HIV/AIDS Risk in the College Population: Modifying the Culture in a Private Religious University.

From 1991 to the present, the AIDS Task Force in a private religious university has established a broadbased, multidisciplinary, multifaceted program aimed at reducing sexual risk taking as well as related behaviors. This has been accomplished at no cost to the university. The task force has focused on facilitating linkages among interested groups within the university and on maintaining quality programming. Success is indicated by increased openness to dialogue about sexual issues, as well as increased participation in AIDS education activities.

Key words: HIV/AIDS education, college students, high-risk behaviors.

In its most recent study of HIV prevalence in the college population, the Centers for Disease Control and Prevention estimated that 1 in 500 college students was HIV-infected (Gayle et al., 1990). Surveillance from then until now shows that the greatest increase in HIV infection is in the young adult population (Centers for Disease Control and Prevention, 1998). Across the United States, institutions of higher education are - concerned that the college environment, which affords young people a new and greater degree of independence, also increases the risk of transmission of HIV.

The university community under consideration is a medium-size private religious institution in a suburban setting within the mid-Atlantic region. Most of the 6,150 resident undergraduate students come from metropolitan areas within the mid-Atlantic and northeastern states, long recognized to be epicenters for HIV/AIDS (Centers for Disease Control and Prevention, 1998).

An annual survey conducted by the university confirms that the student profile of this campus community approximates the national student profile in terms of sexual risk taking and related high-risk behaviors such as alcohol use. Over the past 6 years, the university AIDS Task Force has devised numerous strategies for modifying the campus culture in relation to AIDS/HIV risk. That this has taken place in a religiously affiliated institution is noteworthy. To its credit, the AIDS Task Force has never received a budget from the university. All of its activities are funded through ribbon sales, other fund-raising, and donations from student organizations across campus. Among secular as well as religiously affiliated schools within the region, this institution is regarded as a leader in the area of HIV/AIDS prevention. These strategies will be described below.

Review of Literature

By the age of 19, well over three quarters of American women and men have experienced sexual intercourse (Sonenstein, Pleck, & Ku, 1991; Trussel & Vaughn, 1991). College students are fairly knowledgeable about HIV/AIDS (Jacobs, 1993; Lewis, Malow, & Ireland, 1997). However, there is little evidence to date that high-risk behavior is diminishing (Lewis et al., 1997; Resnick et al., 1997). Sexual risk taking reflects students' claim to "just know" that their partner is safe, that most of the time intercourse is not planned, that students underestimate the prevalence of sexually transmitted diseases and HIV/AIDS, that alcohol is often involved in sexual decision making, and that self-efficacy is often an issue for students (Curtis, 1992; Mahoney, Thombs, & Ford, 1995; Noell et al., 1993).

The greatest predictors of sexual activity among students include alcohol and drag use and perceived peer norms, and the greatest predictor of students' use of alcohol is their perception of peer norms about drinking (Epstein, Botvin, Diaz, & Schinke, 1995; Resnick et al., 1997; Shafer & Boyer, 1991; Towberman & McDonald, 1993). Heavy alcohol use among college students has become the focus of national media attention in the past year and is substantiated by data from a national survey of 38,000 college students. At least 11% of the students in this survey had been taken advantage of sexually while intoxicated, 5.8% have taken advantage of someone else sexually while intoxicated, and 36% have done something they later regretted because of drinking (Presley, Meilman, & Lyerla, 1993). Of private university students who are freshmen, 54.3% drank beer, and 57.2% drank liquor as high school seniors (Higher Education Research Institute, 1997). Ample research supports the influence of peer norms on adolescents' and young adults' behaviors (Kelly et al., 1994; Magura et al., 1989; McKusick, Coates, Morin, Pollack, & Hoff, 1990; Slap, Plotkin, Khalid, Michelman, & Forke, 1991; Stevens, 1994; Stiffman, Dore, Cunningham, & Earls, 1995).

American students are exposed to considerable information about HIV/AIDS. Although classes or even entire courses focusing on HIV/AIDS risk reduction do increase students' knowledge of the disease and may reduce fear and bigotry related to the disease, AIDS information alone does not change students' sexual behaviors (Bellingham & Gillies, 1993; DiIorio, Parsons, Lehr, Adame, & Carlone, 1993; Goertzel & Bluebond-Langer, 1991; Keller, 1993; Vicenzi & Thiel, 1992). Educational efforts are more …