Prepared For: Melissa Webb

ID #29

Assignment #4: Research Report

Date: March 8, 2006

Prepared for: Melissa Webb

Prepared by: Patricia Nichols Patricia Nichols 33021802 Fletcher Hall Gainesville, FL 32612 (727) 686-4274

March 8, 2006

Ms. Melissa Webb, MAB 1515 Fifield Hall University of Florida Gainesville, FL 32609 (352) 392-4711 ext. 216

Attention: Ms. Melissa Webb, MAB

Subject: Final Research Report

I am very pleased to announce the conclusion of the research report entitled, “Sexually Transmitted Diseases among College Students.”

In this final research report, you will find statistics from both primary and secondary research yielding powerful information regarding the sexual health of college students. The survey of 28 students in AEE3033 Research/Business Writing at the University of Florida showed 82% of respondents knowing the most about HIV/AIDS, with very little knowledge of other sexually transmitted diseases. This indicates that some of the most prevalent diseases among college students, such as herpes and chlamydia, are not well- known to the majority of college students. Sexually transmitted diseases (STD) education is of particular importance among this age group.

Some recommendations to address this problem at the University of Florida include conducting a survey with a larger sample size and a mandatory course requirement for entering freshmen on the health risks of sexually transmitted diseases. These recommendations are expanded upon in this research report.

The research presented in this report on sexually transmitted diseases prompts action in the University of Florida community to educate its students on the risks and dangers of STDs. I hope you find this report compelling, and that you wish to embark on the promising journey of educating our students.

Thank you for your time.

Sincerely, Patricia M. Nichols Abstract

College students today are contracting sexually transmitted diseases at an increasingly rapid rate. Risky sexual behavior, paired with the lack of knowledge about sexually transmitted diseases, contributes to this increasing number. In this report primary and secondary research was compiled about STDs in the life of college students. A questionnaire was distributed among students in AEE3033 Research/Business Writing at the University of Florida with 28 respondents. Questions included information on knowledge of sexually transmitted disease, where they first heard about sex, and risky sexual behavior. Responses about where students first heard about sex showed a majority of respondents heard about sex from their friends before any other source. Responses also showed, congruent with research, that students have a high level of knowledge about HIV/AIDS but not much knowledge about other STDs which are prevalent among college students. Students are in need of educational programs geared towards sexually transmitted diseases other than HIV/AIDS. There is also a need for a larger sample size of students for a questionnaire of this nature. Sexually Transmitted Diseases Among College Students

By: Patricia Nichols

Introduction

For some, the topic of sexually transmitted diseases and sexual behavior is a personal, uncomfortable, and unpleasant subject. Despite the fact that sexually transmitted diseases (STDs) are extremely and increasingly widespread, the knowledge of sexually transmitted diseases in the United States and how to prevent them is not. Most people remain unaware of the full extent of the consequences of promiscuous sexual behavior, in part due to the emphasis placed on the potential for pregnancy (Reddy, 1999, p. 73). This factor, due to urgency, outweighs the other life-threatening consequences.

Though STDs are common, they are also very difficult to track. Many STDs show little or no symptoms, which also means they are likely to go unnoticed, particularly among college students. College students are more likely to be dependent on parents or guardians for medical care and would therefore be more likely to ignore possible signs of

STDs for fear of their parents or guardians becoming aware of the situation. According to the Center for Disease Control and Prevention [CDC] (2000), even diagnosed diseases are “frequently not reported and counted” (p. 1).

So where does the United States go from here? The rapid spread of STDs in the

United States is not simply going to disappear. The only way to combat this problem is with research about these diseases and their contraction, followed by knowledge and education of the general public so they can protect themselves against these diseases. The purpose of this research report is to educate the general college population about the effects of STDs, paired with information about how to avoid risky behavior that may result in contracting an STD. Alternate forms of STD education, such as packets for college freshmen and/or a required course, should also be considered. This research report presents findings that would be helpful in determining the necessity of STD educational programs for college students.

Literature Review

When people ponder unprotected sexual intercourse, two things come to mind: pregnancy and HIV/AIDS. The problem occurs when it is seen only in these terms. If this is the case, the entire realm of other known sexually transmitted diseases, including syphilis, chlamydia, herpes, and gonorrhea, are completely ignored. Chlamydia has few detectable symptoms and has been known to go undetected in women for years, which can cause internal damage leading to infertility (Nevid, 1995, p. 3). Another virus, human papillomavirus (HPV), is an extremely common and contagious STD (Morse, Holmes,

Ballard, 2003, p. 94). It can lead to cervical cancer in women, penal and anal cancer in men, as well as infertility in both men and women. Low risk strains of HPV can cause genital warts. There is no accurate testing for HPV, and it is not well known. This makes it a large risk for college students (Horner, 2004, p. 7).

