1565. Incidence of sexually transmitted infections (STIs) in the U.S. military is associated with female gender, increasing length of service and non-deployment
Session: Poster Abstract Session: Clinical Infectious Diseases: Sexually Transmitted Infections
Saturday, October 10, 2015
Room: Poster Hall
Background: Numerous studies have found higher rates of sexually transmitted infections (STIs) among military personnel than the general population, but the cumulative risk of acquiring STIs throughout an individual’s military career has not been described.

Methods: Using ICD-9 diagnosis codes, we analyzed the medical records of 100,005 individuals from all service branches, divided in equal cohorts (n=6,667) between 1997 and 2011. Incidence rates were calculated for pathogen-specific STIs along with syndromic diagnoses (cervicitis, vaginitis, urethritis and pelvic inflammatory disease). Descriptive statistics were used to characterize the individuals within each accession year cohort, and i­n order to determine the proportion who had experienced at least one STI, repeat infections were censored.

Results: The total sample included 70,99­5 males and 29,010 females.  The STI incidence rates (per 100 person-years) for women and men were as follows: chlamydia (3.5 and 0.7), gonorrhea (1.1 and 0.4), HIV (0.04 and 0.07) and syphilis (0.14 and 0.15). During the 15-year study period, 22% of women and 3.3% of men sustained a pathogen-specific STI; inclusion of syndromic diagnoses increased these percentages to 41% and 5.5%, respectively. Higher rates of pathogen-specific STIs were observed among African-Americans compared with Caucasians (11.3 vs 3.8, p<0.001), enlisted service members compared with officers (5.5 vs 2.7, p<0.001) and individuals with a history of deployment compared with non-deployed individuals (6.8 vs 4.4, p<0.001). In the overall sample, increasing number of years of service was associated with an increased likelihood of an STI diagnosis (p<0.001 for trend).

Conclusion: In this survey of military personnel, we found very high rates of STI acquisition throughout military service, especially among women. While longitudinal increases of STI diagnoses are partially the result of longer follow-up time, the high rates observed among women demonstrate that STI-related risk is significant and ongoing throughout military service. Lower STI incidence rates among men probably represent under-diagnosis and demonstrate a need for enhancing male-directed screening and diagnostic interventions.

Robert Deiss, MD1,2,3, Octavio Mesner, MS4, Richard Bower, MD5, Jose Sanchez, MD, MPH6, Edgie Co, DO, PhD7, Anuradha Ganesan, MD, MPH8, Grace E Macalino, PhD8 and Brian Agan, MD, FIDSA2,3,4, (1)Division of Infectious Diseases, Naval Medical Center of San Diego, San Diego, CA, (2)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, (3)Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, (4)Infectious Disease Clinical Research Program, USUHS, Rockville, MD, (5)Naval Medical Center of San Diego, San Diego, CA, (6)Armed Forces Health Surveillance Center, Silver Spring, MD, (7)William Beaumont Army Medical Center, El Paso, TX, (8)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD

Disclosures:

R. Deiss, None

O. Mesner, None

R. Bower, None

J. Sanchez, None

E. Co, None

A. Ganesan, None

G. E. Macalino, None

B. Agan, None

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