My goal in writing this series of articles is not to engage in a long boring lecture about the immoral nature of premarital sex. Rather, it is to arm you with information about STDs, not just in the form of medical information and statistics, but to provide you with hypotheticals illustrating how STDs can affect your life long term. Your chances of contracting an STD in college are about one in four. You’re probably telling yourself “Doesn’t happen in my crowd.” Yes, STDs do happen in “your crowd.” All the time. More than half the participants in a study done among college students believe they can tell if someone has an STD just by looking at them. That statistic goes a long way in understanding the sociological contributors to the STD epidemic. You have the same chances of contracting an STD at your local junior college as you do at Harvard or Stanford, regardless of the crowd you hang out with there. Presidents of the “best” sororities and fraternities get infected, too. Very few of your peers are going to tell you they have an STD because 80% don’t know they are infected, or if they do know they are embarrassed about it. It’s a hush-hush thing, which serves as yet another factor that misleads college students about the epidemic nature of STDs on college campuses.
There is a reason we have 7 billion Humans on Earth. The instinct to reproduce, to have sex, is among the most powerful instincts in our species. Hormones that drive this, primarily testosterone levels in both males and females, peak around college age and start falling off around age 30. STD pathogens evolved to take advantage of this human instinct that oftentimes overrides logical cautious thinking, and they have been very successful in doing so. STD bugs don’t care who you are, what your SAT score is, what socioeconomic group you come from, or what country you inhabit. Their only job is to survive and to reproduce, and they are Equal Opportunity Infecters. The combination of alcohol (especially binge drinking) or other drugs with this overwhelmingly powerful reproductive instinct yields a synergistic, one plus one equals three advantage for transmission of STDs. The combination of hormones and intoxicants causes logical, cautious thinking to fly out the window, greatly decreasing your ability to protect yourself by using condoms, or by abstaining altogether. People who are intoxicated often have sex with people they never would have otherwise, and they are far, far more likely, directly proportional to degree of intoxication, not to protect themselves by using condoms. If epidemiologists were asked to design the top two perfect environments for STD proliferation, it would be an MTV Spring Break Party or Saturday night on a large college campus located in a major metropolitan area.
Party nights on college campuses are an STD microbe’s playground. When college kids party, STD bugs party. Remember that. We’ve all heard “Friends Don’t Let Friends Drive Drunk.” Considering the health threats, “Friends Don’t Let Friends Have Drunk Sex,” either. It’s not a bad idea to assign a second task to your Designated Driver, or assign a second person the role of Designated Drunk Sex/STD Preventer when you go to a party together. Seriously. This person needs to be a little assertive to qualify for the job, since he/she is going to grab your arm as you are leaving the party with someone, your judgment obviously impaired. The idea is to give you one chance to seriously rethink what you’re doing, not to fight with you about it or create a scene.
The most important point to be made is that sexual contact with another human being is not to be taken lightly, especially where viral STDs are concerned. Once these viruses move in to your body, they do not move out. When you have sex with someone, you are for all practical purposes as far as STD viruses are concerned, having sex with all of your partner’s partners. Millennials are known for their more fluid approach to sexuality. More of you experiment with same sex relationships. More of you describe yourselves as bisexual than previous generations. Again, no moral judgments here, but this characteristic does increase risk of STDs.
Let’s start with the most common STD: Human Papilloma Virus, or HPV. You’ve heard of genital warts. Some of you have probably seen the gross pictures of genital warts which are caused by several strains of this virus. Warts are not the biggest problem caused by HPV, however. Other strains of HPV are known in the medical community as THE cause of cervical cancer in women. Some young women are fortunate enough to have been vaccinated for some strains of HPV, but this does not eliminate their risk of cervical cancer. Young women who have had sex have very likely contracted some strains of HPV, but could still benefit from the vaccine. Those who are vaccinated will still have to be monitored, since new strains of HPV are always evolving, and the vaccines protect against only about 70% of the strains that cause cervical cancer. Just as we can’t cure the common cold because the numerous viruses that cause colds are constantly changing, neither can we cure HPV. Most men and many women become infected without their knowledge, and therefore unwittingly pass the virus on to others. There is no test for HPV in men unless they have an active lesion that can be tested. If a young man infects a young woman with HPV, she is not going to call him years later to inform him she has just been diagnosed with carcinoma in situ and has had a procedure that could jeopardize her ability to have children, and will require continuous monitoring for cancer for the rest of her life. The guy will never know about the problems his refusal to use a condom has caused in the lives of his female sex partners, unless of course he marries one of them. Many women don’t discover their HPV infection until years or even decades after being infected, when they are diagnosed through a Pap smear.
As a general rule, STDs have more health and reproductive consequences in women than in men. Young women tend to be less assertive than their older counterparts. Eighteen year old Jane College is far less likely to insist on a condom to protect herself from STDs, especially if her new boyfriend, 20 year old Joe College, who oftentimes does not know he is carrying STDs, insists on not using a condom because “it feels better.” Sixty per cent of college women say they would still have sex if their partner refused to wear a condom. Women are not quite this “door- matty” as they get older and wiser, but unfortunately STDs score big proliferation advantages from this characteristic of younger women. In a perfect world, both Jane and Joe College would always use condoms because they are aware that this sexual interlude could later cause Jane College to become infertile and/or to get cervical cancer. Since the intent here is not to scare you into abstinence, regular Pap smears protect women from cervical cancer with very few exceptions. It is far better however, to avoid infection in the first place.
Armed with this knowledge, you should insist on safe sex or no sex at all. Sexually active college students should assume they are infected with HPV if they have ever had even one incident of unprotected sex. The more sex partners you have, the more strains of HPV you are likely to have.
HPV is also strongly associated with increased anal cancers and increasingly, throat and mouth “oropharangeal” cancers from oral sex with an infected partner.
Since HPV is spread by mere skin to skin contact, it is the most common STD. Human Papilloma Virus spreads exponentially on college campuses because of its ability to evolve quickly, the difficulty those infected often have in recognizing infections, and the tendency of those who do know they are infected to keep it secret. Choose your partners carefully, watch the drinking, and above all, practice safe sex.
Next Week Part 2: Herpes, Chlamydia, and a bit about PID.