Background In the U.S., military members experience a higher incidence of sexually transmitted infections (STIs) than the age and gender-adjusted general population, placing a costly and preventable burden on the military health system (MHS). These increased rates are likely due to differences in both individual and network level risk factors. To assess the feasibility of a survey examining the impact of sexual network risk factors on risk, a survey assessing STI individual and network level risk factors to include a 90-day sexual partnership inventory was piloted at a single military medical center. Methods A sample of 50 military beneficiaries completed a computer-assisted self-interview (CASI) cross-sectional egocentric survey administered on a tablet. Demographical and clinical data were captured from the electronic medical record. Non-parametric statistics were used to analyze the data. Results 45 of 50 subjects (90%) completed the survey. 40 (88%) subjects completed at least one partnership survey and reported 1 to 20 partners per subject. Respondents were mostly active duty (91.8%) and had been active duty for less than five years (68.2%). Common risk behaviors were explored and included meeting partners online (68.75%) and having partners who use drugs (48.94%) or are heavy drinkers (44.68%). Partnership inventories suggest sexual concurrency and disassortative mixing on age, racial and ethnic groups, and military service. Conclusion While previous studies demonstrate that service members will complete sexual risk behavior surveys, this pilot egocentric partnership study demonstrates their willingness to provide detailed information on risk behaviors as well as detailed information on sexual partnerships. While we report on statistically significant associations, these may be subject to bias due to the underlying characteristics of the source population. As a result, these data will not likely be reflected in the full study population. 80% of pilot subjects completed the questionnaire and submitted at least one partnership survey, indicating the possibility of gathering more diverse individual sexual risk questionnaires from active duty service members. Based on these data, a multisite study of sexual networks was implemented in the MHS and is currently under analysis. Disclosures All Authors: No reported disclosures
types jointly influence individuals' STI risk reduction strategies. Methods We analyzed data from 2011-2017 National Survey of Family Growth for 5,948 and 5,433 unmarried, non-cohabiting sexually active women and men aged 15-44. To describe sexual network position, we created four dichotomous variables that included both past-year number of opposite-sex sex partners (one, multiple) and perceived partner non-monogamy (PPNM, yes/no). Relationship type was defined as a steady or casual sex partner at last sex. Prevalence ratios were used to assess the relationship between network position and two past-year outcomes: condom use at last sex and STI testing. Results were stratified by relationship type. Results 54% and 47% of women and men aged 15-44 had one partner with no PPNM. 6% and 4% had one partner with PPNM, 22% and 29% had multiple partners with no PPNM and 17% and 20% had multiple partners with PPNM. Men with multiple partners and PPNM had the lowest prevalence of condom use of all four groups (37.7%, CI: 33.5, 44.1 compared with 52-56%). Moreover, women and men in this group with a steady sex partner had higher prevalence of past-year STI testing if they reported PPNM than if they did not (women: aPR=1.31; CI: 1.11, 1.55, men: aPR=1.47; CI: 1.19, 1.81). This same relationship was not seen for women and men whose last sex was with a casual partner. Conclusion Individuals' STI risk reduction strategies depend on sexual network position and relationship type. Those with PPNM and a steady sex partner may seek STI testing more frequently. Proxy sexual network measures from national surveys may help target STI prevention and testing interventions. Disclosure No significant relationships.
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