The Chicago Tribune, Sunday, November 16, 1997
Anne Little, Tribune Staff Writer.

They usually have students laughing in a matter of minutes at their stand-up comedy routine, which is frank, explicit and sometimes risque. But they believe that a strait-laced approach to their subject would be about as effective as a lead balloon.

Their message is: Don't mix sex and alcohol. Alcohol clouds your judgment, and sex under the influence might not be as safe as it would be if you were stone cold sober.

Goldman, 33, knows that only too well. That was how he contracted HIV, he said, the virus that causes acquired immune deficiency syndrome, when he was a student at Indiana University, Bloomington. In the summer of 1992, seven years after he graduated, he learned that he was HIV positive. Although his AIDS symptoms so far have been kept in check by a variety of drugs, Goldman does not expect to outlive his parents.

"There's nothing worse than telling your mom and dad you will probably pass away before they do," he said at a presentation in the spring titled "Friendship in the Age of AIDS," at Dominican University (then Rosary College) in River Forest.

Goldman and Sullivan, 28, who were best friends in college, formed a touring company on AIDS education after Goldman learned he was HIV-positive. Their program covers the bases on AIDS prevention. They acknowledge that abstinence is the best way to prevent any sexually transmitted disease. But with surveys showing that a majority of college students are sexually active, they focus on means of prevention: Never have intercourse without using a condom or oral sex without a dental dam. They also emphasize that anyone who thinks he or she is at risk should be tested for HIV.

"We try to calm their fears about testing," Sullivan said.

"The sooner a student is tested, the sooner he can get on (therapeutic) drugs" if the test is positive, Goldman said. "We are moving into an era when AIDS could become a long-term manageable illness."

Dominican, which has a total enrollment of about 1,800, and many other universities and colleges throughout the country have taken steps in the last five years to educate students about AIDS prevention. Estimates indicate the HIV rate among college students in 1990 (the latest year such a survey was done) was about 1 in 500. The estimates are based on an HIV risk profile of college students prepared for the American College Health Association from studies done between 1990 and 1996. However, the incubation period for AIDS can be 6 to 10 years, so many students with HIV, like Goldman, can remain symptom-free for several years after they leave college.

The association, based in Baltimore, recommends a broad-based approach to AIDS education, said Dee Braver, assistant project director. "Colleges are doing a wide variety of things, mostly involving awareness," she said. They include enhancing self-esteem, special support groups, peer education in small group meetings and including AIDS information in course subjects.

Many schools, however, have shifted in recent years to more direct prevention programs from awareness, educators said.

Goldman's and Sullivan's presentation at Dominican was part of a five-year AIDS prevention program funded by a grant from the federal Centers for Disease Control and Prevention in Atlanta and administered by Southern Illinois University, Carbondale. Dominican was among 55 colleges and universities in Illinois, called the Postsecondary HIV Prevention Consortium, to participate in the funding program.

The funding, however, ended at the close of the 1996-97 school year. The demonstration program was funded in four other states: New Jersey, Florida, California and Texas. These states were selected because of their high incidence of AIDS cases, said Lisa Swenarski de Herrera, health communications specialist for the CDC.

Another part of Dominican's program was observation of AIDS Awareness Week in March, when posters were displayed, pamphlets distributed and videos made available, said Liz Quinn, director of health services for the university. During that week, the students held prayer services and candlelight vigils. Also, health professionals were invited into classrooms, and panels from the national AIDS quilt, which contains names of people who have died of AIDS, were displayed on campus.

"I think the project has been effective," Quinn said. "Some students have said they changed their behavior. The students are now able to talk about AIDS-- not just as a gay disease.

"Yes, we are a (Roman) Catholic school," she added, "but we worry about our children's lives."

The school hasn't yet planned any programs for this year, Quinn said.

Peer education is a common approach to AIDS prevention. Northwestern University, Evanston, has had student peer educators for more than 20 years, said Patti Lubin, co-director of health education. They now are being trained in AIDS prevention counseling by the American Red Cross and a regional agency called BEHIV, which stands for Better Existence for HIV.

NU, with a total enrollment at both campuses of about 17,000, is among five postsecondary schools nationwide to receive a five-year CDC grant administered by the college health association to prepare and implement a comprehensive HIV prevention plan.

"We actually have a multilevel approach," Lubin said. "A lot of schools are doing that. They have found that a one-time hit is not enough."

Under the grant, a workshop on self-esteem for student leaders and staff from the division of student affairs and the College of Arts and Sciences was held in September.

In addition to presentations by peer educators, resident assistants make information available to dormitory residents on what resources are available at the university. The sororities and fraternities also have their own peer educators, and volunteer student health aides, trained in cardiopulmonary resuscitation, first aid and counseling, work with students in residences.

