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(Monday, June 7 -10:15-11:30 a.m.)

Bob Thompson:

I'm Bob Thompson, the athletic director at Bergen Community College and may I introduce David Finnane, president of Teamwork Partners.

David Finnane:

This is not a situation at college where you'll get drunk, perhaps get arrested, make some mistakes and n be allowed to play for a certain period of time. Those are things when you're 35 years old, if they don't progress to more serious stages, you can look back and say, I can't believe I lived through it. When we talk about HIV and AIDS, it's not something that you can look back on in five years and say, I can't believe I made it through. Because of the nature of the virus and, ultimately AIDS, I would say we're going to see a significant amount of young people we work with infected with AIDS, barring a cure in the next 10 years.

Today, I would like to talk about what research tells us about student-athletes' knowledge about HIV and their behavior. I would then like to talk very briefly about HIV and AIDS because, even today in our profession, there is uncertainty and mis-statements being made about HIV and AIDS and what the difference is. Finally, we'll talk about how to set up a program on your campus, a program that can address these issue1 in an effective way. I also want to tell you that if you have any questions, please feel free to ask at any time.

Let's look at the research first. Currently, 10 million people in the world have mv. By the year 2000, i is estimated that 40 million cases of mv will have occurred, 1.5 million cases in the United States. Of those cases, 75 percent are heterosexual. Although, I don't think it should matter if it's a homosexual or IV drug- using issue, I think we should pay as much attention to it even if it is effecting those populations. It's no longer above population. We can't sit down and say H1V affects this population. It's not a risk population, it's a risk behavior. When we talk about mv or AIDS, we're not talking anymore about groups. We're talking about people in rural areas, African-Americans, Hispanics, and Caucasians. It doesn't matter where you live. If you have risk behaviors, there's a chance you can become H1V infected.

Research has found that six out of II of the student-athletes, or a little over half, answered questions incorrectly. Fifty percent thought insect bites could transmit HIV .Thirty-three percent were uncertain about toilet seats and cups, 20 percent thought condoms were loo percent effective to prevent transmission. Fifty percent worried about past and current behavior with regard to their sexuality and HIV/AIDS. Sixty-six percent reported in that survey that after learning about HIV and AIDS, they did not change their behavior. Seventy-five percent reported no change in condom use. If they didn't use them before, 75 percent are reporting that they're not using them after. Fifty percent reported no change in behavior with new partners. Those that have been educated perhaps had one partner who have had other partners, are reporting that there'! been no change in their behavior. Another survey showed that eight of the 10 questions were answered correctly. In Missouri, six of the 11 questions were answered incorrectly and in Wisconsin, eight out of 10 were answered correctly.

In 1990, there was another study where 87 percent were sexually active, 18 percent practiced anal intercourse and of those 18 percent, 16 percent did not use condoms. What the research tells us, and it's a litt bit mixed as far as how much the young adult knows, that well over 50 percent are reporting that even if the: knew, they wouldn't change their behavior. There's a difference between providing education and providing preventative education. If you tell me about it, but you don't give me a reason to make risk-free behavior choices, I'm likely to continue with my patterns. We need to get to elementary, middle-school and high school and at your level and provide a preventative message. Don't tell people about HIV without a preventative message. I'm not certain that young people will make the same decision as we would based on the information that they're given. Why that is, I'm not sure. Perhaps it is maturity. Perhaps it's life experiences. Perhaps it's when you're 18 years old, you don't listen to what somebody tells you about 10 years from now. Regardless what the reason is, we haven't done an effective job in educating our students and student-athletes about HIV and AIDS.

My personal opinion is that we haven't done a good job in college athletics. We have been guilty in college athletics. I've worked in this business with you everyday. We stereotype that virus as being a homosexual and IV drug-using disease. As long as it is with that group, then it doesn't effect our student- athletes. It's not an issue we need to deal with. I would predict your school total would be less than one percent have experienced IV drug use. Therefore, if it was simply an IV drug user issue, none of you would need to be here. Let me re-iterate that it's very clear in the research and the educational material today that it has nothing to do with who you are or where you live. It has everything to do with what kinds of decisions you make. I believe that the prevention programs we need to put in place need to be on-going, thorough and well thought out.

