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

Scott, Paul T.; Hakre, Shilpa; Myles, Otha; Sanders‐Buell, Eric; Kijak, Gustavo H.; McCutchan, Francine E.; O’Connell, Robert J.; Peel, Sheila A.; Eggleston, John C.; Sateren, Warren B.; Robb-McGrath, Micaela; Mott, Robert L.; Tobler, Steven K.; Nolan, Eileen; Petruccelli, Bruno P.; Michael, Nelson L.; Cersovsky, Steven B.

doi:10.1089/aid.2011.0363

Cited by 11 publications

(11 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, most data on STIs and HIV in military personnel come from studies of new recruits or those on active duty, and not among recent Veterans. (29) Risk behaviors for STI and HIV may persist among recent Veterans returning to their communities; however routine surveillance is no longer performed.…”

Section: Discussionmentioning

confidence: 99%

STI Diagnosis and HIV Testing Among OEF/OIF/OND Veterans

Goulet

Martinello²,

Bathulapalli³

et al. 2014

Medical Care

View full text Add to dashboard Cite

Importance Patients with an STI diagnosis should be tested for HIV, regardless of previous HIV test results. Objective Estimate HIV testing rates among recent service Veterans with an STI diagnosis and variation in testing rates by patient characteristics. Design, setting, and participants The sample comprised 243,843 Veterans who initiated Veterans Health Administration (VHA) services within one year after military separation. Participants were followed for two years to determine STI diagnoses and HIV testing rates. We used relative risks regression to examine variation in testing rates. Main outcomes and measures We used VHA administrative data to identify STI diagnoses and HIV testing and results. Results Veterans with an STI diagnosis (n=1,815) had higher HIV testing rates than those without (34.9% vs. 7.3%, p<0.0001), but were not more likely to have a positive test result (1.1% vs. 1.4%, p=0.53). Among Veterans with an STI diagnosis, testing increased from 25% to 45% over the observation period; older age was associated with a lower rate of testing, while race and ethnicity, multiple deployments, PTSD, and substance abuse disorders were associated with a higher rate. Conclusions and Relevance Since VHA implemented routine HIV testing, overall rates of testing have increased. However, among Veterans at significant risk for HIV because of an STI diagnosis, only 45% had an HIV test in the most recent year of observation. Other patient characteristics such as alcohol and drug abuse were associated with being tested for HIV. Providers should be reminded that an STI is a sufficient reason to test for HIV.

show abstract

Section: Discussionmentioning

confidence: 99%

STI Diagnosis and HIV Testing Among OEF/OIF/OND Veterans

Goulet

Martinello²,

Bathulapalli³

et al. 2014

Medical Care

View full text Add to dashboard Cite

show abstract

“…Studies suggest that the deployment cycle is often associated with increased stress and psychological distress, which tends to increase risk taking behavior, in-cluding sexual promiscuity (2). There may be a relationship between HIV infections and deployment due to the findings of acute HIV infection close in proximity to predeployment period (7). It has also been noted that prevalence of STI increased among service members deployed to Iraq and Afghanistan between 2005 -2009 (8).…”

Section: Discussionmentioning

confidence: 99%

“…The effect of sexually transmitted infections on productivity among soldiers is also of concern. One study noted that five soldiers had to terminate deployment early to be evaluated for lymphadenopathy secondary to HIV, while two additional soldiers contracted an STI in addition to HIV and had to terminate deployment early (7). Another study suggests that at least 25% of HIV-positive service members leave the military within the first 16 months Although we were able to gather some data for prevalence of STI among deployed military personnel, the ma-jority of publications evaluated for this study pertained to rates of STI among active duty service members without specifying their deployment status.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is necessary to evaluate the effects of deployment on issues related to consequences of behavioral health. Al-though there are numerous studies evaluating the prevalence of sexually transmitted infections (STIs) among U.S. military personnel, we currently do not have sufficient data to evaluate the effect of deployment on the prevalence of STIs (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Sexually transmitted infections continue to pose a risk to military personnel.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Retrospective Study Evaluating Sexually Transmitted Diseases in Military Personnel During Deployment. Is There a Need to Change Current Practices?

