BACKGROUND:
Sexually
transmitted infections (STIs) are prevalent in the U.S. military. However,
there are limited data on risk-factor differences between sexes.
METHODS:
We used
data from the 2008 Department of Defense Survey of Health Related Behaviors
among active duty military personnel to identify risk factors for self-reported
STIs within the past 12 months and multiple sexual partners among sexually
active unmarried service members.
RESULTS:
There
were 10,250 active duty personnel, mostly white (59.3%) aged 21 to 25 years
(42.6%). The prevalence of any reported STI in the past 12 months was 4.2% for
men and 6.9% for women. One-fourth of men and 9.3% of women reported 5 or more
sexual partners in the past 12 months. Binge drinking, illicit substance use,
and unwanted sexual contact were associated with increased report of sexual
partners among both sexes. Family/personal-life stress and psychological
distress influenced number of partnerships more strongly for women than for men
(Adjusted Odds Ratio [AOR]=1.58, 95% Confidence Interval [CI]=1.18-2.12 and
AOR=1.41, 95% CI=1.14-1.76, respectively). After adjusting for potential
confounders, we found that the report of multiple sexual partners was significantly
associated with the report of an STI among men (AOR, 5.87 [95% CI, 3.70-9.31],
for ≥5 partners; AOR, 2.35 [95% CI, 1.59-3.49], for 2-4 partners) and women
(AOR, 4.78 [95% CI, 2.12-10.80], for ≥5 partners; AOR, 2.35 [95% CI,
1.30-4.25], for 2-4 partners).
CONCLUSIONS:
Factors
associated with the report of increasing sexual partnerships and report of an
STI differed by sex. Sex-specific intervention strategies may be most effective
in mitigating the factors that influence risky sexual behaviors among military
personnel.
Difference in behaviors of sexually active unmarried service members by gender, 2008 HRBS dataset (n=10,250)
| Characteristics | Men (n=6,822)
| Women (n=3,428)
| p-value
|
|---|
| n | % | 95% CI | n | % | 95% CI | |
|---|
| Alcohol and Drug Use | | | | | | | |
| Binge drinking | 4101 | 61.1 | (57.1, 65.2)^ | 1290 | 38.1 | (35.1, 41.2) | <.001*** |
Any illicit substance use, past
12 mo. | 588 | 10.3 | (8.5, 12.1) | 215 | 6.6 | (4.2, 9.1) | <.001*** |
| Marijuana | 466 | 8.3 | (6.4, 10.1) | 178 | 5.5 | (3.1, 7.9) | 0.007** |
| Cocaine | 210 | 3.6 | (2.6, 4.6) | 66 | 2.0 | (1.0, 3.0) | 0.014* |
| Ecstasy | 178 | 3.2 | (2.5, 3.9) | 66 | 2.3 | (1.3, 3.3) | 0.055 |
| Methamphetamine | 102 | 1.7 | (1.2, 2.2) | 30 | 0.9 | (0.5, 1.2) | <.001*** |
| Heroin | 89 | 1.4 | (1.0, 1.8)^ | 20 | 0.5 | (0.1, 0.9) | 0.004** |
| Other illicit substance | 297 | 5.1 | (4.3, 5.8)^ | 70 | 2.3 | (1.3, 3.3) | <.001*** |
Any prescription drug use for
non-medical purpose, past 12
mo. | 1291 | 20.4 | (18.7, 22.1) | 771 | 23.8 | (21.2, 26.3) | 0.006** |
