High-Risk Behavior and Sexually Transmitted Infections Among U.S. Active Duty Servicewomen and Veterans

Abstract

The number of women who are active duty service members or veterans of the U.S. military is increasing. Studies among young, unmarried, active duty servicewomen who are sexually active indicate a high prevalence of risky sexual behaviors, including inconsistent condom use, multiple sexual partners, and binge drinking, that lead to unintended and unsafe sex. These high-risk sexual practices likely contribute to chlamydia infection rates that are higher than the rates in the U.S. general population. Human papillomavirus (HPV) infection and cervical dysplasia may also be higher among young, active duty servicewomen. Little is known about the sexual practices and rates of sexually transmitted infections among older servicewomen and women veterans; however, women veterans with a history of sexual assault may be at high risk for HPV infection and cervical dysplasia. To address the reproductive health needs of military women, investigations into the prevalence of unsafe sexual behaviors and consequent infection among older servicewomen and women veterans are needed. Direct comparison of military and civilian women is needed to determine if servicewomen are a truly high-risk group. Additionally, subgroups of military women at greatest risk for these adverse reproductive health outcomes need to be identified.

Sexual Behaviors and Sexually Transmitted Infections in a Nationally Representative Sample of Women Veterans and Nonveterans

“…Nonetheless, very little is known regarding sexual behaviors and sexually transmitted infections (STIs) in this population, or whether there are differences compared with women nonveterans. 5 Evidence suggests that active duty women frequently engage in high-risk sexual behaviors, defined by the U.S. Preventive Services Task Force as using condoms inconsistently, having multiple concurrent partners, having a new partner, or having sex while under the influence of alcohol or drugs. 6 For example, a number of surveys with active duty women suggest that only a minority report using condoms regularly [7][8][9] and that nearly a third report having sex under the influence of alcohol or drugs.…”

“…Such data are important to improve women veterans' reproductive health with targeted screening and interventions. 5 Therefore, the objectives of this study were to examine lifetime sexual history, sexual activity in the last year, and STIs among women veterans and nonveterans who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2010.…”

Systematic review and meta-analysis of HIV prevalence among men in militaries in low income and middle income countries

“…While women in the military represent a very small portion, they are at increased risk for HIV 11. Women constitute a small proportion of low-income and middle-income countries’ (LMICs) militaries challenging obtaining sufficient data characterising female military data in LMICs.…”

Inconsistent condom use among women veterans and active duty servicewomen

“…The rate of chlamydial infection in female active duty soldiers is significantly greater than in comparative groups of women in the general population. 3 Ingham and Crosby et al substantiate that the aetiology of improper and inconsistent use of condoms must be identified to plan and implement effective public health interventions to eradicate the global problem of sexual transmission of infection. It is likewise imperative that the aetiologies of risky sexual behaviour of young women in the military be understood.…”

“…Clearly, US active duty servicewomen and veterans face unique and difficult challenges regarding their reproductive health, and this issue needs more focus. [1][2][3] …”