As a response to an increased incidence of HIV at universities in the Triangle, the state of North Carolina has extended its offer to cover HIV testing to Duke students.
At the May American College Health Association's meeting, it was decided that "any insertive or receptive sexual contact" should warrant an STD test, said Dr. William Christmas, director of student health services.
The new test--previously not implemented by Duke Student Health Services due to expense--is more reliable and can determine if a patient is HIV-positive within three weeks of exposure to the virus, instead of the normal six to eight weeks.
Dr. Edward Wiesmeier, an expert who attended the conference, is not as supportive of this new program.
"While it is good for the curious person, it is certainly not essential to find out in three weeks instead of six to eight weeks, and it is more expensive," said Wiesmeier, assistant vice chancellor of student development and health at the University of California at Los Angeles.
Traditionally, Duke sends the blood samples to a private laboratory for screening, but they will now be sent to state facilities. If the first HIV test is negative, North Carolina will also assume the responsibility of additional testing for several months to ensure the fact that the HIV did not manifest, since it may take up to three months for antibodies to develop.
Members of Duke student health services, however, were willing to offer HIV testing, but students rarely went for the necessary follow-up tests. This posed a problem, since students may have exposed the virus to others during the variable window.
In spite of the apparent neglect of some Duke students at risk for HIV, others have been overly cautious, officials said.
During the past year, there have been numerous complaints of Duke students being refused sexually transmitted disease tests. Administrative Coordinator of Student Health Ray Rodriguez, however, said students unnecessarily demand tests when they have not had any sexual contact.
"We were never negligent. We simply did risk assessment. If you didn't have any sexual contact there is no way you could contract an STD and in those cases, tests were denied. But we never turned down a student who asked for an HIV test," said Rodriguez.
Sourav Sengupta, a member of Duke Educational Leaders in Sexual Health (DELISH), is pushing for modifications that will soon be implemented.
"It is always great when we can get a more reliable notification method that minimizes the waiting time of such an emotional issue," Sengupta said.
While more modern techniques will facilitate STD testing, it does not provide a solution to the spread of these diseases. The fact that HIV is on the rise in North Carolina has convinced the state and the Centers for Disease Control and Prevention to strongly recommend tests to be administered to anyone who feels at risk for sexually transmitted diseases. Under Duke's student health plan, tests for HIV, chlamydia, syphilis and gonorrhea are covered.
"The new trend we are seeing is that students are now relying on tests to protect their sexual partners, but they are not protecting themselves," Christmas said. "Most students report that they use condoms, but there are those who don't."
The health center is still bound by North Carolina regulations to report results of HIV tests face-to-face with the patient in a supportive environment and to offer counseling since it is an emotional experience. All tests will still remain confidential or anonymous, based on the patient's decision.
Although there have been no new reported incidences of HIV at Duke within the past four years, the numbers of infected students in the Raleigh-Durham area have increased. It is increasingly important to understand how and why it is spreading among college students in the area, officials noted.
"While Duke is only a small piece, this is the first time we have the ability to create models of an epidemic. By including Duke in the testing, the CDC and the state can monitor the behavior of HIV more completely," said Rodriguez.
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