| Stimulants | 188 | 3.3 | (2.7, 3.9) | 108 | 3.3 | (2.4, 4.1) | 0.993 |
| Tranquilizers | 416 | 6.8 | (6.0, 7.7) | 275 | 8.4 | (6.9, 10.0) | 0.032* |
| Sedatives | 219 | 3.7 | (3.0, 4.4) | 142 | 4.4 | (3.1, 5.7) | 0.346 |
| Painkillers | 1199 | 18.9 | (17.2, 20.5) | 717 | 22.2 | (19.6, 24.9) | 0.009** |
| Steroids | 156 | 2.6 | (2.1, 3.0) | 55 | 2.0 | (1.3, 2.8) | 0.248 |
| Sexual Risks | | | | | | | |
| Condom use at last sex | 2685 | 43.0 | (40.9, 45.1)^ | 1005 | 32.1 | (28.8, 35.4) | <.001*** |
| Main partner at last sex | 4404 | 62.9 | (61.1, 64.6) | 2839 | 82.5 | (80.2, 84.8)^ | <.001*** |
No. of sex partners, past 12
mo. | | | | | | | <.001*** |
| 5+ | 1654 | 25.2 | (23.5, 26.8)^ | 339 | 9.3 | (7.8, 10.8) | |
| 2-4 | 2705 | 39.8 | (38.4, 41.2) | 1278 | 38.4 | (35.2, 41.6) | |
| 1 | 2463 | 35.0 | (34.0, 36.1) | 1811 | 52.3 | (48.5, 56.0)^ | |
No. of NEW sex partners, past
12 mo. | | | | | | | <.001*** |
| 2+ | 3403 | 51.3 | (50.2, 52.3)^ | 1069 | 30.7 | (27.3, 34.1) | |
| 1 | 1574 | 23.4 | (22.5, 24.3) | 965 | 31.3 | (29.4, 33.3)^ | |
| None | 1799 | 25.3 | (24.3, 26.4) | 1383 | 37.9 | (35.2, 40.7)^ | |
| Unwanted sexual contact | 196 | 2.9 | (2.3, 3.6) | 515 | 14.2 | (12.0, 16.4)^ | <.001*** |
| STI, past 12 mo. | 273 | 4.2 | (3.5, 4.8) | 217 | 6.9 | (5.7, 8.1)^ | <.001*** |
| Mental Health Indicators | | | | | | | |
| Depression | 1567 | 24.8 | (23.2, 26.4) | 977 | 28.4 | (26.6, 30.2)^ | 0.002** |
| Anxiety | 871 | 13.9 | (12.2, 15.5) | 678 | 20.3 | (17.6, 22.9)^ | <.001*** |
| PTSD | 762 | 12.2 | (10.7, 13.7) | 467 | 13.9 | (12.4, 15.4) | 0.097 |
| Overall stress | | | | | | | <.001*** |
| Low | 3370 | 48.9 | (46.1, 51.6)^ | 1421 | 40.9 | (37.7, 44.1) | |
| Moderate | 1821 | 27.0 | (25.6, 28.4) | 1079 | 31.6 | (29.5, 33.7)^ | |
| High | 1571 | 24.1 | (21.7, 26.5) | 904 | 27.5 | (25.1, 29.8) | |
| High military-related stress | 1765 | 27.1 | (25.1, 29.1) | 1068 | 31.4 | (28.6, 34.2) | <.001*** |
High family or personal-life
stress | 1256 | 19.2 | (17.7, 20.6) | 815 | 22.9 | (20.9, 25.0)^ | <.001*** |
| Any gender-Related stress | -- | -- | -- | 2887 | 86.0 | (83.9, 88.1) | -- |
| Psychological distress | 1053 | 16.6 | (15.1, 18.1) | 782 | 22.2 | (19.3, 25.1)^ | <.001*** |
| Suicide ideation | 341 | 5.7 | (4.9, 6.4) | 193 | 5.4 | (3.9, 7.0) | 0.797 |
| Suicide attempt | 85 | 1.4 | (1.0, 1.8) | 79 | 2.2 | (1.4, 3.0) | 0.048* |
^95% confidence intervals of the prevalence estimate do not overlap
*p<0.05;
**p<0.01;
***p<0.001; P-values derived by Rao-Scott Chi-Square Test Percentages shown are weighted; n’s are unweighted
- 1From the *Department of Epidemiology, Fielding School of Public Health, †Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, and ‡Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA.
- Sex Transm Dis. 2014 Jun;41(6):359-64. doi: 10.1097/OLQ.0000000000000133.