It's one thing to bring a speaker in who relates to the student-athletes, is not intimidated by the student- athlete population and can provide the material in an effective way and insist through their ability as well as their manner that the athletes listen to him versus someone from the Health Center who may be very good in a one-on-one. But, in a group of 50 student-athletes, that's an intimidating group. Because of that, they provide the information, but they don't do it in an effective way. In my opinion, that's a waste of time. It feels good to do something. It's better to do that than nothing. But, I would suggest that when you start to look at the educational programs, make sure that when you put them in place, they will work.

HIV stands for Human Immunal Deficiency Virus. People with HIV don't necessarily have AIDS. Of all the people infected in the United States, those with AIDS are 20 percent. Of all the people infected in the United States, those with HIV is equal to 80 percent. I told you earlier that 1.15 million people in our country have HIV or AIDS. Eighty percent of them have HIV , 20 percent have AIDS. my, basically, attacks the conductor system of your immune system. my attacks the system that tells your body when you get a cold or an ear infection that you have this thing. Get rid of it and your body takes care of it. It creates antibodies to deal with it. my goes in and tells that conductor that it can't work the way it's supposed to work. It sends out messages or, ultimately, the helper cells that attacks disease. illY has been an epidemic since 1983 and we're talking about it in 1993. We're a little late. NACDA is not the only group that's late. Schools are behind, business is far behind, our country is far behind.

When you're affected by lllV, in addition to affecting the conductor system, it also sends out messages that don't accurately fight the virus or disease. mv is transmitted three ways --one is sexually. Not through kissing or petting, but through intercourse. It's also transmitted through blood, IV drug use, transfusions or occupational; for instance, if a doctor pricks himself with a needle. According to the research they have now, there's a .005 percent chance that if you poke yourself with an mv infected needle, you'll become lllV infected. That's less than one-half of one percent. There's a lot of media attention given to what are the physicians going to do, what are the risks and what are the dangers. That sensationalism applies to some of the ways to transmit. I want to tell you that although lllV and AIDS is very common, it's difficult to transmit. To me, that's scary. To me, that means that we've had to work at transmitting. It's not easy to do. You need to practice unsafe, risky behaviors often in order to become infected.

Finally, the other way to transmit it is through birth. Whether it's before birth through pregnancy, interestingly enough, most women who are infected don't give the baby the virus during pregnancy. Most kids contact it at birth. Most kids when tested in the womb and are born do not have my. They do a blood test and there's no sign of it. More typically, it occurs at birth. Obviously, without getting too graphic, because of the blood involved in that process, it gets on the baby, in it's mouth and that is when it is transmitted which, to me, is quite amazing. It's not clear why that is, but it's clear that's the case.

Babies are coming infected through breast milk. In the Third World countries that don't have alternatives to breast milk, they are knowingly breast feeding, aware that's it's likely they will infect their uninfected child who made it through the whole process uninfected. Now, the baby gets it through breast milk, but they have a choice. Either they take that risk or the child dies.

We can't get it from glasses, coughing or a toilet seat. HIV is difficult to transmit and it's not a free floating virus. If there is blood on a basketball court, be aware that as soon as the blood begins to dry HIV immediately begins to die. It can't live outside the body for very long. In order for you to get HIV I AIDS I a football field or basketball or a volleyball court, there would have to be blood spilled. You would have to lean down with your open wound that is bleeding and rub your hand in it often and rigorously. Still, it's unlikely that you would become infected. As soon as it's out of the body, it's difficult to transmit unless there's a lot of blood.

Thirty percent of the blood in New York state is brought in from Europe. People believe that you can my from giving blood. You can't get my from donating blood. If that's the only reason you don't don~ please do, because we need the blood. If you don't, somebody else might. Sweat cannot transmit my. There is my in sweat, but far too small of an amount to make a difference. If there's an athlete on your team who has my you mayor may not know about, there is no fear of getting illY from them. It will no happen. Please remember that my is not AIDS. my causes AIDS.

AIDS is Acquired lmmunal Deficiency Syndrome. There is a deficiency in your immune system which you get from the virus which breaks down the conductors for your immune system. Deficiency, again, is a deficient immune systems. And finally, syndrome, which are basically symptoms associated with one particular virus or disease problem. Of all of the people infected in our country, approximately 20 percent have AIDS, 80 percent have lllV. You can define whether someone has AIDS. They do a test of the antibodies in the blood system. By that antibody count, which goes up, and cells that fight the viruses go down. Those cells are called key cells. The more antibodies you have, the more unusual amounts of antibodies you have, the more likely it is that you have a virus. They have a cut-off point they use to determine what is symptomatic of lllV and, ultimately, of the AIDS virus.

