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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e31820a7f4d
Epidemiology and Prevention

Medical Encounter Characteristics of HIV Seroconverters in the US Army and Air Force, 2000–2004

Hakre, Shilpa DrPH, MPH*; Brett-Major, David M MD, MPH†‡; Singer, Darrell E MD, MPH§; O'Connell, Robert J MD§; Sateren, Warren B MPH§; Sanchez, Jose L MD, MPH‖; Agan, Brian K MD¶; Michael, Nelson L MD, PhD§; Scott, Paul T MD, MPH§

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Background and Methods: Active duty US Army and Air Force military personnel undergo mandatory biennial HIV antibody screening. We compared pre- and post-HIV seroconversion health status by conducting a case-control study, which evaluated all medical encounters and sociodemographic factors among incident HIV seroconverters and HIV-negative controls from June 2000 through February 2004.

Results: A total of 274 HIV seroconverters and 6205 HIV-negative personnel were included. In multivariate analysis restricted to male personnel (cases = 261, controls = 5801), single marital status (adjusted odds ratio [AOR] = 14.37), clinical indicators or symptoms within four years of HIV diagnosis (AOR = 6.22), black race (AOR = 5.88), nonindicator clinical syndromes within 2 years of HIV diagnosis (AOR = 3.31), any mental disorder within 4 years of HIV diagnosis (AOR = 3.04), increasing service-connected time (AOR = 1.69), and older age (AOR = 1.12) were associated with HIV diagnosis among males. A prior history of a sexually transmitted infection (STI) was associated with post-HIV seroconversion STI (ORM-H = 4.10). Similarly, a prior history of mental disorder was associated with post-HIV seroconversion mental disorder (ORM-H = 4.98). Forty-seven (18%) male cases were hospitalized at least once after HIV diagnosis; infectious diseases, and mental disorders made up 53% of initial admissions.

Conclusions: HIV seroconversion was associated with increased health care-seeking behavior, STIs, and mental disorders, some of which may be amenable to screening. The higher STI rate after HIV diagnosis may partially be a consequence of monitoring, but secondary transmission of STI and possibly HIV require further definition and subsequent tailored preventive interventions.

© 2011 Lippincott Williams & Wilkins, Inc.


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