ⁵ According to the CDC, it is only when males use latex condoms consistently and correctly that the risk of STD transmission is reduced, although it is never entirely eliminated. When it is not consistently used or improperly used, the protective effect is diminished. ⁸ If the college students’ actions in the previously mentioned study represent the greater American college student population, the study shows that they are at a great risk for STD acquisition.

As previously mentioned, pregnancy is also a common consequence of having unprotected sex in college students. In a study by Mary Hickey with a sample size of 609 female college students between the ages of 18 and 24, 15% of them indicated having previously been pregnant. Out of the 15% group, 87% had been unplanned pregnancies. ¹⁶Taking part in risky sexual activities therefore results in various health issues.

A study that took place in the 1990’s showed that the prevalence of STD’s in college samples ranged from 5 to 20% and that 1 in every 500 students were infected with Human Immunodeficiency Virus (HIV). ⁹ Although, STD and HIV rates are different today than they were in the 1990’s, this clearly shows that it has been a very real and important issue in the college student population for many years. Nonetheless, not all college students partake in this type of behavior. In a study by Prince et al., it was found that 72% of sexually active students who used condoms did so due to fear of HIV contraction and about 75% of them had a conversation about HIV prevention with their partner. ¹⁴ “Safer sex” is therefore possible when the individuals are more educated on the actual risks of having unprotected sex.

Espinosa-Hernandez et al. state that according to the CDC, HIV infection rates are higher in ethnic minorities than for White Americans in the United States. In a study at an urban minority-serving university, 14% of the 1130 students sampled reported taking part in risky sexual behavior, defined as having had more than one sexual partner within the past year and not having used a condom during vaginal intercourse.⁷ In another study where sexual behaviors, attitudes and ethnic identity were being compared, it was found that among three ethnic groups: Whites, Blacks, and Latinos, Latino Americans were reported as having riskier behaviors in regards to condom usage. Additionally, it was found that White Americans were less fearful of AIDS than the other ethnic groups. ¹¹ In a 2006 CDC report, the number of HIV cases diagnosed among those between 20 and 24 years of age and divided by race and gender were as follows:

Table 1. Cases of HIV/AIDS diagnosed in 2006 by race/ethnicity and sex among the 20-24 year-old in the U.S. population

White	Males: 703	Females: 192
Black	Males: 1579	Females: 654
Latino/a	Males: 568	Females: 184
Asian	Males: 28	Females: 10
American Indian	Males: 5	Females: 8
Native Hawaiian/Pacific Islander	Males: 10	Females: 0

When analyzing the data outlined in the table, it is clear that HIV/AIDS has a high prevalence in Black (or African American) males and in the Black population as a whole. In another study, it was stated that African Americans account for 56% of all reported HIV cases in the U.S., which is more than half of the American population as a whole.¹³

Race/ethnicity then does have a trend when it comes to HIV/AIDS numbers in the United States. As previously mentioned, this is also apparent with other sexually transmitted diseases. Kennedy et al. state that according to a Gurman and Borzekowski study, 59% of Latina college students, out of a sample of 1000, did not use protection during their last sexual encounter. These same women had also engaged in anal sex with four or more partners within the past year. These risky behaviors put them at a greater risk of contracting an STD or becoming pregnant. Studies have shown that Black and Latina female college students have a disproportionate rate of unintended pregnancies. ¹⁷

College students’ risky sexual behaviors are also associated with the environment they are in. For instance, in one study, it was found that those involved with fraternities or sororities had more sexual partners within the past year but that their condom usage was the same as the non-Greek student population. Table 2, taken from the study, outlines this difference:

Table 2. Mean or frequency of sexual behavior and norms by Greek membership

Having multiple sexual partners during a short period of time being a type of risky sexual behavior should be prevented as much as possible. The aforementioned study therefore shows a trend in students affiliated with the Greek system being at a greater risk for STD’s and unplanned pregnancies due to having multiple partners. ¹² Another subgroup of college students who partake in unsafe sexual activities are athletes. According to Grossbard et al., studies have shown that there are greater sexual risk-taking behaviors, as well as alcohol use, in college athletes when comparing them to non-athlete college students. ¹⁵

One underlying reason for the behavior of practicing risky sex is that college students tend to not view themselves as the type of person who is at risk of becoming infected with an STD. ⁹ This therefore causes a problem as far as disease prevention is concerned. If students do not believe that they could easily become infected with an STD or become pregnant [if the student in question is female] then they will continue to fail in practicing “safer sex.” (i.e.: contraceptive use, having monogamous relationships, etc.) Other than feelings of invincibility, reasons that women under the age of 24, according to a study outlined by Kennedy et al., take part in “unsafe sex” are due to being inexperienced in negotiating sexual relationships, having the desire to have sex and developmental vulnerabilities. ¹³ If one is sexually active because of the desire to have sex or the feeling of comfort it gives them then it will be hard to tell them to be abstinent. However, these individuals can be educated on why they should practice “safer sex”.

In essence, sexual abstinence is the only way to have “safe sex.” The use of various contraceptives including latex condom usage is known as “safer sex.” Since the majority of college students are sexually active⁵, it is of immense importance to continue the promotion of prevention programs that aim at educating students on how to take part in safer sex practices starting at an early age. The target college student population should be students of color, especially Blacks and Latinos, as they comprise the larger number of STD and unplanned pregnancy cases. The push for abstinence that was practiced for many years did not help in significantly reducing STD contractions or unplanned pregnancies in the general population and in college students; instead, as a result, students are not as educated on good sex practices or on how one becomes infected with STD’s.