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Fewer students sexually active, but condom use still low

STANFORD - Fewer Stanford students are sexually active, but among those who are, the rate of condom use is still low, according to a survey just released by Cowell Student Health Services.

Of 1,155 students who filled out anonymous survey forms in May 1993, 71.8 percent said they had been sexually active during the previous school year - down from 76 percent in 1990.

About half of the respondents said they had made “a significant life change” because of HIV/AIDS, ranging from remaining a virgin (14 percent) or insisting on condom use (13 percent), to seeking a lifelong partner (6 percent) or stopping sex altogether (3 percent).

At the same time, 71 percent of those not married or in long-term relationships who had penovaginal intercourse - and 73 percent of those not married or in long-term relationships who had anal intercourse - said they did not use condoms consistently for the transmission of HIV and other sexually transmitted diseases. Indeed, 10 percent of these students said they used no contraception at all.

“What we've seen in the campus culture is that students are exercising much more caution about being sexually active at all, and if so, who their partners are,” said Carole Pertofsky, director of the Cowell Health Promotion Program. “Students are also waiting longer, and I hope this results in a better quality of relationship for everybody.”

Regarding the low rate of condom use, she added, “I think that the issue of changing behaviors, and particularly behaviors that are linked to human pleasure, is very challenging work. I think we've made a mistake by approaching HIV education as a technical issue, where all we need to do is describe condoms and how they work, and everybody will be on track. In fact, this is a terrifically complex set of behaviors at the intersection of philosophy and religion and psyuchology.”

She said she hopes recent Cowell efforts, including a free, anonymous HIV-testing program and a new residence-based peer health counselor program, will make students less complacent about HIV. “While the odds [against getting HIV] are in most people's favor,” she said, “none of us who are sexually active are not at risk. Nationally 1 out of 500 students is HIV positive, and Stanford students are no different.''

Cowell Student Health Services surveys Stanford students every three to five years on their health and health-related behaviors. The 1993 questionnaires were mailed to a random sample of 2,987 registered students, about 20 percent of the student body. Of these, about 39 percent were filled out and returned.

General health good

Generally, the survey found, Stanford students feel good about their physical health status, with 85 percent describing their health as good or excellent.

Paralleling other recent surveys and national campus trends, few Stanford students said they use any substances, legal or illegal, with the notable exception of alcohol (85 percent said they had drunk alcoholic beverages in the past year). About half said they engaged in regular aerobic exercise three or more times a week. More than 80 percent reported always wearing their seatbelts while riding in automobiles.

The survey uncovered some marked gender differences. Just 18 percent of undergraduate women and 23 percent of graduate women described their health as excellent, compared to nearly 38 percent of undergraduate men and 30 percent of graduate men.

One of the students' biggest complaints was lack of sleep. Only about one in 10 said that they get enough sleep every night to feel rested, with undergraduate students reporting significantly less sleep than graduate students surveyed. Nearly one in four said they felt tired without any apparent reason, often or almost always.

“Scientific studies have shown that college students are the second most sleep-deprived population in the United States, the first being medical school interns and residents,” the study said. “Stanford students, especially undergraduates, seem to follow this national norm.”

Students also voiced concerns about nutrition, weight and body image. Although most had desirable “body mass indexes” according to criteria set by the American College of Sports Medicine, only one-third of students questioned said they felt their weight was acceptable.

Again, sharp gender differences were noted. Nearly half of undergraduate women respondents reported dieting during the school year, while just 8.5 percent of undergraduate men respondents reported dieting. (Only 3 percent of students surveyed reported clinical indications of an eating disorder, however.)

Bicycles appear to be a particular hazard for students on the Stanford campus. While one in eight respondents reported a bicycle accident in the previous year, less than one in three reported wearing a bike helmet even occasionally, putting themselves at greater risk of head injury.

“The National Health Objectives for the Year 2000 have a goal of 50 percent of bicyclists always wearing safety helmets,” the survey report said. “The difference between this goal and our student rate of helmet use highlights a significant campus challenge to increase safety among cyclists.”

Sex, alcohol data

In addition to providing information about general student health and safety behaviors, the 1993 survey offers the most detailed statistics yet gathered on Stanford student sexual behavior. Among the findings:

  • Among respondents who had been sexually active during the school year, 93 percent reported activity with only the opposite sex.
  • Nearly 70 percent said they limited their activity to only one partner, about 15 percent said they had limited themselves to two partners, and another 15 percent said they had three or more partners during the year.
  • About 47 percent of the sexually active students had been tested, or planned to be tested, for the HIV antibody. Of those who had, 0.1 percent reported positive status.
  • Women reported a significantly higher level of confidence than men in their ability to insist on safer sex behavior in high-risk situations, from refusing sex without a condom to asking a partner about previous HIV history.

For many students, the survey showed, sex and alcohol are linked. Forty-three percent of sexually active respondents said that they had sex under the influence of alcohol or drugs during the school year; 8.2 percent said it happened several times a month and 35.2 percent indicated it happened a few times a year.

Of the 83 percent of respondents who said they do drink alcohol, about 27 percent reported drinking three to five drinks per episode.

“A significantly larger percentage of undergraduate men (51 percent) are in this category,” the survey said, “and a significantly greater percentage of undergraduates than graduates drink three or more drinks per drinking day.”

More than a third of all respondents said that they had driven or been in a car with an intoxicated driver during the school year, 16 percent said they had some memory loss related to alcohol, and 13 percent said they had missed classes because of alcohol consumption.

Mental health data

In their personal lives, most respondents said they often or always feel energetic (64 percent) and over half are very satisfied with their academic performance. Most also said they were satisfied with their relationships with their parents, partners and friends. A smaller majority were satisfied with their relationships with roommates, professors and advisers.

Four in five students said they felt at least some stress in their personal or family lives. One out of three students said they felt anxious or tense often if not almost always, and half of all student respondents said they often or almost always felt overwhelmed by things to do.

One in four of the student respondents said they “often or almost always felt tired without any apparent reason” (compared to one in five in 1990). One in five students said they felt lonely often or almost always; and the same proportion reported feeling at least sometimes “that life is not worth living.”

“Stanford students see themselves as resilient, but a significant number also experience substantial psychological distress,” the report noted. “There are important gender differences in this area.”

For example, of the few students not satisfied with their appearance, the majority were women. Women also were more likely than men to have mixed feelings about their academic performance at Stanford, and to feel anxious, overwhelmed by things to do, tired without apparent reason, lonely, depressed and to feel at least occasionally that life is not worth living.

“Given the high expectation Stanford students have of themselves, and the tremendous academic challenges they take on, it's really important that we maintain a strong safety net for these students,” said Alejandro Martinez, director of Counseling and Psychological Services at Cowell.

“While from the outside the university is often perceived as an oasis from the real world, our data clearly indicate that students are not immune from the day-to-day stresses of life or from those acute traumas that everyone faces in their lives.”

Women in particular, Martinez said, “are experiencing significant distress at Stanford and we need to pay more close attention to their needs.”

It may be, he said, that women are more willing to discuss the stress that they are under and that men are more guarded in their survey responses.

“But I also think women have tremendous expectations of themselves, and probably a higher sense of responsibility - not just for themselves but for others. The environment is also in some ways harsher for them here at the university. There needs to be a significant level of support, not just personal and psychological, but intellectual and academic as well.”

A summary of the findings is available by calling Martinez at 723-3785. A complete report will be available by April 1.



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