Chicago Tribune - May 3, 2002
James Janega and Jeremy Manier, Tribune staff reporters. James Janega reported from Huron, S.D., and Jeremy Manier reported from Chicago

But the growing network of young people here who may have been exposed looks sadly familiar to researchers who have watched HIV tear its way through other communities.

Studies suggest that college students have slightly lower overall HIV infection rates than the general population, about 2 cases per 1,000 students. Experts said some reasons may be low rates of intravenous drug use, good access to health care and education about preventing infection. Officials at the Centers for Disease Control and Prevention and college health experts could find no reports detailing significant HIV clusters on American college campuses.

"I'm not aware of any similar occurrence, even though theoretically it could happen," said Dr. Richard P. Keeling, editor of the Journal of American College Health.

Nikko Briteramos, 18, the Si Tanka-Huron University student whose arrest sparked a South Dakota public health investigation, pleaded not guilty Thursday to charges that he knowingly spread the disease by having sex with his girlfriend without telling her he is HIV positive.

Regardless of Briteramos's role in it, the cluster of South Dakota cases shows how just one HIV infection can spark a crisis, Keeling said. Such clusters have surfaced with other sexually transmitted diseases such as gonorrhea and syphilis, he said.

"College is fertile ground for sexually transmitted infections," said Keeling, who has chaired a committee on HIV and AIDS for the American College Health Association since 1984. "It takes people away from home, changes their social environment and introduces them to new networks of people. This happens in an atmosphere of celebration and partying, with an emphasis on exploration."

Briteramos's classmates at Huron said experimentation can be tempting in their tiny town of 11,000 residents, surrounded by miles of rolling rangeland.

"It's kind of boring," said Robert Buggs, 22, a Huron student from Atlanta. "Certain people don't have anything to do up here. It's just like an extracurricular activity, having sex for fun."

Some students said they saw Briteramos' arrest as a warning that sexual promiscuity on college campuses can quickly turn deadly and that schools have been lucky to avoid larger HIV problems.

"People aren't thinking before they have sex, they don't think of the consequences," said LaTonya Holmes, 20, a student from Englewood, Colo. "People have multiple partners. And who's to say those people don't have multiple partners? We're all connected somehow."

Since Briteramos, a freshman center on the college basketball team, was diagnosed with the disease during a Red Cross blood drive in March, three people who had sex with him or one of his former partners have also tested positive for HIV. The list of sexual contacts for those four has grown to more than 50, investigators said.

In the days after Briteramos was arrested last week, about 200 other college students and local youths streamed into nearby clinics and doctors offices to be tested for the disease. While administering those tests, public health officials found at the college and in Huron an established pattern of unprotected sex with multiple partners, a key factor in the possible spread of the disease, said South Dakota Department of Public Health spokeswoman Barb Buhler.

"At this point, what they are seeing is people that have multiple sex partners and that they have other sexually transmitted diseases," Buhler said. "That doesn't mean there aren't other risk factors, but that's what we've found so far."

Among the people already tested are students at the local high school, some of whom recently have had sex with Huron University students, Huron Mayor Mary Pearson said.

"The age group that it involved indicated that it could have involved some upperclassmen at the high school," Pearson said, adding that there even had been some uncomfortable discussion of holding a meeting about the risks of HIV infection for middle school students. "We have heard that not only high school kids, but middle school kids have had ... visitation ... to the university. Let's put it that way."

It's not the first time HIV has made dramatic inroads into a rural community. One of the most notorious cases involved Nushawn Williams, a young drifter from Brooklyn who in 1997 was directly linked to 13 HIV cases in upstate New York.

Williams, later sentenced to 4 to 12 years in prison for not telling his partners about his HIV status, had sex with 47 women in upstate Chautauqua County after he was infected, according to a 1999 CDC report.

Briteramos' case has thrown the state into turmoil, inspiring newspaper editorials urging abstinence and prompting health officials to call meetings at town halls and school gymnasiums.

Last week Gov. Bill Janklow appealed for calm while likening the disease's potential to spread through the state to a chain reaction igniting "a nuclear bomb." He called Briteramos' alleged actions "no different than pointing a gun at somebody and pulling the trigger."

The last decade has seen a slight decrease in sexual activity among young people nationwide, while condom use has increased, according to CDC figures. South Dakota is about average or better--58 percent of sexually active high school students in the state reported using condoms as of 1999.

But the rarity of AIDS in the region may make some people more reckless, said Beth Palleria, a graduate of Huron who works in her family's coffee shop on the south end of town.

"People here are more careless because they assume you can't get anything like AIDS in a tiny little town," Palleria said.
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