Abstract
BackgroundSexual health in the military comprises a range of concerns including sexually transmitted infections (STI), unintended pregnancy, sexual violence and sexual dysfunction. This study aims to estimate the prevalence of sexual health concerns by gender in the French military and compare these prevalences to estimates in the general population.MethodsCOSEMIL, the first sexual health survey in the French military comprises a probability sample of 1500 military personnel. Chi-square tests were used to compare lifetime abortion, STIs and sexual assault, and recent sexual dysfunction and sexual satisfaction by gender and explore the association between these indicators and current sexual risk (condom use at last intercourse).ResultsWomen were more likely than men to declare negative sexual health outcomes, with the greatest difference related to sexual assault (24.3% versus 5.1% of males, p < 0.001) and sexual dysfunction hindering sexuality (15.2% of females versus 5.3% of males, p < 0.001). Women were also twice as likely to report ever having an STI (6.7% versus 3.4%, p = 0.03). Comparison with the French general population indicates lower percentages of STIs among military men (2.9% versus 4.9%) and higher percentages of abortion (17.6% versus 14.3%) forced sex (10.6% versus 7.4%) and sexual dysfunction (14.2% versus 9.3%) among military women.ConclusionThese results highlight gendered pattern of sexual health in the French military with women suffering greater sexual risks than men. Military health services should include women’s health services to address the sexual and reproductive health gender gap.
Highlights
Sexual health in the military comprises a range of concerns including sexually transmitted infections (STI), unintended pregnancy, sexual violence and sexual dysfunction
Comparing our study sample to the 115 individuals who refused to participate and completed a short refusal questionnaire, we found no significant difference in age, military rank, number of years in the military and deployment history but higher refusal rates in the Navy as compared to the Army or the Air Force
Exploring the interconnection between the different negative dimensions of sexual health among the military (STIs, forced sex, abortion and sexual dysfunction causing distress), we found that women were more likely than men to report any unfavorable sexual health experience (39.4% versus 21.7%, p < 0.001) and more likely to report at least two unfavorable outcomes as compared to men (11.7% versus 2.0%, p < 0.001)
Summary
Sexual health in the military comprises a range of concerns including sexually transmitted infections (STI), unintended pregnancy, sexual violence and sexual dysfunction. This study aims to estimate the prevalence of sexual health concerns by gender in the French military and compare these prevalences to estimates in the general population. Female recruits are less likely to hold a graduate degree and less represented at higher military ranks as compared to men [18, 19]. Within this population, we seek to 1) describe the prevalence of several dimensions of sexual health by sex and compare these prevalences to estimates in the general population 2) explore the intersection of these different dimensions and how they relate to current reports of condom non-use with a casual partner as an indicator of sexual risk
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