New findings provide insight into HIV epidemic in the U.S. Army

The repeal of the Don’t Ask, Don’t Tell policy allows characterization of the epidemic for the first time

Results of a recently initiated comprehensive HIV characterization program helps paint a detailed portrait of the HIV epidemic within the U.S. Army. The results of the study, based on data collected since the repeal of Don’t Ask, Don’t Tell (DADT) in 2011, were published in the Journal of Acquired Immune Deficiency Syndrome. The analysis was conducted by the U.S. Military HIV Research Program (MHRP) at the Walter Reed Army Institute of Research.

The findings mirror larger HIV trends across the U.S., with the majority of new cases being male. The majority of HIV-infected Soldiers had engaged in same sex relations and were African-American.

“More frequent testing and pre-exposure prophylaxis may be warranted in certain high-risk groups,” said Shilpa Hakre DrPH, MPH, first author on the paper. “We also found infrequent condom use, which needs to be addressed to avoid secondary infections.”

In 2012, the U.S. Army Public Health Command implemented a new, comprehensive program to capture information to help them identify people at higher risk of becoming HIV infected and inform prevention strategies. Soldiers newly diagnosed with HIV were administered a standardized case report form that documented socio-demographic, sexual and other risk behavior. According to U.S. Army statistics, HIV incidence increased among Soldiers from 2009 to 2012, with new diagnoses among male soldiers accounting for the rise. The DADT policy, which prevented public disclosure of same-sex relations, hindered the collection of data on sexual risk behaviors among HIV-infected soldiers and transmission risks were largely unknown.

The DADT repeal has enabled service members to disclose same-sex relations to health care providers, which has allowed epidemiologists to track demographic and behavioral characteristics among those service members infected with HIV. These findings are significant because they help to characterize at-risk populations, enabling the Army to better target risk reduction and health intervention efforts.

Researchers are working with the U.S. Army Public Health Command and other military Services to develop and implement HIV prevention interventions and test them as they are rolled out to ensure they are effective. “Our goal is to decrease HIV and related infections in the U.S. Military,” said MHRP director COL Nelson Michael. “Having access to data to inform HIV prevention efforts is critical to successful interventions.”

See the paper abstract here.