According to the National Center for Health Statistics [NCHS], in 2000 there were 32, 871 new cases of syphilis, 834,555 new cases of chlamydia, and 351,852 new cases of gonorrhea (p. 4). Other statistics show that there were 918, 286 new cases of

HIV/AIDS in 2003 (CDC, p. 7). Compared to the rate of new chlamydia cases in 2002, it is evident that the frequency of STD cases is rising. If the spread of chlamydia continues at this rate, in the next few years it could surpass the rate of AIDS. It is important to take note that these numbers are only the ones that are reported, discovered, and recorded. Many cases of STDs go unnoticed and undocumented, leaving only a guess as to the actual numbers and rate at which they spread.

It is also important to keep in mind the effects of parents and guardians on contracting STDs at an older age. In one report done by the Sexuality Information and

Education Council of the United States (SEICUS) in 2000, the argument was made that primary sexual education should come directly from the parents. The report stated that though sexual education can be complemented by educators and religious organizations, it is most beneficial to the child when it comes straight from the parents (p. 3). Another report from the same council stated that those who are open with their parents and hear about sexually transmitted diseases are less likely to contract them as they grow older, even into their college years (p. 5).

Methodology

A questionnaire was distributed to 30 students in the University of Florida

Research/Business Writing class, AEE 3033, on February 15, 2006. This questionnaire had 13 questions on a broad range of topics about sexually transmitted diseases. The questions included both closed and open-ended questions. The closed-ended questions included Likert scale and demographic questions to ensure the targeted audience was reached. Twenty-eight of all the surveys distributed were returned. The survey served as the primary research method for this experiment. This information was used to help analyze and compare the data to secondary research on sexually transmitted diseases in the United States among college age students. The questionnaire was completely anonymous. A sample of the questionnaire is included in Appendix A of this research report. Results

Information was gathered through a 13-question survey randomly distributed to

30 students in an AEE3033 Research/Business Writing class at the University of Florida.

Of the 30 distributed questionnaires, 28 were completed and returned. Questions were asked to determine the demographic of the individuals involved in the study. Of the twenty-eight participants, two were male and twenty-six were female. This demographic illustrates a sample error in the research. The proportion of males to females in this study is not equivalent to the actual demographic of college students. A larger sample size would be needed to correct this error. A question was also asked to determine the age of the respondents. Of the 28 respondents, 85.7% (n=24) reported being either 19 or 20 years old. Another 10.7% (n=3) responded as being between the ages of 21 and 23. Only one person reported being in the age range of 24 or older. Not a single respondent reported being younger than 19 years old. This sample demographic would be considered typical of college students, with the average age being 19 or 20 years old.

When the respondent was asked if he/she had ever had or currently has a sexually transmitted disease, only 4% (n=1) responded “yes.” This response could be the result of a measurement error known as social desirability. This is the idea that respondents may not answer truthfully because they know how they are expected to answer by society, or what the “correct” answer is. Another possibility is that the sample error comes into play with this question. Secondary research would suggest that it is not indicative of college students that only one out of twenty-eight respondents would have an STD. A larger sample size would be needed to determine if 4% is representative of the college student demographic. One question that was particularly interesting pertained to the respondents’ knowledge of different STDs. When asked which of the following STDs they were most informed about, the majority of respondents, 82% (n=23), answered HIV/AIDS. Given the campaigns and publicity of this deadly STD, secondary research indicated that those results are not surprising. Herpes was the virus which respondents knew about secondly, with 25% (n=7) reporting to know more about it than any other. Finally chlamydia came in third with only 4% (n=1) respondent reporting to know more about it than any other

STD. Syphilis was not well-known by any respondents, and no one answered “none of the above”, indicating that HIV/AIDS is the STD about which most college students are informed. These results are illustrated in Figure 1.1. This figure illustrates the distribution of knowledge pertaining to sexually transmitted diseases.

