1539. Pilot Study of Sexual Networks and Sexually Transmitted Infection Risk in a Military Population

Abstract

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

A Comparative Analysis of Reported Chlamydia and Gonorrhea Cases Among US Army Soldiers, 2015 to 2019

“…Higher operational tempo and the stress of these lifestyle interruptions may also influence CT rates. Increases have been documented before and after deployments and changes in assigned duty locations 23,24 . Other individual risk factors such as increased alcohol use and low condom use may also contribute to the elevated rates 25 …”

“…The ongoing US gonococcal epidemic is driven largely by increased rates among sociodemographic, cultural, and geographic subpopulations 1,2 . High-risk populations in the Army may be similar to those in the US population, as is evidenced by the higher rates of NG among the military community of HIV preexposure prophylaxis users 24 . However, the overall contribution of the disease burden to the military population at large may be less.…”

“…Increases have been documented before and after deployments and changes in assigned duty locations. 23,24 Other individual risk factors such as increased alcohol use and low condom use may also contribute to the elevated rates. 25 The Army's lower overall age-and sex-adjusted NG rates may reflect differences in high-risk subgroups such as men who have sex with men, differing sexual network risks, or the presence of other unmeasured confounders.…”