People are ultimately defined as having AIDS by having less than 200 helper cells or key cells. If you have 200 or less, you qualify for the definition of AIDS. Most likely, people will begin to develop pneumonia, cancer and other opportunistic diseases and virus that take place because your immune system i so deficient it can't fight off the pneumonia.

Education is as important as any I've given you so far. It's estimated that from the day you become H infected until the day that you develop AIDS, is approximately 10 to 12 years. We're not sure when Magic Johnson developed the virus. We are sure that typically, the latency period, as it is called, is 10 to 12 years from when you become infected. That means that if Magic became infected shortly before he knew that h~ became infected, it could be another 10 years before he is even remotely sick. It takes awhile for this virus break down your immunal system which ultimately leads to opportunistic infection, which leads to AIDS. That's called the latency period.

There's no way to detennine when the person who has my was infected. They may have been ii six years ago. So, if you start your clock from there, it may show that it only took four years to get , when really, it took 10. We just knew about the virus for four years. It's difficult to detennine. Acc the research, after people have been tested for the virus, it has shown in approximately 10 to 12 years.

At about six weeks, people typically when they're infected with HIV , get the flu. They get a fever, chi and they're nauseous. Perhaps they get a sore throat. You'll stay home from work for a couple of days an you get better. This time is referred to as the window period. Typically, about six weeks after people are infected with the virus, they get sick. Unfortunately, when they get sick, they don't think they have HIV, t think they have the flu. They get better and for the next possibly IO to 12 years, they remain virtually symptomless. During the window period, there is no way to know if I'm HIV positive. My body and my immune system has not begun to be infected enough to show on the test. However, I'm still contagious. I still carrying it and I'm still able to give it to you.

They suggest that you should have an HIV virus test six weeks after your last risk behavior encounter and again, six months following your last risky encounter or behavior. Six weeks and six months because you can come in five weeks and three days, get tested and find no problem. You go back out and have sex with two different people in the next three weeks and you could be infecting those people, or you might not be. You don't know. You were tested and found negative. If you had taken the test three weeks later, you would have come up positive. You would have known. Very cleary .Although the latency period is 10 to 12 years, the window period is about six weeks. That is an average.

They suggest you be tested in six weeks because it's likely to show up at six weeks but, it may not. If it doesn't, do it again in six months. If you were before the six-week period and it did not show up, do it again at six months, because it will. If you have a test six months after your last risky encounter, if you test negative, you're negative. There are two tests. One is the general test that if it comes back no, you're not. If it comes back positive, they give you the Western Block Test. The Western Block is very specific HIV .In most states, testing is confidential and/or anonymous. You do not have to give your name, you are given a number. They post your number after the results. In some states, you will give your name, but it is kept confidential.

A lot of people feel they have the right to know about other people. Is my doctor my positive, is my dentist illY positive? I want to know if my athletic trainer is my positive. It says very clearly that, right now, people have a right to that confidential information. We would rather do anonymous testing so that if you're illY positive, you find out all about it and change your behavior and don't infect anybody else. A lot of states expect you to do that.

There are four basic treatments. There's primary care which is staying healthy. The second care is getting anti-retro viral treatment or A VT .You can have treatments which are intended to slow down the virus. There are immune system modulators which are very complicated. In a general term, they are intended to be fixers. They are to fix your immune system. Your immune system is like a car. If you don't take care of your car and your alternator begins to go and it doesn't drive well, your transmission will begin to go, and so on. Your body is the same way. We give people who are positive drugs to simply try to prolong the latency period, to make it last longer. Obviously, while they are living, we can enhance the pleasures of their lives.

A lot of attention is spent, not only on the cure for AIDS, but also on trying to figure how to lengthen this latency period. We're not certain that we can come up with a cure for AIDS because it's a virus and it changes very rapidly. We can't come up with a cure for AIDS now, but we'll somehow try to lengthen it until we can.

There's one very clear way to protect against the transmission of AIDS through sexual behavior and that's abstinence. Occupationally, it's to take the required precautions. OSHA has now required athletic trainers to wear gloves at all times. They are also pushing the fact that when blood is spilled on a uniform, it has to be immediately replaced by another uniform. In any given game, you may have your athletes changing two and three times. This will be time consuming as well as costly. You 'II have to buy three sets of uniforms for everybody because of blood spills. That's the most stringent guideline being pushed. I'm not certain that this will be ultimately approved. Obviously, condom use protects against my and AIDS. However, it should be clear to you, but we should make it clear to the young people, that it is not 100 percent effective. Condoms can break and semen can seep out, so that's not 100 percent. You ask people if they protect themself and they say, "Yes, I use a condom." That's a barrier, but it's not 100 percent.