Figure 1.1

STDs College Students are Most Informed About

s t 20 f n o e

d r 15 e n b o 10 p m s u e 5 N R 0 HIV/AIDS Chlam ydia Herpes Syphilis None of the Above

Sexually Transmitted Disease

When respondents were asked where they first heard about sex, the answers varied. The mode response was parent/guardian with 35.7% (n=10) responding in that way. Next came school or church with 25% (n=7). Third and fourth were close with

TV/movies at only 17.8% (n=5) and friends at 14.3% (n=4). Only one person responded as “other”, specifying that they did not remember where they first heard about sex. The only respondent to state that they were infected with an STD first heard about sex from friends.

When respondents were asked to determine how promiscuous most college students are, 67.8% (n=19) responded with “often promiscuous.” Seven respondents,

25%, answered occasionally promiscuous, while only 7% (n=2) answered with always promiscuous. None of the respondents answered with “not promiscuous at all.” The majority of respondents saw their peers as often promiscuous. This illustrates how the respondents see college students as a group when it comes to promiscuity.

The next two questions posed some confusion. When asked at what age which the respondent lost his/her virginity, 17.8% (n=5) answered age 16 or younger, 32.1% (n=9) answered 17 making that age the mode, 10.7% (n=3) answered age 18 and the same amount answered age 19 or above. Eight respondents, 28.6%, said they were still a virgin. The problem occurs with the answer to question number ten. This question asked how often the respondent used protection in the form of condom or barrier when having sex. Only six answered that this question was “not applicable” even though in the previous question eight said they were still a virgin. This could be due to the fact that protection can be used in oral sex, which is not always included in the definition of “sex”.

This would be a measurement error due to a lack of clarity in the question. The answers to question ten are detailed in Figure 1.2.

Figure 1.2 Frequency of Condom/Barrier Use Among College Students During Sex

14.3% Never 28.6% Rarely 10.7% Sometimes Usually 10.7% 14.3% Always

The breakdown of the previous percentages is as follows: 28.6% (n=8), 14.3%

(n=4), and 10.7% (n=3). This illustrates the amount of students who never or rarely use protection, which is approximately 25% (n=7). That would mean that one out of every four respondents in this survey rarely or never use protection in the form of a condom or barrier when engaging in sexual intercourse.

Conclusion

The information collected from the 28 completed questionnaires and in secondary research shows that college students have a generally low knowledge of STDs and a high level of risky sexual behavior (DESA, 2004, p. 3). Both these factors could help in leading to the contraction of sexually transmitted diseases. Even though only one respondent in this survey reported ever having a sexually transmitted disease, responses to other questions would statistically suggest this is not the case.

One recommendation that should be given consideration is conducting this same survey with a larger sample size. Out of the 30 surveys that were distributed, 28 were completed and returned. Only one of these respondents reported having a sexually transmitted disease. This is not congruent with statistics found in secondary research. According to the American Social Health Association [ASHA] (2002), about half of all new sexually transmitted diseases in the United States in the year 2000 occurred among youth ages 15 to 24 (p.3). The median age range of this group would be college students.

This leads to the question of whether respondents feel into the social desirability error and did not answer honestly.

Another possibility is the respondents are unaware that they are currently carrying an STD. A sample of 5,000 out of the 48,000 students at the University of Florida would yield a response rate of at least 2,000, which would be a sufficient amount to conduct reliable research concerning STDs among college age students in Florida. Once a sample size of at least 2,000 students responded to the survey, more accurate data could be obtained to determine whether or not STDs are a significant problem among college students. Though the primary research would suggest that only 4% (n=1) of the respondents have had STDs, if the survey was completed on a larger scale, the responses would probably yield a greater percentage of students who have had STDs.

One question mentioned in the results section of this report was concerning the respondents’ knowledge of different STDs. This included HIV/AIDS, syphilis, chlamydia, herpes and a “none of the above” option. Eighty-two percent (n=23) of the respondents said they were most informed about HIV/AIDS. Only 25% (n=7) had knowledge about other STDs. Though the widespread knowledge of HIV/AIDS is very beneficial and important in society, the need for other sexual health knowledge is important. These other diseases, if gone undetected, can lead to infertility, as well as other health problems, including death. Funding for sexual health programs for college students is imperative for their well-being. One option would be to formulate a packet of information that would be given to every incoming student at orientation. Every new student must go through the orientation process, so this would be a great method to ensure everyone received the materials. Another option would be to implement a course that is required for all incoming students to enroll in. The course would include, but not be limited to, information on sexually transmitted diseases and risky sexual behavior that would increase the risk of contracting a STD. One focus would be placed on knowledge of sexual partners’ history. One study indicated that disease risk is increased for people who do not know their partners’ sexual history (Hollander, 2004, p. 217). Another option, rather than requiring an entire course, would be to add to the curriculum for First Year

Florida courses. These courses are for incoming students to become acquainted with college life and the University of Florida. Mandatory curriculum could be implemented to include the information on sexually transmitted diseases. Any or all of these recommendations would help in the education of University of Florida students on the dangers of STDs.