2019

View full text Add to dashboard Cite

Background: Historically, the US Military has made significant contributions toward the treatment and prevention of common sexually transmitted infections (STI) including syphilis, gonorrhea, and human immunodeficiency virus. Although there have been numerous studies evaluating the prevalence of STIs among service members, there is a lack in studies that evaluate the prevalence of STIs acquired by U.S. military personnel during the deployment period. Objectives: The objective of this study is to evaluate the rates of sexually transmitted infections (STI) among U.S. military personnel within the deployment period to determine if further studies are needed to evaluate its significance on public health. Data Sources: We retrospectively collected data published between the years 2005 to 2018 of US military active duty members who tested positive for human immunodeficiency virus (HIV), human papillomavirus (HPV), herpes simplex virus I (HSV I), herpes simplex virus II (HSV II), Chlamydia trachomatis (CT), Neisseria gonorrhoeae, and Syphilis. We performed a literature review using Medline, PubMed, and Google Scholar to collect data from publications related to sexually transmitted infections among U.S. military servicemen published between the years 2005-2018. Study Eligibility Criteria: Inclusion criteria for post-deployment group included those who tested positive for a given STI during deployment (time spent during active duty) and those who tested positive in the period up 180 days upon returning from deployment. Results: The total sample size from our study included 4984014 active duty military personnel, of which 1321706 (27%) individuals had a prior history of deployment. From the total sample size, 265886 (5.3%) of service members had a positive STI diagnosis. Among those with a positive STI diagnosis, 9083 (1.7%) were diagnosed while they were deployed, whereas 14121 (2.7%) were diagnosed in within 180 days of returning home. Conclusions: Although there is insufficient data regarding pre-deployment versus post-deployment rates of sexually transmitted infections, the available data we analyzed regarding post-deployment STI suggests that it may be beneficial to screen service members for common STIs immediately upon return from deployment. Individuals who are predisposed to participating in high risk sexual behavior pose a higher risk of returning home with a sexually transmitted infection. Therefore, a screening questionnaire administered upon return from deployment to stratify high risk sexual behavior would be beneficial in identifying individuals that need to be tested for STIs. Deployed soldiers returning home with STIs have the potential to infect their spouses/significant others. In addition, the risk of untreated STIs has the potential to pose a public health issue, especially when considering that overseas deployed soldiers may contract strains of viruses or bacteria that have the potential to develop resistance to current standard of treatment within the United States. Additional studies are needed to ...

show abstract

“…Although source patients that are U.S. military members are presumed to be very low risk because of mandatory HIV screening before deployment, it should be noted that cases of HIV-positive service members have been identified during deployment. 17 In contrast to countries with limited public health data regarding HIV infection, military operations performed in areas with high HIV prevalence pose several additional challenges. For example, there are 9 countries in Sub-Saharan Africa with an HIV prevalence of 10%, with Swaziland the highest at 26%.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of HIV Postexposure Prophylaxis for Occupational and Nonoccupational Exposures at a Deployed U.S. Military Trauma Hospital

Okulicz¹,

Murray²

2012

Military Medicine

View full text Add to dashboard Cite

Objective: Postexposure prophylaxis (PEP) is an important strategy to prevent human immunodeficiency virus acquisition after occupational and nonoccupational exposures. Since exposures to blood and other body fluids commonly occur in a combat setting, it is important to evaluate PEP utilization in the deployed environment. Methods: This is a retrospective review of Public Health, pharmacy, and medical records for PEP cases at a U.S. military trauma hospital in Afghanistan from February 1, 2007 through June 30, 2012. The decision to initiate PEP and the antiretroviral regimens selected were also evaluated for concordance with published Centers for Disease Control (CDC) guidelines. Results: At total of 31 cases were prescribed PEP over the 65-month study period, including 27 occupational and 4 nonoccupational exposures. Of the 23 cases with sufficient data for evaluation, 18 (78.2%) initiated PEP in concordance with CDC guidelines and the discordant cases were prescribed PEP secondary to patient request. Antiretroviral regimens were in concordance with CDC guidelines in 27 of 31 (87.1%) cases, with most discordant cases prescribed differing durations of PEP. Conclusions: Despite the challenges of health care delivery in a deployed environment, the decisions to initiate human immunodeficiency virus PEP and the selection of antiretroviral regimens were typically concordant with CDC guidelines. BACKGROUND The human immunodeficiency virus (HIV) targets CD4+T cells leading to immune destruction and eventually the development of acquired immunodeficiency syndrome in untreated cases. HIV is typically transmitted by sexual contact, intravenous drug use, or by mother-to-child transmission. For the military population, sexual contact is the primary method of HIV transmission since prenatal care is readily available and intravenous drug use is rare with an incidence of 1%.

show abstract

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

Cited by 11 publications

References 13 publications

STI Diagnosis and HIV Testing Among OEF/OIF/OND Veterans

STI Diagnosis and HIV Testing Among OEF/OIF/OND Veterans

A Retrospective Study Evaluating Sexually Transmitted Diseases in Military Personnel During Deployment. Is There a Need to Change Current Practices?

Evaluation of HIV Postexposure Prophylaxis for Occupational and Nonoccupational Exposures at a Deployed U.S. Military Trauma Hospital

Contact Info

Product

Resources

About