High-risk Behavior Among U.S. Military HIV-Infected Active-Duty and Retired Personnel

Abstract

BackgroundDespite a high incidence of sexually transmitted infections (STIs), sexual behavior among U.S. military personnel remains understudied. Since 2014, the U.S. Military HIV Natural History Study has administered a behavioral questionnaire to a cohort of HIV-infected active-duty (AD) and retired personnel (RP). We compared patterns of risk behavior between AD and RP.MethodsMale participants who completed a behavioral questionnaire (n = 1,465) were included in this study. Chi-square and stepwise logistic regression were used to compare AD with RP. Our model included all behavioral variables listed below with adjustment for age and race. We assumed a priori that duty status would be correlated with age and selected the former as our variable of interest, hypothesizing that AD would engage in a higher number of risk behaviors.ResultsSelected demographics and behavioral data are summarized below.AD (n = 731) %RP (n = 734) %Univariate Odds (95% CI)Multivariate Odds (95% CI)DemographicsMedian Age (IQR)30 (26,37)51 (46,57)Race--White32.745.0--Black46.143.6--Hispanic/Other21.211.4Behavioral DataConsumed > 6 drinks on a single occasion (past year)50.932.12.2 (1.7,2.8)Ever experienced injury from drinking84.572.92.0 (1.6,2.6)Ever used hard drugs7.317.60.4 (0.3,0.5)0.5 (0.3,0.9)High self-perceived risk for STI22.119.11.3 (1.0,1.6)> 2 new sexual partners in past three months22.614.51.7 (1.3,2.3)Ever had sex with woman65.982.80.4 (0.3,0.5)Ever had sex with man82.179.81.2 (0.9,1.5)Condomless anal intercourse in last 3 mos (casual partner)29.527.21.1 (0.8,1.5)Condomless anal intercourse in last 3 mos (anonymous partner)22.318.21.3 (0.9,1.8)AD had significantly (P < 0.01) higher rates of gonorrhea (6.4) and chlamydia (6.0) per 100 person-years (py) than RP (2.2 and 1.6, respectively); syphilis rates did not differ between the groups (AD 1.2/100 py; RP 1.3/100 py).Conclusion In contrast with our hypothesis, we found a high prevalence of sexual risk behavior among both AD and RP, and only lifetime use of hard drugs was independently associated with duty status. Despite high STI rates, ~20% in either group reported high self-perceived risk for STIs and/or recent condomless sex with an anonymous partner. Our findings demonstrate a need for intensive STI screening and counseling among HIV-infected military personnel in multiple career stages.Disclosures All authors: No reported disclosures.