Commentary on the article “Students perceive low risk for HIV”

I am writing with regard to the article entitled “Students perceive low risk for HIV,” published on April 2, which describes the ongoing HIV testing program on campus called Know Your Status. It has been my pleasure to be involved with KYS since 2008, and I am grateful to the hardworking program directors and multiple volunteer testers for their efforts every Monday in the Bryan Center as well as at Durham Technical Community College. As I believe this is a very important public health endeavor, I wanted to help clarify several points.

In the article there is reference to an unpublished study looking at 1000 Duke students which found that 55.4 percent exhibited risky behaviors. It is very important to recognize how one defines “risky behavior” however. In this particular study, the authors defined it as “students who reported having unprotected sex or sharing needles, had two or more sexual partners in the past year or were men having sex with men.” More recently, we looked at risk behaviors using an objectively derived criteria which has been validated in emergency departments. Using the Denver Risk Score, the percent of students exhibiting risky behaviors was found to be only 15 percent. Unfortunately, 70 percent of these students inaccurately assessed their own risk for HIV infection as being either low or non-existent, indicating the need for ongoing educational efforts.

Since 2006, we have tested almost 2000 students at both Duke and Durham Tech. There has been only one true positive case at Duke and two true positives at Durham Tech (a third case was found to be a false positive and the fourth was already known to have HIV). Interestingly, rates on college campuses across the U.S. are low despite the growing numbers of new infections among young people between the ages 13 and 29. As pointed out by Dr. Chuck Hicks, the higher rate at Durham Tech is most likely due to the fact it is a commuter campus with older (more sexually experienced) students.

Sincerely,

Dr. Mehri McKellar, MD Division of Infectious Diseases