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Get Tested for HIV

By Dr. Peter Leone

Since June 2001, at least 56 college students in North Carolina have been newly diagnosed with HIV, the virus that causes AIDS. This increase has been sudden and is being touted as a new outbreak that may extend to other campuses in the Southeast.

Dr. Peter Leone was lead researcher on the study that found a high incidence of HIV among college students.

If the initial 2003 incidence rates are maintained, North Carolina will experience a 21 percent increase in the rate of HIV cases reported for 18-35 year-old males and a 19 percent increase for 18-35 year-old females.

In Wake County, N.C., alone, the number of infected 18-25 year olds increased from six in 1998 to 23 in 2002.

These numbers, along with similar figures for syphilis, show that we are now seeing the return of syphilis and the sudden resurgence of HIV in young adults.

An outbreak of HIV has never been previously noted among college students. In response, a team of five individuals from the Centers for Disease Control and Prevention has been assigned to North Carolina to assist with the state�s ongoing investigation.

The new HIV cases were identified through voluntary counseling and testing services.

Since most students have not traditionally considered themselves at risk for HIV infection, the 56 new cases almost certainly represent only the beginning of a new wave of infections.

They also are associated with meeting partners in clubs and via the Internet and involved a network of more than 30 colleges and universities.

These new HIV cases suggest that the virus is being transmitted rapidly via sexual networks of young adults.

When syphilis and HIV are found within the same sexual network, the risk of HIV transmission and acquisition may increase five- to tenfold.

HIV and STD testing is available at local health departments and, for college students, at student health services.

Traditional HIV antibody testing will detect the virus eight to 12 weeks after infection.

Special screening tests have been developed that can detect primary HIV within one to two weeks after an individual is infected.

Many, if not most, individuals with primary HIV infection have nonspecific viral symptoms that may include fever, rash and swollen lymph nodes. Physicians frequently mistake the symptoms for the flu, infectious mononucleosis, genital herpes or a �nonspecific� viral illness. Individuals with primary HIV have extremely high viral levels in blood and genital secretions and may be 10 to 1,000 times more infectious than individuals in the later stages of HIV infection.

Rapid transmission from partner to partner may occur during this phase, since individuals are not aware of infection and may not be using barrier methods to prevent transmission to partners.

Unless primary HIV infection is suspected and an appropriate test for detection of HIV in the blood is done, the diagnosis may be missed entirely.

A new program for HIV testing and screening for primary HIV was instituted in November 2002 through the joint efforts of the HIV/STD Prevention and Care branch of the N.C. Department of Health and Human Services, the N.C. Public Health Laboratory and University of North Carolina at Chapel Hill.

Now is the time to take an inventory of your own risk factors for HIV, syphilis and other sexually transmitted diseases.

The only safe sex is no sex, but there are other steps you can take toward risk reduction. Know your HIV and syphilis status and know your partner�s status, too. If you chose to be sexually active, then use condoms for oral, anal or vaginal sex.

If you engaged in recent unprotected sex, get tested. Should you develop fever, rash and swollen glands within two to four weeks of having unprotected sex, see your clinician and discuss having an HIV test that includes testing for primary HIV.

In North Carolina, all county health departments offer free, confidential HIV testing that will also allow the diagnosis of primary HIV.

The recent trends in HIV seen on our college campuses reflect the national trend of increasing HIV rates in young adults.

If you are sexually active, you are potentially at risk for HIV infection whether you are straight, gay or bisexual.

Dr. Peter Leone is HIV medical director at the North Carolina Health Department. He was lead researcher on the North Carolina study that found 84 newly infected male college students over the past three years, 73 of them black. This article originally appeared in The Campus Echo at North Carolina Central University in October.

Posted March 22, 2004