In light of recent errors, The Argus would like to set the record straight about sexually transmitted infections (STIs) on campus. While it is now well known that a recent STI testing clinic organized by the AIDS and Sexual Health Awareness (ASHA) student group resulted in three positive tests (though not for HIV, as was originally published), these results require clarification. According to Dr. Davis Smith, the University’s medical director, only one of these tests was actually a new diagnosis.
“These results are consistent with known rates of infection among the tested population,” Smith wrote in an all-campus email on Saturday. “They were neither surprising nor alarming.”
Although Smith does not see the data as reason for panic, The Argus would like to emphasize that the results do not fully represent the prevalence of STIs on campus, as only 150 students made it to the Green Street Arts Center for testing.
“Some would say that ours is a particularly sexually-active campus,” Smith said in an interview with The Argus. “I don’t know about data that supports or refutes that, but it’s a pretty commonly held notion. Whether or not that’s the case, it’s not a place that is awash in sexually transmitted infections. But by the same token, everybody should be using condoms for their first two years with a partner.”
Certain STIs are extremely common, both on campus and nationally. The most common is human papillomavirus (HPV), which often does not cause symptoms and is usually eradicated by the immune system within two years. The main problem with HPV infections is that they can be unknowingly spread between partners. HPV causes two disease states: genital warts, which are usually harmless and treatable, and precancerous changes of the cervix or anus. While these precancerous changes can lead to cancer if left untreated, they are slowly progressive and are usually quite treatable if detected early by routine screenings like pap smears.
Smith estimates that five percent of men who get tested have genital warts. Nationally, approximately 12 percent of pap smears show some abnormality.
“Most of those are very low grade and lots of them get better without intervention,” he said. “This is by no means saying that 12 percent of women have cancer. They’re called atypical cells of undetermined significance. It’s a tiny percent that wind up getting [treatment].”
Up to 60 percent of adults have Type 1 Herpes, an oral infection that can be transmitted to the genitals by oral sex. Normally, Herpes causes no symptoms, but it can cause rashes, as well as fever, aches, flu-like symptoms, and swelling of the inguinal (genital) lymph nodes.
“It’s thought that most people acquire oral herpes in early childhood. It’s always blamed on an old aunt: an old aunt who kisses you,” Smith said. “I feel bad for old aunts. It could also be uncles.”
Type 2 (or genital) Herpes is much less common—nationally, about 20 to 30 percent contract the infection. Roughly 55 percent of genital herpes among college students is caused by Type 1 Herpes. Oral sex is considered the most common mode of transmission.
Smith has limited data about overall rates of Type 1 Herpes on campus, but what he has suggests the number is less than the 60 percent of national average for adults. The Davison Health Center treats a case of genital Herpes roughly once every two weeks.
A third common STI is molluscum contagiosum, which is usually thought of as a childhood disease, but can also be transmitted by skin-to-skin contact among adolescents. It can cause red bumps on the lower abdomen that can be frozen off like warts.
Viral infections are usually undetectable to visual inspection, and testing technology is of limited utility so even people who get tested may carry Herpes or HPV unknowingly.
“I would hope that would motivate most people to use condoms,” Smith said. “Or decide not to, which is fine, but that needs to be a conscientious decision. There needs to be an informed consent. You and your partner need to talk.”
Bacterial infections are less common than viruses and easier to detect and treat. The most common bacterial STI is Chlamydia—approximately two to three percent of people who have two or more sexual partners a year have it. According to Smith, the Health Center sees an average of 15 to 20 cases a year. Most of these people show symptoms or have a partner who has been diagnosed, although most people with Chlamydia show no signs of the infection. Gonorrhea is the next most common bacterial STI, but it is so rare at Wesleyan that Smith has stopped routinely screening for it.
Unlike viral infections, which can only be managed, these bacterial STIs can be eradicated if detected.
Although no HIV tests administered last week came back positive, this correction does not imply that HIV is totally absent on campus.
“On a national basis HIV rates among college students are about one in 1000 and I would say that our experience here bears that out,” said Smith, who added that giving an exact number of cases on campus would be inappropriate.
The Health Center also tests for syphilis when desired or indicated by patient history. Rates of syphilis have risen in recent years, especially among men who have sex with men. Anonymous, Internet-mediated sex is thought to be a major risk. While there have been cases of students being treated because of contact with a positive case, the Health Center has not otherwise diagnosed a case of syphilis in years.
“Wesleyan students are really terrific in my experience about getting sexual health screening, certainly when I go to other campuses or national meetings people are really amazed, especially by how many men come in to get tested,” Smith said. “One of the things I’m very proud of is that our patient population is very representative of the Wesleyan population. I see guys from every clique and demographic imaginable.”
Of course, since some infections are undetectable, students are always encouraged to be careful.
“Life is fraught with uncertainty and sex is fraught with uncertainty,” Smith said. “Even people who are responsible and getting tested may have something that can’t be diagnosed. You have to live with that uncertainty. And if you can’t, you should keep your pants on.”
Students can get tested at any time by making an appointment with the Health Center, where costs vary depending on which tests are administered—Smith encourages students to come in not only for screenings, but also for counseling.
“I’m interested in people understanding how their bodies work,” he said. “I consider myself philosophically pro-sex. There is this possibility of infection. It’s pretty small and a little bit of communication can probably obviate the risk…All people should feel free to come in and get individualized messages.”
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