Longitudinal survey of condom use across a US Navy and Marine Corps shipboard deployment.

Objectives: Condoms are highly effective in preventing sexually transmitted infections (STIs) but implementation is often inconsistent with use rarely examined across travel transition periods. We examined the prevalence of condom use among ship-assigned US military personnel across an overseas deployment cycle and identified factors associated with condom non-use.

Methods: Longitudinal survey data were collected from ship-assigned US Navy/Marine Corps personnel on 11 ships before (T1), during (T2) and after (T3) an overseas deployment.

Cross-Sectional Study of Sexual Behavior, Alcohol Use, and Mental Health Conditions Associated With Sexually Transmitted Infections Among Deploying Shipboard US Military Personnel.

Introduction: 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.

Materials And Methods: 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).

Self-reported HIV-positive status but subsequent HIV-negative test result using rapid diagnostic testing algorithms among seven sub-Saharan African military populations.

HIV rapid diagnostic tests (RDTs) combined in an algorithm are the current standard for HIV diagnosis in many sub-Saharan African countries, and extensive laboratory testing has confirmed HIV RDTs have excellent sensitivity and specificity. However, false-positive RDT algorithm results have been reported due to a variety of factors, such as suboptimal quality assurance procedures and inaccurate interpretation of results. We conducted HIV serosurveys in seven sub-Saharan African military populations and recorded the frequency of personnel self-reporting HIV positivity, but subsequently testing HIV-negative during the serosurvey.

HIV/AIDS Securitization: Outcomes and Current Challenges.

Background: The securitization (i.e., framing of a health issue as a security threat) of HIV/AIDS by the United Nations Security Council in 2000 changed the belief that HIV/AIDS is only a health issue.

Conducting HIV Seroprevalence and Behavioral Epidemiology Risk Surveys (SABERS) Among Partner Military Populations.

Background: Characterizing HIV infection and associated risk behaviors within military populations is critical for understanding the epidemic and informing prevention activities. However, the prevalence of HIV and related risk behaviors is often unknown. Further, militaries may not have the systems in place or the staff expertise to conduct HIV surveillance and risk behavior studies.

Pre-deployment Alcohol Misuse Among Shipboard Active-Duty U.S. Military Personnel.

Introduction: The burden of alcohol misuse is unknown among shipboard U.S. Navy and Marine Corps military personnel immediately prior to deployment and may be elevated.

Sexually transmitted infections and sexual behaviour of deploying shipboard US military personnel: a cross-sectional analysis.

Objectives: Sexually transmitted infection (STI) prevalence and risk behaviour may differ at different phases of deployment. We examined STI prevalence and sexual behaviour in the predeployment time period (12 months prior) among recently deployed shipboard US Navy and Marine Corps military personnel.

Methods: Data were collected from 1938 male and 515 female service members through an anonymous, self-completed survey assessing sexual behaviours and STI acquisition characteristics in the past 12 months.

Low prevalence of neurocognitive impairment in early diagnosed and managed HIV-infected persons.

Objective: To describe the prevalence of neurocognitive impairment (NCI) among early diagnosed and managed HIV-infected persons (HIV+) compared to HIV-negative controls.

Methods: We performed a cross-sectional study among 200 HIV+ and 50 matched HIV-uninfected (HIV-) military beneficiaries. HIV+ patients were categorized as earlier (<6 years of HIV, no AIDS-defining conditions, and CD4 nadir >200 cells/mm(3)) or later stage patients (n = 100 in each group); both groups were diagnosed early and had access to care.

Cross-sectional assessment of prevalence and correlates of blood-borne and sexually-transmitted infections among Afghan National Army recruits.

Background: Few data are available in Afghanistan to shape national military force health practices, particularly with regard to sexually-transmitted infections (STIs). We measured prevalence and correlates of HIV, syphilis, herpes simplex 2 virus (HSV-2), and hepatitis C virus (HCV) among Afghan National Army (ANA) recruits.

Methods: A cross-sectional sample of male ANA recruits aged 18-35 years were randomly selected at the Kabul Military Training Center between February 2010 and January 2011.

Elevated CD8 counts during HAART are associated with HIV virologic treatment failure.

Objective: To evaluate whether elevated CD8 counts are associated with increased risk of virologic treatment failure in HIV-infected individuals.

Design: Retrospective cohort study.

