HIV Infection Among U.S. Army and Air Force Military Personnel: Sociodemographic and Genotyping Analysis

Abstract

Since 1985, the U.S. Department of Defense has periodically screened all military personnel for HIV allowing for the monitoring of the infection in this dynamic cohort population. A nested case-control study was performed to study sociodemographics, overseas assignment, and molecular analysis of HIV. Cases were newly identified HIV infections among U.S. Army and Air Force military personnel from 2000 to 2004. Controls were frequency matched to cases by gender and date of case first positive HIV screening test. Genotyping analysis was performed using high-throughput screening assays and partial genome sequencing. HIV was significantly associated with black race [odds ratio (OR) = 6.65], single marital status (OR = 4.45), and age (OR per year = 1.07). Ninety-seven percent were subtype B and 3% were non-B subtypes (A3, CRF01_AE, A/C recombinant, G, CRF02_AG). Among cases, overseas assignment in the period at risk prior to their first HIV-positive test was associated with non-B HIV subtype infection (OR = 8.44). Black and single military personnel remain disproportionately affected by HIV infection. Most non-B HIV subtypes were associated with overseas assignment. Given the increased frequency and length of assignments, and the expanding HIV genetic diversity observed in this population, there is a need for active HIV genotyping surveillance and a need to reinforce primary HIV prevention efforts.

HIV/STI Prevalence Study Among Military Conscripts in Estonia

“…Some previous studies indicate STI prevalence rates among military personnel are higher than rates associated with the non-military population. Other studies found STI rates in military personnel are similar to those of the general population [2,3,15,16]. Within the armed forces, factors found to modify risk include: age, gender, race, marital status, length of military service, full time or reserve status, and rank.…”

“…STI rates are influenced by the presence of active testing policies. A military with HIV/STI screening tests at entrance would admit fewer persons with prior HIV infection, thereby lowering the potential prevalence [15].…”

Short Communication: Investigation of Incident HIV Infections Among U.S. Army Soldiers Deployed to Afghanistan and Iraq, 2001–2007

“…This was not unexpected as these findings are consistent with those in a previous report of the epidemic of HIV in the U.S. Army and Air Force. 2 However, these data demonstrate that HIV infection results in short-term morbidity and lost duty time in the combat environment. The realities of the current combat environment support the rationale that served as a basis for implementing force-wide screening policies 25 years ago.…”

“…The epidemic in the Army is similar to that in the U.S. general population; HIV infection disproportionately affects blacks and males and also disproportionately affects certain regions of the country including the South and Northeast. [2][3][4] By regulation, all U.S. soldiers are subject to periodic serologic screening for HIV every 2 years. In addition, soldiers who deploy to combat are also screened both prior to and after returning from deployments.…”

“…For each case, archived serum remaining from the last seronegative HIV test performed prior to deployment was obtained from the Department of Defense Serum Repository (DoDSR) 11 and subjected to confirmatory HIV serologic testing 2,12 and nucleic acid amplification testing (NAAT, Amplicor HIV-1 Monitor v 1.5, Roche). Acute HIV infection (AHI) in an individual was identified by an HIV-seronegative sample that was NAAT positive.…”