Methods: Incident infections among non-deployed Army soldiers from 2011-2014 were identified from the US Military Disease Reporting System-internet. A thirty-day gap-in-care rule was used to define incident cases. US national incidence rates (IR) for similar demographic groups were obtained from the CDC’s 2013 Sexually Transmitted Disease Surveillance Report. Estimates of compliance with recommended annual chlamydia screening for sexually active women under 25 years were obtained from published reports.
Results: A total of 33,001 incident chlamydia infections were reported for the Army during 2011-2014, reflecting an overall IR of 1658 infections/100,000 soldiers per year. Army incidence declined from a high of 1768/100,000 soldiers in 2011 to a low of 1620/100,000 soldiers in 2014. Similarly, the US rate decreased 1.5% from 2012 to 2013. In both US and Army populations rates among women were higher, especially in women under 25. Among female soldiers 17-24 years, the 2013 IR was 8053/100,000; the IR for US females 15-24 years was 3340/100,000. The CDC estimated 45.1% of sexually active US women under 25 with a commercial health care plan were screened for chlamydia in 2012, while the Army Medical Command estimated 61.7% of sexually active female beneficiaries (soldiers, and soldier/retiree family members) under 25 were screened during the same time.
Conclusion: Declines in chlamydia incidence in both Army and civilian populations were observed. Possible reasons for the Army decline are being explored. Rates were higher among soldiers; however, this may reflect differences in demographics as the Army is made up of a higher proportion of young at-risk individuals and does not include 15-16 year old adolescents who may be less sexually active. Increased screening rates within the Army may also contribute to higher estimates. However, incidence estimates likely remain conservative given the asymptomatic nature of infection and the likelihood of under-reporting.
J. Gaydos, None
L. Pacha, None
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