Sexually transmitted diseases are an increasing problem for college students.

Faced with difficult decisions, many students do not know where to turn. Many students are not aware of the risks associated with promiscuous sexual behavior, and adopt the “It can not happen to me” mentality. It is the goal of this research to bring to light these issues, and succeed in educating college students on the dangers of sexually transmitted diseases. Through the implementation of educational programs, the University of Florida community can effectively mitigate the impact of sexually transmitted diseases.

References

American Social Health Association (2002). STD/STI Statistics/Fast Facts. Retrieved February 11, 2006 from www.ashastd.org.

Centers for Disease and Control Prevention. (2000). Tracking the hidden epidemics: trends in STDs in the United States. Atlanta, GA: Centers for Disease and Control Prevention.

Department of Economic and Social Affairs. (2004). Population, reproductive rights and reproductive health with special reference to HIV/AIDS: a concise report. New York: United Nations.

Hollander, D. (2004). Disease risk is increased for those with wrong ideas about partners’ behavior. Perspectives on Sexual and Reproductive Health, 217-218.

Horner, M. J. (2004). College males awareness of and attitudes toward the human papillomavirus. Gainesville: University of Florida.

Morse, S., Holmes, K., Ballard, R. (2003). Atlas of Sexually Transmitted diseases and AIDS. London: Mosby.

National Center for Health Statistics (2000). Monitoring the Nation’s Health. Retrieved February 10, 2006 from www.cdc.gov/nchs.

Nevid, J. S. (1995). Choices: Sex in the age of STDs. Boston: Allyn and Bacon.

Reddy, S. P. (1999). Sense and Sensibilities: the psychosocial and contextual determinants of STD-related behavior. Tygerburg, South Africa: Medical Research Council, Corporate Communication Division.

Sexuality Information and Education Council of the United States (2000). Establishing National Guidelines for Comprehensive Sexuality Education, Lessons and Inspiration from Nigeria. Retrieved February 11, 2006, from www.siecus.org.

Appendix A ID# 29 Sexually Transmitted Diseases among College Students

I am a student at the University of Florida in the College of Agricultural and Life Sciences and the College of Liberal Arts and Science. I am conducting a survey for a research/business writing class. The purpose of this survey is to determine the knowledge, as well as opinions, of college students on sexually transmitted diseases. I am asking for your help in gathering this information, which will be utilized to assess attitudes towards sexually transmitted diseases. There are no risks or benefits involved with this survey, your information will be kept confidential and no part of these results will be published.

Please answer the following questions to the best of your ability, choosing only one answer.

1. Have you ever had/do you currently have a sexually transmitted disease? a. Yes b. No

2. If you answered yes to the above question, was this STD contracted during your time in college? a. Yes b. No c. Not applicable

3. Which of the following sexually transmitted diseases are you most informed about? a. HIV/AIDS b. Chlamydia c. Herpes d. Syphilis e. None of the above

4. Where did you first hear about sex? a. Parents/Guardians b. TV/Movie c. School/Church d. Friends e. Other: please specify______.

5. In your opinion, how promiscuous are most college students? a. Not promiscuous at all b. Occasionally promiscuous c. Often promiscuous d. Always promiscuous 6. If you have contracted an STD, did this occur while under the influence of a drug, such as alcohol or marijuana? a. Yes b. No c. Not applicable

7. How often do you go to places such as bars, clubs, etc where underage drinking occurs? a. Never b. Sometimes c. Often d. Very often

8. Are you in a committed, long-term relationship? a. Yes, over 6 months b. Yes, under 6 months c. No, but dating occasionally d. No, not dating at all

9. How old were you when you lost your virginity? a. Under 16 years old b. 17 years old c. 18 years old d. 19 and above years old e. Still a virgin

10. How often do you use protection in the form of a condom or barrier when having sex? Please circle your answer.

0 1 2 3 4 5 Never Sometimes Always

11. Did you know the sexual history of your last sexual partner? a. Yes b. No c. Not applicable

12. What is your gender? a. Male b. Female

13. What is your age? a. 17 to 18 b. 19 to 20 c. 21 to 23 d. 24 or older