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

Goulet, Joseph L.; Martinello, Richard A.; Bathulapalli, Harini; Higgins, Diana M.; Driscoll, Mary; Brandt, Cynthia; Womack, Julie A.

doi:10.1097/mlr.0000000000000253

Cited by 11 publications

(12 citation statements)

References 21 publications

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“…In one study of health behaviors in a representative sample of all active duty service members, both male and female, across all branches, over a third reported seldom or never using condoms with new sexual partners ( Barlas, Higgins, Pflieger, & Diecker, 2013 ). Veterans also have higher prevalence of substance use disorders and mental health issues, including posttraumatic stress disorder (PTSD), which have been linked to sexual risk behaviors and STIs ( Goulet et al, 2014 ; Hoerster et al, 2012 ; Hutton, McCaul, Santora, & Erbelding, 2008 ). There is also evidence that indicates that male veterans have a higher lifetime prevalence than nonveterans of having extramarital sex and paying for sex ( London, Allen, & Wilmoth, 2013 ; London & Wilmoth, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Sexual Behaviors and Sexually Transmitted Infections Among Male Veterans and Nonveterans

et al. 2017

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Little is known about the sexual health of male veterans. This study used nationally representative data from the 2011 to 2013 National Survey of Family Growth to compare sexual behaviors and history of sexually transmitted infections (STIs) between male veterans and nonveterans. The sample included 3,860 men aged 18 to 44 years who reported ever having sex with a man or woman. The key independent variable was veteran status. Sexual behavior outcomes included ≥6 lifetime female partners, ≥10 lifetime partners of either sex, ≥2 past-year partners of either sex, having past-year partners of both sexes, and condom nonuse at last vaginal sex. STI outcomes included past-year history of chlamydia, gonorrhea, or receiving any STI treatment; lifetime history of herpes, genital warts, or syphilis; and an aggregate measure capturing any reported STI history. Logistic regression models were used to evaluate associations between veteran status and each outcome. In models adjusting for age, race/ethnicity, education, income, and marital status, veterans had significantly greater odds than nonveterans of having ≥6 lifetime female partners (OR = 1.5, 95% CI [1.02, 2.31]). In models adjusting for age and marital status, veterans had significantly greater odds of having partners of both sexes in the past year (OR = 4.8, 95% CI [1.2, 19.8]), and gonorrhea in the past year (OR = 3.2, 95% CI [1.2, 8.5]). Male veterans were thus significantly more likely than nonveterans to have STI risk factors. Health care providers should be aware that male veterans may be at higher risk for STIs and assess veterans’ sexual risk behaviors.

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Section: Introductionmentioning

confidence: 99%

Sexual Behaviors and Sexually Transmitted Infections Among Male Veterans and Nonveterans

et al. 2017

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“…A 2005 survey of 80 commercial health plans showed an overall HIV screening prevalence of almost 20% [22]; while a 2006–2007 survey of six health insurance plans indicated an overall HIV screening prevalence of nearly 33% [9]. In 2009–2010, another study using Sexually Transmitted Diseases (STD) surveillance network data reported a HIV screening prevalence of 51% [26], which was similar to a 2014 survey of Veterans Health Administration (VHA) administrative data which showed a 45% HIV screening prevalence [10]. Our study showed a rather sizable improvement from the 15% HIV screening prevalence recorded in a similar study that utilized 1998 Medicaid claims data from four states [14].…”

Section: Discussionmentioning

confidence: 82%

“…Screening can identify patients infected with HIV, and it facilitates the prompt initiation of antiretroviral therapy (ART), which inhibits progression to AIDS and prevents transmission of the virus. HIV-infected persons are more likely to adopt safer sexual behaviors if they are aware of their HIV status [ 9 , 10 ]. HIV screening at the time of STI diagnosis is a teachable moment for patients, providing sexual risk reduction counseling to at-risk persons, safe sex resources like condoms or pre-exposure prophylaxis, as well as informing them of their HIV status.…”

Section: Introductionmentioning

confidence: 99%

HIV Screening Rates among Medicaid Enrollees Diagnosed with Other Sexually Transmitted Infections

Adekeye¹,

Abara²,

Xu³

et al. 2016

PLoS ONE

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IntroductionApproximately 20 million new sexually transmitted infections (STIs) are diagnosed yearly in the United States costing the healthcare system an estimated $16 billion in direct medical expenses. The presence of other STIs increases the risk of HIV transmission. The Centers for Disease Control and Prevention (CDC) has long recommended routine HIV screening for individuals with a diagnosed STI. Unfortunately, HIV screening prevalence among STI diagnosed patients are still sub-optimal in many healthcare settings.ObjectiveTo determine the proportion of STI-diagnosed persons in the Medicaid population who are screened for HIV, examine correlates of HIV screening, and to suggest critical intervention points to increase HIV screening in this population.MethodsA retrospective database analysis was conducted to examine the prevalence and correlates of HIV screening among participants. Participant eligibility was restricted to Medicaid enrollees in 29 states with a primary STI diagnosis (chlamydia, gonorrhea, and syphilis) or pelvic inflammatory disease claim in 2009. HIV-positive persons were excluded from the study. Frequencies and descriptive statistics were conducted to characterize the sample in general and by STI diagnosis. Univariate and multivariate logistic regression were performed to estimate unadjusted odds ratios and adjusted odds ratio respectively and the 95% confidence intervals. Multivariate logistic regression models that included the independent variables (race, STI diagnosis, and healthcare setting) and covariates (gender, residential status, age, and state) were analyzed to examine independent associations with HIV screening.ResultsAbout 43% of all STI-diagnosed study participants were screened for HIV. STI-diagnosed persons that were between 20–24 years, female, residing in a large metropolitan area and with a syphilis diagnosis were more likely to be screened for HIV. Participants who received their STI diagnosis in the emergency department were less likely to be screened for HIV than those diagnosed in a physician’s office.ConclusionThis study showed that HIV screening prevalence among persons diagnosed with an STI are lower than expected based on the CDC’s recommendations. These suboptimal HIV screening prevalence present “missed opportunities” for HIV screening in at-risk populations. Measures and incentives to increase HIV screening among all STI-diagnosed persons are vital to the timely identification of HIV infection, linkage to HIV care, and mitigating further HIV transmission.

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“…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%

“…Sexually transmitted infections continue to pose a risk to military personnel. Despite the US military's significant contributions toward the treatment and prevention of STIs, military populations continue to have higher rates of sexually transmitted infections in comparison to the civilian population (1). This is of concern, considering sexually transmitted infections such as HIV, can lead to long-term morbidity.…”

Section: Introductionmentioning

confidence: 99%

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

2019

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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 ...

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

Cited by 11 publications

References 21 publications

Sexual Behaviors and Sexually Transmitted Infections Among Male Veterans and Nonveterans

Sexual Behaviors and Sexually Transmitted Infections Among Male Veterans and Nonveterans

HIV Screening Rates among Medicaid Enrollees Diagnosed with Other Sexually Transmitted Infections

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

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