Taking the Initiative

Last spring, The Crimson published a series of articles which reported an alarming increase in the number of chlamydia cases treated at University Health Services (UHS) in the first three months of 1998. This prevalence rate exceeded the figure provided for the greater Boston area by the Massachusetts Department of Public Health. With over 60 percent of students on campus reporting sexual activity (Aids Education & Outreach survey, Fall 1998), the response to this report was surprisingly muffled.

However, on the one year anniversary of the UHS report, the TV newsmagazine 20/20 contacted officials at UHS to solicit interviews for a report they were planning on airing, one which would uncover a supposed epidemic of sexually transmitted infection (STIs) at Harvard. The reality is that Harvard lies somewhere in the middle of this spectrum of alarm--on one hand, last spring's UHS report should awaken Harvard students to the fact that they are not immune to sexually transmitted infections; on the other, the prevalence of STIs on the Harvard campus should not elicit irrational alarm. Rather, the proper response by sexually active students should be to educate themselves about sexual health issues and to protect and empower themselves in their sexual activities.

The fact that students are not talking about STIs is not surprising. Many students on campus are not sexually active. Sexually active students often feel uncomfortable discussing these sensitive and private issues, even with their doctors. Infections occur as a result of this silence. At the other extreme, some student perceive themselves to be invulnerable to infection, whether it be because they believe that their sexual activity is limited to members of an insolated community or because they don't think that infection can happen to them. The myth that Harvard students are not at risk for contracting STIs must now be shattered by the UHS statistics.

Regardless of the rationale behind the limited discourse about sexual health issues on campus, the dangers of sexually transmitted infections cannot be underestimated. According to the US Public Health Service, over 33,000 Americans become infected with an STI each day. At least one in four Americans will contract an STI some time in their lives. Some viral STIs including genital herpes and genital warts can be transmitted via skin-to-skin contact, and are incurable. In up to 75 percent of individuals infected with chlamydia (the most common STI on college campuses), gonorrhea, and/or other bacterial infection, symptoms never appear. However, if left untreated, these infection often lead to complications such as sterility, cervical cancer, and/or pelvic inflammatory disease. STI infection should be of particular concern to sexually active women, as infection are more easily transmitted to women than to men. In addition, health problems associated with STIs are often more common and serious in women than in men. Early diagnosis of infection is key--many of the most common STIs (including chlamydia and gonorrhea) can be cured with antibiotics. What is at stake is not only one's personal health, but also the health of his or sexual partners--present and future.

Then how do you protect yourself and your partner? Sex educators often speak of a spectrum of risk and encourage individual to engage in the lowest risk activities they perceive as reasonable for themselves. At one end of the spectrum is abstinence, which is the behavior of choice among Harvard student, whether it be because of moral, religious or health reason. Abstinence is, in fact, the only sure-fire way of protecting oneself from infection by STIs.

However, for student who choose to engage in sexual activity, the most effective means of protection are education and empowerment. An excellent source of information is one's primary care physician. Every sexually active person should request an STI screening with each regular checkup--it is a common and recommended procedure, but one that will not be administered unless requested. Other sources of information and facts can be accessed via the AEO (Harvard AIDS Education & Outreach) homepage (www.hcs.harvard.edu/~aeo), which is linked to STI information pages sponsored by the CDC, American College Health Association, and other health organizations.

Armed with this information, it is the responsibility of every sexually active individual to empower themselves in negotiations of sexual behavior. For the sake of your physical as well as emotional health, take all the precautions that you need to make yourself as comfortable with the encounter as you can be. These precautions include communicating with your partner--discuss your and your partner's sexual histories and be honest. At the same time, for the sake of your own health and safety, take care in trusting your partner, especially a new one. Do not hesitate or be afraid to say no--many people realize too late the consequences of their sexual behavior far outweigh its ephermeral pleasure. Set your own personal limits of sexual behavior before each sexual encounter and maintain them. Most importantly, be prepared--educate yourself about sexual health issues, empower yourself in your sexual negotiations and protect yourself in your sexual encounters.

During the past two months AEO has instituted a campus-wide condom availability program with the support of UHS, the Undergraduate Council, and other campus peer education and counseling groups based on the recommendation of several hundred student surveyed last spring by our organization. Condom boxes have been placed in all undergraduate houses, where students have access to a constant supply of free lubricated and non-lubricated condoms, lubricant, and instructions on proper condom use, and are restocked weekly. We encourage students to utilize this resource if they choose to engage in sexual activity, but warm that condoms are only effective if used correctly, and do not provide sufficient protection from certain STIs which are spread through skin-to-skin contact.

On this one-year anniversary of the UHS STI report, the hope is that this editorial will spark awareness, self education, and discussion about sexual health issues among students on campus. For any of a number of reasons, college students often overlook concerns about their personal health. I urge you, amidst this season of midterms and with Spring Break approaching, to take a few minutes to educate yourself about sexual transmitted infections if you are sexually active and to assume an active role in taking care of your sexual health. David Chao '99 is a co-director of Harvard AIDS Education & Outreach