Project CARES - Condom Accessibility and Responsibility for Every Student, an on-campus research study of student sexual health - will launch this spring under the direction of Ben Colburn '10. Student participants will receive 42 condoms in their mailboxes over the span of three months and will take two online surveys to provide information on student sexual health and the University's current condom distribution system. The project's goal is to determine the most effective way to encourage safe sex on campus.
The lack of information on safe sex among college students is alarming, Colburn said. Nationally, adolescents ages 18-25 report an average condom usage rate of 50 percent, according to Colburn and Naomi Ninneman, a University health educator specializing in sexual education. They said, however, such statistics generally do not exist specifically for college campuses.
Colburn said his previous research with the Global Alliance to Immunize Against AIDS - a local NGO that also has an on-campus branch to promote HIV awareness - has suggested that Brown students are not fully aware of the most effective means of safe sex. He said he noticed a lot of anxiety at an on-campus AIDS testing he attended last year.
"I heard a lot of interest in people wanting to know their (infection) status," Colburn said. "They felt they were safe because they were in the Brown bubble, but also saying, 'I think I may have been doing something that might put me at risk.' "
Curiosity piqued, Colburn administered a survey on the next test date to explore students' perceptions of safe sex, HIV transmission and general sexual activity. His sample of 61 participants was not statistically significant, he said, but the data hinted at practices of unsafe sex on campus. Most survey participants were able to identify high-risk sexual activities, but confusion existed over which body fluids transmitted HIV. Participants also reported a condom usage rate on par with the national average of 50 percent for people ages 18 to 25.
Colburn is now taking his preliminary research to the next level with his official on-campus study, Project CARES. The group consists of Colburn, seven friends and three mentors: Ken Mayer, a professor of medicine who also works at the Fenway Institute in Boston; Cynthia Rosengard, a sexual health specialist at Lifespan and Rhode Island Hospital; and Matthew Mimiaga, a biostatistician and post-doctoral fellow at the Harvard School of Public Health.
Project CARES is funded by Youth Venture, a group that invests in socially conscious youth start-ups, and GAIA.
Designed to learn more about men's attitudes and behaviors surrounding safer sex, Project CARES targets biologically male Brown undergraduates. Though they would like to include males and females, Colburn's small, low-budget study could not handle the necessary 204 members of each sex needed to make his research statistically significant, he said. Literature suggested the study would have more impact with males as the target group, according to Colburn.
Additional requirements include that participants be between the ages of 18 and 25 and will be on campus for the spring semester. Colburn said he prefers subjects be sexually active.
"If you have tons of sex without condoms because your girlfriend is on the pill, that's fine," Colburn said. "We just want to get baseline information to see what the general sexual health is for Brown."
To accomplish this, Colburn plans to administer a series of online surveys. Participants will complete the first questionnaire during the last week of January and will then receive seven condoms in their mailbox every two weeks for three months. At the end of May, they will complete another survey to determine any changes in sexual activity.
The study's success depends largely on its participants, said Colburn, who so far has gathered about 17 subjects through table slips, advertisements in The Herald and on Facebook, talking to fraternities and word of mouth. He said he hopes an incentive program offering free tea, coffee, barbecues and gift certificates to Miko's Exotic Wear will encourage students to recruit their friends.
"I have 5 boxes of 10,000 condoms sitting in GAIA's downtown offices that I want to get rid of," Colburn said.
Participants' honesty is also important, he said, since data depends solely on their answers.
"We're not going to ask them to send condoms back to us," Colburn said. "In any social science, it's pretty imprecise, and ultimately you have to depend on people that they're telling the truth."
Honest answers are the only way Colburn can test the University's condom distribution system, which is one of the largest components of the study. Currently, Health Services supplies Durex condoms in their first- and third-floor bathrooms and relies on Residential Peer Leaders to pick up condoms to supply their residence halls. Under an honors system, students pay 15 cents per condom.
But Colburn's preliminary research suggests that this system needs improvement.
The 15-cent price tag is a problem, according to Colburn. He said 15 cents is an awkward denomination and that students believe they should be receiving condoms at no charge.
"People are resentful because other schools get them for free," he said. "They feel like Brown is ripping them off."
"There are definitely issues with it," said Eva Kolker '10, a Residential Counselor in Wayland House. She said in many cases, charging for public condoms is a way to indicate high quality.
"But here we're using Durex, and people know it's good quality," she said. "I understand health ed wants (the price) as a token, but the point is we want people to have safe sex. So why not just let people take?"
Kolker said if the University abolished payment for condoms, the system would be more effective because students would take condoms for precautionary measures.
"If you're right in the moment, you don't want to run out to your RC's door," she said. "Especially dealing with first years. They still think the rules matter," she laughed. "You don't want them to have to hesitate by charging."
Jason Ma '10 was indifferent to the price tag on a condom. "It would be great if they were free," he said. "But if I need a condom, I'm going to get a condom."
Accordingly, students seem to abide by the honors system. "People actually do pay me," Kolker said. "I'll notice condoms gone, and then a few days later, I'll have money in my door."
Ninneman agreed that in general, the honors system is a success. She said that though RPLs often sound surprised when students drop off money, the fact is that they are bringing money in. "We don't get 100 percent of the money," she said. "But we come pretty close."
Besides the price for protection, Colburn said the condom distribution system's logistics create problems. Participation in the program is not mandatory, and an online survey of RPLs suggested that many are "too lazy or too tired" to walk to Health Services to replenish their dorm's supplies, he said.
Ninneman, however, noted that Health Services recently held an open house for RPLs and said she tries to remind RPLs to check supplies.
Yet another issue, Colburn said, is the public display of protection. Condoms are kept on counselors' doors, and many students feel the system is intimidating.
"Think about Keeney, where it's hallways for miles, and if someone sees you, it's like, 'Oh, you're having sex,' " Colburn said. "It's very stigmatizing."
Ma said he has never used the University's condom distribution system, but that he believes students should not be uncomfortable getting a condom from such public areas. "I mean, you're having sex," he said. "We're legal, we're grown. Just do it."
Condoms in the first- and third-floor bathrooms of Health Services offer an alternative. But Colburn said he believes this does not solve the whole problem.
"If you go to Health Services, it's not like you have to say to a 55-year-old nurse, 'I'm about to engage in vaginal intercourse, may I have a condom?' " said Colburn. "But just like RPLs don't want to walk across campus, students don't want to go to Health Services to get a condom."
Colburn said he hopes Project CARES will address these issues and more concerning sexual health at Brown. Ultimately, he said he wants students to practice safe sex.
Though lack of funding is an obstacle to collaboration, Ninneman said Health Services is definitely interested in Colburn's results and shares his ultimate goal. She said Health Services has an extensive sexual education program, including lectures, programs, table slips, RPL training, counseling and a sexual education Web site.
The Web site is a "huge resource" that many students aren't aware of, according to Ninneman. "We get lots of hits, but not as many from Brown campus as from off of Brown campus," she said. "I get questions from people who are not Brown students."
Ninneman, who assumed her position as health educator in August, said promoting the Web site is one of her goals. She wants students on campus to be aware of the best way to protect themselves and believes that Colburn's study will contribute to these efforts.
"We're on your side," Colburn said. "We want you to be sexually safe."
