Infectious Behavior: You Gave Me What?

When you bring home a one-night stand from the local bar, or even step barefoot into a dorm shower, you may be putting yourself at great physical risk.

So we spoke to doctors from several universities about sexually transmitted infections, sexual dysfunction, steroids, pregnancies and even pubic-hair removal. It wasn’t pleasant.

I. You gave me what?
Most college-student health centers spend lots of time screening patients for sexually transmitted infections, or STIs. Doctors say the number-one reason students schedule appointments is for Pap tests or pelvic exams. Their results might come as a surprise: You’re definitely carrying something, and that something is called HPV. Dr. Davis Smith, medical director of the student health center at Wesleyan University, says: “For college-aged students moderately sexually active – about two to three partners a year – the likelihood of exposure to an HPV (Human Papil-lomavirus) is 100 percent.” Ouch!

Information about HPV, though widely available, varies in content, and much of what’s disseminated is an exaggerated scare tactic, says Dr. Smith. Even though most sexually active students are probably carrying at least one type of HPV, the likelihood of having a high-risk type (which can lead to anal or cervical cancer) is very low. Some types of HPV can lead to genital warts; yes, they’re unattractive and can be passed on to a partner, but they don’t pose a medical threat. Just use condoms and get regular check-ups to be safe, OK?

After HPV, the most common STIs on campuses include chlamydia, molluscum and herpes. Thankfully, most campus doctors interviewed reported few or no new cases last year of gonorrhea, syphilis and HIV.

Dr. Scott Spear, director of clinical services at the University of Wisconsin, Madison, says that herpes is often spread because people don’t realize that oral herpes (‘cold sores’) can be transmitted to the genitals. Many of his patients with genital herpes have contracted the infection through oral sex.

II. Failing the Test
Melissa Kenzig, director of health promotion at Columbia University, reports that more than 60 percent of female students nationwide claim to have had a routine gynecological exam (which tests for the most common STIs) in the past year. Far fewer men get screened for STIs, and, according to most doctors we asked, will get tested only if they have symptoms or particular risk factors.

Some students fail to get tested until it’s too late, falsely believing they were being safe by limiting their sexual encounters to numerous monogamous relationships. Dr. Kelly Bennett, medical director at Texas Tech University, says ‘serial monogamy’ can still result in her patients testing positive for STIs. “In their minds, they’re not promiscuous because they’re not cheating. You can still pick up STDs from changing partners – even if partners have only had sex within monogamous relationships.”

Dr. Brad Buchman, clinical director of student health services at the University of California, San Diego, claims that very few students on his campus are ‘sleeping around.’ A recent poll conducted by the school’s clinic reveals that 60 percent of respondents claimed to have had no, or only, one partner in the past month; only five percent said they’d slept with more than five people in the past month.

Dr. Buchman, though unsure, believes that “most people with multiple partners are using condoms a majority of the time.” Dr. Bennett, at Texas Tech, isn’t so optimistic, estimating that 75 percent of her patients are active, and less than 50 percent of them are using condoms. A third of those who don’t use condoms are promiscuous, she estimates. Moreover, Dr. Bennett said, many students with HPV won’t tell their partners. With chlamydia or herpes, however, students tend to fess up.

III. Guilt, drugs and small children ‘ feel like sex?
There are those who have sex – and those who can’t. Many college students suffer from sexual dysfunction. As Wes-leyan’s Dr. Smith says: “I saw so many last year with dysfunction, I gave a talk on it.”

Although erectile dysfunction, impotence, premature ejaculation and lack of sex drive were common complaints among male patients, doctors interviewed agreed that sexual problems are rarely physiological. Dr. Smith estimates that 95 percent of cases are emotional or psychological in origin. “The atmosphere for sex is so charged and there’s so much pressure,” he says. ‘All of a sudden a guy is in bed with someone he hardly knows, and he kind of panics, and the penis is expressing that.” Ah, yes: penis ennui.

Antidepressants are a big cause of erectile dysfunction, according to Dr. James Farrow, director of the men’s clinic at Tulane University’s student health center. Although sexual side effects are common, they can usually be overcome with drugs such as Viagra, which the doctor prescribes temporarily until the patient regains sexual confidence.

Feeling guilty about sex often manifests itself in physical problems, says Dr. Kelly Bennett, especially at a school such as Texas Tech, which is mostly Catholic.

Another cause of erectile dysfunction is steroid use. Steroid-users tend to avoid medical exams because the signs are obvious to doctors. Thinning hair and bad acne are definite clues. “The kicker,” says Dr. Bennett, “is when you find their testicles have shrunk to the size of small grapes.”

A more worrisome sexual problem may be the occasional unwanted pregnancy. Dr. Spear at UW-Madison says that the availability of emergency contraception, often referred to as ‘the morning-after pill,’ has decreased by about half the number of positive pregnancy tests, from 13 percent to seven percent. Those who are pregnant usually get abortions, Dr. Spear says. At Texas Tech, Dr. Bennett estimates that 2/3 of her pregnant patients abort. “They are usually younger, in a new relationship or unsure who the daddy is,” she says. “Most girls in long-term monogamous relationships keep their babies.”

IV. Unusual Inquiries
Dr. Smith, at Wesleyan, says he sees a surprising number of male patients who have contracted genital warts or a staph infection from using a friend’s clippers to trim their pubic hair. Forty percent of the doctor’s male patients do pubic-hair maintenance, and a skin infection is not uncommon. The doctor’s first question is often whether the patient is sharing his clippers or razor.

Dr. Kelly Bennett, at Texas Tech, after treating a woman with a severe vaginal discharge, fielded the question: “Does it taste bad to you, too?”
Another patient claimed she couldn’t be pregnant: She was a lesbian. Yes, she had slept with a male friend but assumed there was no risk because she ‘wasn’t attracted to him.’ If we had a dime for every time that happened to us….

V. Fun Facts
75 percent of college students had zero or one sexual partner in the past school year. Of those:
3.3 percent reported using a condom the last time they had oral sex.
48.6 percent reported using a condom the last time they had vaginal sex.
23 percent reported using a condom the last time they had anal sex.

Data collected from the 2003 National College Health Assessment, coordinated by the American College Health Association and reported by Melissa Kenzig of Columbia University.

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