Feasibility, acceptability, and short-term impact of a brief sexually transmitted infection intervention targeting U.S. Military personnel and family members

Abstract

Background Over the past 10 years, incidence of sexually transmitted infections (STIs) has increased to record numbers in the United States, with the most significant increases observed among adolescents and young adults. The US military, where the majority of active duty personnel are 18–30 years old, has seen similar increases. However, the US military does not yet have a standardized, service-wide program for STI education and prevention. Methods The KISS intervention (Knocking out Infections through Safer-sex and Screening) was adapted from an evidence-based intervention endorsed by the US Centers for Disease Control and Prevention and consisted of a one-time, small group session. Content included STI/HIV knowledge and prevention, condom use skills, and interpersonal communication techniques. The intervention was pilot tested for feasibility and acceptability among a population of service members and medical beneficiaries at Joint Base Lewis-McChord in Washington state. Results A total of 79 participants aged 18–30 years were consented to participate in the pilot study and met entry criteria, 66/79 (82.5%) attended the intervention session, and 46/66 (69.7%) returned at 3 months for the final follow-up assessment. The intervention sessions included 31 male (47.0%) and 35 female (53.0%) participants. Almost all participants felt comfortable discussing sexual issues in the group sessions, reported that they intended to practice safer sex after the intervention, and would also recommend the intervention to friends. Knowledge about STI/HIV prevention significantly increased after the intervention, and intervention effects were maintained at 3 months. About one-fifth of participants tested positive for N. gonorrhea or C. trachomatis infection at enrollment, while none had recurrent STIs at the final visit. Use of both male and female condoms increased after the intervention. Conclusions The KISS intervention was feasible to implement in the military setting and was acceptable to the active duty service members and other medical beneficiaries who participated in the pilot project. Further studies are needed to determine if the KISS intervention, or others, effectively decrease STI incidence in active duty personnel and would be appropriate for more widespread implementation. Trial Registration Retrospectively registered as the pilot phase of clinicaltrials.gov NCT04547413, “Prospective Cohort Trial to Assess Acceptability and Efficacy of an Adapted STI/HIV Intervention Behavioral Intervention Program in a Population of US Army Personnel and Their Medical Beneficiaries—Execution Phase.”

Prevalence of Urogenital Mycoplasma genitalium Infection at 2 US Army Medical Facilities

“…We conducted cross-sectional analyses of enrollment visit data from US Army service members and other Military Health System beneficiaries participating in a randomized controlled trial of a group-based STI/HIV behavioral intervention (Knocking out Infections through Safer sex and Screening [KISS]; ClinicalTrials.gov identifier: NCT04547413) 22 …”

“…gov identifier: NCT04547413). 22 The study included active-duty army personnel and other beneficiaries of the Military Health System (e.g., adult children and spouses of service members, US Army Reserve). Additional inclusion criteria were to be aged 18 to 30 years; receive care at a military health care clinic for at least 12 months from enrollment; not scheduled for a permanent change of station or deployment within 3 months from enrollment; self-reported to not be pregnant or trying to become pregnant if female or conceive with a female partner if male; HIV antibody negative (confirmed by enzyme immunoassay/Western blot on serum at the enrollment visit); had vaginal, anal, or oral sex in the past 30 days; and had a clinical indication for STI screening in the past 6 months.…”