Harbertson Judith, Scott Paul T, Lemus Hector, Michael Nelson L, Hale Braden R
Department of Defense HIV/AIDS Prevention Program, Defense Health Agency, 140 Sylvester Rd Bldg 306, San Diego, CA 92106.
Leidos, Inc., 10260 Campus Point Dr., San Diego, CA 92121.
Mil Med. 2019 Dec 1;184(11-12):e693-e700. doi: 10.1093/milmed/usz070.
Limited comprehensive data exist on risk behavior associated with sexually transmitted infections (STI) among ship-assigned US military personnel during the predeployment time period (PDT). This study examined whether sexual risk behaviors, alcohol use, involuntary drug consumption (IDC), posttraumatic stress disorder (PTSD), and depression during the 12 months prior to deployment were associated with provider-diagnosed STIs in this population.
Using cross-sectional data collected during 2012-2014 among sexually active personnel, multivariable regression assessed factors associated with STIs among all men (n = 1,831). Stratified analyses were conducted among men who have sex with women (MSW, n = 1,530), men who have sex with men or men and women (MSM, n = 83), and excluded those not reporting sexual partner gender (n = 218).
Among MSW, transactional sex (AOR 3.8, 95% CI 1.5-9.4) meeting sexual partners at work (AOR 4.3, 95% CI 2.0-9.2), IDC (AOR 6.6, 95% CI 3.0-14.5), and incomplete mental health assessments (AOR 4.4, 95% CI 1.6-12.0) were significantly associated with STIs after adjustment. Among all men, those who identified as MSM (AOR 4.6, 95% CI 1.9-11.2) and drug screen positive (AOR 3.3, 95% CI 1.3-8.6) were significantly more likely to report an STI.
Previously unreported factors significantly associated with STIs at the PDT among MSW in the adjusted analysis were meeting sexual partners at work and IDC. IDC during the PDT warrants further exploration. These results can inform tailored STI reduction interventions among shipboard personnel and similarly aged civilians undergoing similar transition/travel experiences.
关于部署前时间段(PDT)内美国海军舰艇上服役人员中性传播感染(STI)相关风险行为的全面数据有限。本研究调查了部署前12个月内的性风险行为、饮酒、非自愿药物消费(IDC)、创伤后应激障碍(PTSD)和抑郁是否与该人群中医疗服务提供者诊断的性传播感染有关。
利用2012 - 2014年期间收集的性活跃人员的横断面数据,多变量回归评估了所有男性(n = 1,831)中性传播感染的相关因素。对与女性发生性行为的男性(MSW,n = 1,530)、与男性或男女都发生性行为的男性(MSM,n = 83)进行了分层分析,并排除了未报告性伴侣性别的人员(n = 218)。
在MSW中,经调整后,交易性行为(调整比值比[AOR] 3.8,95%置信区间[CI] 1.5 - 9.4)、在工作中结识性伴侣(AOR 4.3,95% CI 2.0 - 9.2)、IDC(AOR 6.6,95% CI 3.0 - 14.5)以及心理健康评估不完整(AOR 4.4,95% CI 1.6 - 12.0)与性传播感染显著相关。在所有男性中,自我认定为MSM的人(AOR 4.6,95% CI 1.9 - 11.2)和药物筛查呈阳性的人(AOR 3.3,95% CI 1.3 - 8.6)报告性传播感染的可能性显著更高。
在调整分析中,与MSW在PDT期间性传播感染显著相关的先前未报告的因素是在工作中结识性伴侣和IDC。PDT期间的IDC值得进一步探讨。这些结果可为船上人员以及经历类似过渡/旅行经历的同龄平民量身定制减少性传播感染的干预措施提供参考。