NU students also can have anonymous HIV tests by the Evanston Health Department through the NU health department.

Miss America Kate Shindle, an NU senior, has chosen AIDS prevention advocacy as the subject of her platform.

"I think peer education is an effective tool," she said in a telephone interview. "A peer is someone a student can trust and relate to.

"The problem with HIV is that most people (students) know about it, but they don't know enough to make the right choices. You can put out the most impressive program, but in the heat of the moment, if a person can't or is not willing to make the right choice, the program can't achieve what (it was intended to do)."

The fight against AIDS became a crusade for Shindle during her college years, when a close family friend was diagnosed with the disease.

She believes that AIDS education should start in elementary schools with teaching children care and compassion for people with AIDS.

"In junior high, they should be taught how AIDS is transmitted. They should be taught how to protect themselves, all the while with support of students' choice not to have sex."

Nevertheless, she noted that a CDC survey has revealed that about 80 percent of young people have had sex by age 20.

San Diego State University has had a peer education program since 1995, said Sean Kaufman, health educator. Until this year, students could apply to take a semester-long credit class training them in subjects such as the reproductive system, cultural diversity, homosexual and lesbian issues, and the effects of alcohol. After completing the class, they could choose to become peer educators. The school usually has 25 to 30 peer educators who make presentations, do role playing and give out written and electronic information.

Kaufman said he can't gauge the program's effects on the student body, totaling about 32,000. But he has seen a behavior change in the peer educators. "They feel they are held accountable," he said.

Brenda Mora, a junior at San Diego from Bloomington, Ill., is in her second semester as a peer educator. She believes that the training and the work have brought about a "tremendous change" in her. "You feel like you're making a difference, and it feels good when people look up to you for advice," she said.

She believes the program gives students the knowledge to understand what they're doing. "Many of them don't have the tools to make decisions," she said. For example, "some believe AIDS is transmitted by saliva, and some don't know that oral sex can put them at greater risk" than vaginal sex. "And some don't know how to use a condom."

The class for peer educators is in the process of being transformed into a general education class open to all students. In the meantime, the peer educators are working one-on-one, mostly answering questions, Mora said. "I think we get more questions in a one-on-one situation or in small groups" than in presentations to large groups.

AIDS has dropped to second place from its 1995 rating as the No. 1 killer of people age 25 to 44, according to a recent CDC report. (Accidents now are the No. 1 killer.)

The survey didn't ask whether the respondents had attended college, so the drop is not necessarily an indication of successful college AIDS prevention programs, said Laura Kann, chief of the surveillance research section in the CDC's division of adolescent and school health.

In a CDC survey of college health risk behavior, published in August, 68.2 percent of 4,609 students questioned nationwide reported having had sexual intercourse during the three months before the survey. Of that percentage, only 27.9 percent reported consistent condom use.

The college health association's risk profile also concluded that high risk behaviors are prevalent on college campuses. Those behaviors include having multiple sex partners and engaging in unprotected sex. Factors contributing to engaging in unprotected sex included insufficient knowledge of HIV, difficulty in discussing condom use with a partner, and poor communication and assertiveness skills.

The profile also cited alcohol as a major contributing factor toward risk behavior. A significant number of the students reported having had sexual intercourse only because they were intoxicated.

Michael Haines, coordinator of health enhancement services at Northern Illinois University, DeKalb, doesn't believe that alcohol is such a significant factor in the spread of AIDS. "Everybody mixes alcohol and sex," he said. "It's not fair to ask students to live up to things nobody else does. That creates a double standard."

College students are at lower risk for contracting HIV than the national average, which the CDC estimates at 2 per 500, Haines said. "Campuses are one of the safest places."

NIU, with a total enrollment of about 22,000, doesn't focus its safe-sex programs exclusively on AIDS prevention. The school includes AIDS in its program on prevention of sexually transmitted diseases, or STDs, Haines said.

"STDs are far more infectious than HIV," Haines said. He notes that methods of preventing STDs also prevent AIDS. The university makes free condoms available in all residence halls, distributes posters and brochures promoting safe sex, and presents programs of role playing by peer educators.

Haines said university statistics show that as the rate of condom use has increased since the program's inception in 1989, the STD rate has dropped to 4.5 percent in 1996 from 10 percent.

The CDC also allocates funding according to a needs assessment, with the major portion going to nationwide agencies, such as the American Red Cross and Planned Parenthood, which deal with some of the highest risk groups. Under this program colleges and universities are encouraged to have student educators work with these agencies for training and experience.

CAPTION: PHOTO: Friends since their days at Indiana University, Joel Goldman (left) and T.J. Sullivan now do a standup routine about AIDS prevention. Tribune photo by Gerald West.

Copyright 1997/The Chicago Tribune. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Chicago Tribune, 435 North Michigan Avenue, Chicago, IL 60611.
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