Methods: US Military HIV Natural History Study participants who initiated highly active antiretroviral therapy (HAART) in 1996-2008 had 6- and 12-month post-HAART HIV RNA <400 copies per milliliter, ≥ 2 subsequent HIV viral loads and a baseline CD8 count were eligible (n = 817).

A randomized clinical trial comparing revaccination with pneumococcal conjugate vaccine to polysaccharide vaccine among HIV-infected adults.

Background: The risk of pneumococcal disease persists, and antibody responses to revaccination with the 23-valent polysaccharide vaccine (PPV) are low among human immunodeficiency virus (HIV)-infected adults. We determined whether revaccination with the 7-valent pneumococcal conjugate vaccine (PCV) would enhance these responses.

Methods: In a randomized clinical trial, we compared the immunogenicity of revaccination with PCV ( n = 131) or PPV (n = 73) among HIV-infected adults (median CD4 cell count, 533 cells/mm(3)) who had been vaccinated with PPV 3-8 years earlier.

Clinical and epidemiologic characteristics of an outbreak of novel H1N1 (swine origin) influenza A virus among United States military beneficiaries.

Background: A novel swine-origin influenza A (H1N1) virus was identified in March 2009 and subsequently caused worldwide outbreaks. The San Diego region was an early focal point of the emerging pandemic. We describe the clinical and epidemiologic characteristics of this novel strain in a military population to assist in future outbreak prevention and control efforts.

Melioidosis after brief exposure: a serologic survey in US Marines.

Melioidosis is endemic to Southeast Asia. The incidence of infection in visitors is not well known, especially for short visits. Thirteen (38%) of 34 previously unexposed US Marines had positive serology after 2 weeks in Thailand, and one developed acute disseminated disease.

Increasing rates of community-acquired methicillin-resistant Staphylococcus aureus infections among HIV-infected persons.

Community-acquired (CA) methicillin-resistant Staphylococcus aureus (MRSA) rates have rapidly increased in the general population; however, little data on recent incidence rates and risk factors of CA-MRSA infections among HIV patients appear in the literature. A retrospective study was conducted from 1993 through 2005 among patients at a large HIV clinic. Trends in CA-MRSA infection incidence rates, clinical characteristics and risk factors for CA-MRSA were evaluated.

Use of bilirubin as a marker of adherence to atazanavir-based antiretroviral therapy.

We retrospectively reviewed 134 patients to evaluate atazanavir-related bilirubin elevation as an adherence marker. Using a 2 log reduction or undetectable viral load as a marker for suppression, the median bilirubin increase at first follow-up was 1.3 (0.

History of U.S. military contributions to the study of rickettsial diseases.

Rickettsial diseases have affected the military throughout history. Efforts such as those of the Joint U.S.

Pneumonia outbreak associated with group a Streptococcus species at a military training facility.

Background: Although group A streptococci (GAS) infections are a major cause of morbidity and mortality, outbreaks of associated pneumonia are rare. We report an outbreak of GAS pneumonia that occurred at a US military training camp.

Methods: Standard epidemiologic and laboratory procedures were used to characterize the outbreak and causative organism(s).

A case series of group A Streptococcus necrotizing fasciitis in military trainees.

We describe a case series of group A Streptococcus (GAS) necrotizing fasciitis occurring over a 10-week period in military recruits undergoing intense physical training. These cases highlight that GAS may cause life-threatening infections in addition to mild diseases such as pharyngitis. This series suggests that the incidence of severe GAS infections may be increasing in certain populations and it emphasizes the importance of considering prophylactic measures against GAS in high-risk populations.

A cluster of disseminated coccidioidomycosis cases at a US military hospital.

We recently evaluated a cluster of cases of disseminated coccidioidomycosis referred to the Naval Medical Center San Diego. Between March and June of 2002, seven cases were diagnosed and treated. In a 5-year record review (March 1997-February 2002), we found only seven cases of disseminated disease attributable to Coccidioides immitis at the same institution.

Group A streptococcal toxic shock syndrome developing in the third trimester of pregnancy.

Background: Group A streptococcal (GAS) toxic shock syndrome (TSS) is an uncommon, but life-threatening infection during pregnancy and should be considered in rapid onset of shock. Most cases described in the literature have occurred in the puerperium. We report a case of GAS TSS occurring during the third trimester of pregnancy in a previously healthy woman.