We address the information on all of our problems on campus, drug abuse, alcohol, steroids and IllY/AIDS to student-athletes for various reasons. You can make your football or basketball team come to a discussion on these problems and the NCAA gives you resources to handle the education of these problems. You also have a captive audience. You have a population that you can focus your energy on and you can insist, as coaches, that they at least hear it. We can't do that with the general student population. I agree that this is not just a student-athlete issue. It's a student issue, it's a social issue. It's not just relevant to your student-athletes and it should be offered for everyone. To organize your students in groups of 50 for one h and be able to afford to do it or find someone who has the time or someone who is confident to give those presentations to those groups is difficult to do.

What's the risk of two wrestlers transmitting my is a question I've been asked. The research suggests that it is limited. If you 're going to be concerned about the transmission of my, what you should talk abou with your population is their sexual behavior and the decisions they make with regard to protecting themself from the virus and not worry about two wrestlers wrestling. The study has also said that if you want to be sure, be careful. If you see blood on a jersey, tell them they can't wear that jersey. If they get cut, take an immediate time out and until the sore is closed or covered; they cannot play. Take time to clean up the mat change jerseys and clean the wounds. If one wrestler has illY and the other one hasn't, don't worry, you don't get it from breathing on each other.

From the Floor:

Why do we go through all of the change of jerseys, cleaning of mats, etc? The kids will think they won't get mv as long as they change their jerseys and they'll forget everything else.

David Finnane:

Or, they get so sensitive to the fact that you can get it by touching someone's jersey with blood on it. think this is just a precautionary policy.

Who should have these educational sessions? If you do education with your student-athletes, you also need to do educational sessions with your staff, whether it be Ron Heitzinger or myself with Teamwork Partners. We need to make sure that when we do it with you, we also need to do it with your coaches and staff. If I give a 45-minute discussion on alcohol or drugs or mV/AIDS with your men's basketball team 1 your basketball coach has no knowledge of this fashion and has no knowledge of what we talked about or why it's important, he or she will not go back and talk with that team about what they heard. We need to educate the athletes and the staff. We have been most successful when the athletic director or the associate athletic director is in that room during that coach's session showing that they think this is important. If yOl not there, the message is that you think it's important, but not that important. Let's face it, we go to things that have a high priority .I encourage you to set up a program, whether you do it internally or whether yOl bring in a speaker from the outside, and you be involved. Let everyone know you think it's important.

My recommendation on any health and wellness program is that you consider doing it in the fall if can work it into your schedule. If you do these programs in May, the student-athletes will go home ti summer and you won't be around to reiterate what they heard. If you give it in August or September few weeks pass out flyers and in another few weeks pass out another flyer giving people information {) they can get testing and what testing is, you will be continually reminding them of this program. That make a big difference. We need to do it with student-athletes and coaches and we need to do it often. I sayoften, that doesn't mean you need to bring someone in to speak every other week. Just do some things to keep the message out there.

I recommend that you have small groups. We've got to get away from general student populations. It takes time and it needs to be repetitive and, in my opinion, needs to be interactive. When I give a presentation to 50 people, it goes significantly better than when I speak to 100 people. I can see you and I make eye contact with you. If there were 200 people in the room, they would hesitate to ask questions or ! involved. I would look for speakers who are competent, not only knowledgeable about the information, b confident in providing it to your population. Knowing about AIDS doesn't mean they can talk about it in effective way, so make sure you get competent speakers.

What scares me the most about the virus and HIV / AIDS is, if you look at your student-athl~ I think it's fair to say that some of those you work with are sexuallyactive. Maybe 50 percent, and in some schools, maybe less. Research tells us that students know about questionable usage of barrier protection but, they don't do anything about it. They have mY/AIDS risk behavior. Whether we want to believe it or not, and Magic Johnson is an example, there are athletes walking around today that you work with that are my positive. In 10 years, they're going to have AIDS if we don't figure out a cure. For that reason, we need to do more about this issue.

I want to thank you for coming. There aren't perfect answers to every question and that's frustrating. I know it is to me but, we need to provide for all populations and you certainly have one that is more captive than others. Many people don't listen because they don't think it applies to them, so I certainly appreciate those of you who came today. Thank you.