Epidemiology of HIV among US Air Force Military Personnel, 1996-2011

PLoS One. 2015 May 11;10(5):e0126700. doi: 10.1371/journal.pone.0126700. eCollection 2015.

Abstract

Objective: The objectives of this study were to describe the epidemiology of HIV in the United States Air Force (USAF) from 1996 through 2011 and to assess whether socio-demographic characteristics and service-related mobility, including military deployments, were associated with HIV infection.

Methods: We conducted a retrospective cohort analysis of USAF personnel who were HIV-infected during the study period January 1, 1996 through December 31, 2011 and a matched case-control study. Cases were USAF personnel newly-diagnosed with HIV during the study period. Five randomly-selected HIV-uninfected controls were matched to each case by age, length of service, sex, race, service, component, and HIV test collection date. Socio-demographic and service-related mobility factors and HIV diagnosis were assessed using conditional logistic regression.

Results: During the study period, the USAF had 541 newly diagnosed HIV-infected cases. HIV incidence rate (per 100,000 person-years) among 473 active duty members was highest in 2007 (16.78), among black/ African-American USAF members (26.60) and those aged 25 to 29 years (10.84). In unadjusted analysis restricted to personnel on active duty, 10 characteristics were identified and considered for final multivariate analysis. Of these single (adjusted odds ratio [aOR], 8.15, 95% confidence interval [CI] 5.71-11.6) or other marital status (aOR 4.60, 95% CI 2.72-7.75), communications/ intelligence (aOR 2.57, 95% CI 1.84-3.60) or healthcare (aOR 2.07, 95% CI 1.28-3.35) occupations, and having no deployment in the past 2 years before diagnosis (aOR 2.02, 95% CI 1.47-2.78) conferred higher odds of HIV infection in adjusted analysis.

Conclusion: The highest risk of HIV infection in the USAF was among young unmarried deployment-naïve males, especially those in higher risk occupation groups. In an era when worldwide military operations have increased, these analyses identified potential areas where targeted HIV prevention efforts may be beneficial in reducing HIV incidence in the USAF military population.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Black or African American
  • Case-Control Studies
  • Female
  • HIV Infections / epidemiology*
  • HIV Infections / ethnology
  • HIV Infections / psychology
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Marital Status / statistics & numerical data*
  • Middle Aged
  • Military Personnel / psychology*
  • Occupations / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • United States / epidemiology
  • White People

Grants and funding

This work was supported by a cooperative agreement (W81XWH-07-2-0067) between The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), and the U.S. Department of Defense (DoD). The views expressed are those of the authors and should not be construed to represent the positions of the DoD. Co-author Peter Dawson is employed by Biostatistics, The EMMES Corporation. The HJF contracted the EMMES Corporation to provide data management and analysis support for this body of work; this contract was funded by the cooperative agreement between HJF and the DoD. The EMMES Corporation provided support in the form of salary for author PD, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific role of this author is articulated in the ‘author contributions’ section.