2261. High-risk behavior among U.S. Military HIV-Infected Active-Duty and Retired Personnel
Session: Poster Abstract Session: HIV: Sexually Transmitted Infections
Saturday, October 7, 2017
Room: Poster Hall CD
Background: Despite 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.

Methods: Male 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.

Results: Selected demographics and behavioral data are summarized below.

AD (n=731)

%

RP (n=734) %

Univariate Odds
(95% CI)

Multivariate Odds (95% CI)

Demographics

Median Age (IQR)

30 (26,37)

51 (46,57)

Race

--White

32.7

45.0

--Black

46.1

43.6

--Hispanic/Other

21.2

11.4

Behavioral Data

Consumed > 6 drinks on a single occasion (past year)

50.9

32.1

2.2 (1.7,2.8)

Ever experienced injury from drinking

84.5

72.9

2.0 (1.6,2.6)

Ever used hard drugs

7.3

17.6

0.4 (0.3,0.5)

0.5 (0.3,0.9)

High self-perceived risk for STI

22.1

19.1

1.3 (1.0,1.6)

> 2 new sexual partners in past three months

22.6

14.5

1.7 (1.3,2.3)

Ever had sex with woman

65.9

82.8

0.4 (0.3,0.5)

Ever had sex with man

82.1

79.8

1.2 (0.9,1.5)

Condomless anal intercourse in last 3 mos (casual partner)

29.5

27.2

1.1 (0.8,1.5)

Condomless anal intercourse in last 3 mos (anonymous partner)

22.3

18.2

1.3 (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.

Danielle Pannebaker, MD1, Derek Larson, DO2, Xun Wang, MS3, Anuradha Ganesan, MD, MPH4, Jason Okulicz, MD5, Christina Schofield, MD FACP, FIDSA6, Thomas O'Bryan, MD4, Brian Agan, MD7 and Robert Deiss, MD8,9,10, (1)Department of Internal Medicine, San Diego, CA, (2)Division of Infectious Diseases, Naval Medical Center San Diego, San Diego, CA, (3)The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, (4)Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, (5)Infectious Disease, San Antonio Military Medical Center, Fort Sam Houston, TX, (6)Madigan Army Medical Center, Tacoma, WA, (7)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Rockville, MD, (8)Infectious Diseases Clinical Research Program, Uniformed Services University, Bethesda, MD, (9)Infectious Diseases, Naval Medical Center San Diego, San Diego, CA, (10)Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD

Disclosures:

D. Pannebaker, None

D. Larson, None

X. Wang, None

A. Ganesan, None

J. Okulicz, None

C. Schofield, None

T. O'Bryan, None

B. Agan, None

R. Deiss, None

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