When I was a teenager in the 1970s, condoms were kept behind the counter at the pharmacy and could not be sold to minors in some states. In contrast, by the time my kids were in high school, I kept threatening to put a bowl of condoms by the front door for them and their friends. As a gynecologist who trained during the height of the AIDS epidemic in America, that’s just the way I think.
Now that HIV has become more of a chronic illness than a death sentence, the threat seems less immediate. Condom use has dropped from an all-time high in the early 2000s to about 50 percent among college students. Even more concerning is the fact that seniors are more than twice as likely to have casual sex without protection than college freshmen.
As a result, 10 million cases a year (half of all new STDs) occur in people aged 15 to 24 years. It is estimated that approximately 1 in 4 teens may contract an STD. In addition to HIV, there are a surprising number of pernicious players just waiting to put a downer on your day. Viruses, like HPV, herpes and some forms of hepatitis can cause chronic infection that is resistant to treatment. Syphilis, though much less common, is a serious disease which has made a comeback in recent years. On the other hand, the treatment for trichomoniasis, a localized infection which is somewhat harmless in comparison, is a medication which causes severe side effects when combined with alcohol. (So much for your tailgating plans!) Chlamydia is often “silent” in both men and women, but like gonorrhea, is easily screened for with routine testing. Unfortunately, most of these infections have potential for long-term effects, some are becoming more resistant to antibiotics and many are not curable.
The presence of alcohol and other substances is often blamed for the failure to utilize condoms. Although students use condoms less frequently as they progress through their college years, females are more likely than males to use them in cases which involved alcohol. Several other things may contribute to this high-risk behavior. The college population may be perceived as “low-risk” for STDs due to higher educational and socioeconomic status, when this age group is actually at greatest risk. It is likely that as time passes without an obvious negative outcome, a sense of invulnerability develops.
Evidence indicates that in addition to education, marketing and availability are keys to increasing the proper use of condoms, for both contraception and STD prevention. Hence the emergence of cool condoms and their catchy advertising: They look cool, feel great and even taste good! “You wouldn’t show up completely naked to a gun fight, so don’t show up completely naked for you know what.” Even Bill Gates funded a large project to inspire the creation of condoms which increase “pleasure, in order to improve uptake and regular use.”
As part of its mission, the USC Student Health Services describes services including sexual health counseling and screening on its website and provides a variety of free condoms and other products to members of the university community. I’d like to challenge other student organizations to adopt a “No glove, no love” philosophy by making condoms freely available without judgment or disparagement. Just grab one on your way out the door!