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Self-Reported Sexually Transmitted Infections and Sexual Risk Behaviors in the US Military: How Sex Influences Risk

Stahlman, Shauna MPH*; Javanbakht, Marjan PhD*; Cochran, Susan PhD, MS*; Hamilton, Alison B. PhD, MPH; Shoptaw, Steven PhD; Gorbach, Pamina M. DrPH*

Sexually Transmitted Diseases: June 2014 - Volume 41 - Issue 6 - p 359–364
doi: 10.1097/OLQ.0000000000000133
Original Study

Background Sexually transmitted infections (STIs) are prevalent in the US 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.

A study of sexually active men and women in the US military found that risk behaviors for sexually transmitted infections were highly prevalent and varied significantly by sex.

From 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

Source of Funding: This research was supported by funds from the University of California, Los Angeles, Dr Ursula Mandel Scholarship, the 2013–2014 Fellowship in Epidemiology, and National Institute of Mental Health (Research Grant No. P30 MH58107).

Conflicts of Interest: None declared.

Correspondence: Shauna Stahlman, MPH, Department of Epidemiology, University of California Los Angeles, Box 951772, Los Angeles, CA 90095-1772. E-mail:

Received for publication November 11, 2013, and accepted March 31, 2014.

© Copyright 2014 American Sexually Transmitted Diseases Association