Female troops diagnosed with STDs at ‘significantly’ higher rates than men, report says

Women in the U.S. armed forces are diagnosed at significantly higher rates than men for most sexually transmitted diseases, but the greater incidence is likely linked to increased screening of female service members, according to a new report.

From 2013 to 2021, women in active duty were diagnosed with chlamydia at three times the rate of men in service. For gonorrhea, they tested positive at nearly 1.4 times the rate of men; for genital herpes, more than 4 times the rate; and human papillomavirus, 9 times the rate.

Yet men had a higher rate of syphilis: during the period, 5,128 servicemen, or five per 100,000 soldiers, were diagnosed with syphilis, compared to 734 women.

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“With the exception of syphilis, the crude overall incidence rates of all STIs [Sexually Transmitted Infections] were significantly higher among women than men,” analysts from the Armed Forces Surveillance Division noted in the Department of Defense’s May Monthly Medical Surveillance Report, released Tuesday.

Although the data could be interpreted as suggesting that female ward members engage in more risky behaviors and thus contract infections at a higher rate, the study authors, echoing other public health experts, noted that in all services, women are more widely screened for sexually transmitted diseases. infections than men.

Department of Defense guidelines require all potential recruits to be tested for HIV, while women in recruit training are also screened for chlamydia. They are then examined every year until the age of 26 as part of their annual gynecological examinations.

“The higher incidence rates of most STIs in females compared to males can likely be attributed to the implementation of service STI screening programs among female service members,” the report states. “Because an asymptomatic infection with chlamydia, gonorrhea or HPV [human papillomavirus] is common in sexually active women, widespread screening can result in a sustained high number of infections being diagnosed in young women. »

Navy Lt. Karli Woolens, a family medicine specialist at Navy Medicine Readiness and Training Command Bremerton supporting Naval Hospital Bremerton, Wash., agreed.

“They are … more likely to be screened and therefore diagnosed with STIs because of recommended screening programs for all sexually active asymptomatic young and pregnant women,” Woollens said in a Defense Health Agency press release.

Rates for each of the five diseases have varied over the years, but chlamydia, an infection that can go unnoticed but has the potential to cause infertility in women, remains the most common STI in the military.

The report’s authors noted some positive results from 2019: From that year to 2021, rates actually declined for all diseases except syphilis for all service members.

According to the report, chlamydia occurrences for both sexes were higher than the total of the other four most common sexually transmitted diseases combined.

Chlamydia infections rose 19% nationally in the United States from 2015 to 2019, according to the Defense Health Agency, but the disease is not the most common sexually transmitted disease in the country. That title goes to the human papillomavirus, or HPV, whose cases have been steadily declining among service members since 2013 and service women since 2015, according to the report.

This drop can be attributed to the availability of an HPV vaccine, which is not mandatory in the military but is encouraged by doctors for teenagers before joining the military and by military officials as well, notes the report.

The study, which looked at DoD medical data and reports to the division, did not include any data on sexual behaviors, but noted that some service members indicated in behavioral surveys that they engaged in sex. potentially at risk.

The 2018 DoD Health Behavior Survey noted that nearly 35% of respondents had had sex with a new partner without using a condom.

This figure was almost double the rate reported in 2011.

According to the new report, nearly 360,000 soldiers were diagnosed with a sexually transmitted disease between 2013 and 2021. This included 233,886 cases of chlamydia, 37,592 cases of gonorrhea, 5,862 cases of syphilis, 27,238 cases of genital herpes and 55,040 cases of HPV.

Across all departments, rates of chlamydia, gonorrhea, and genital herpes virus were highest in the military. The Navy had the highest overall rate of syphilis and HPV.

For all diseases except HPV, junior enlisted personnel, through E-3, had the highest incidence rates. Junior officers through O-3 had the highest HPV incidence rate.

Among military occupational specialties, motor transport personnel were diagnosed with chlamydia, gonorrhea, and syphilis at the highest rates, while those in healthcare specialties had the highest rates of herpes and HPV.

The report noted that data was not included for five military medical facilities using the MHS Genesis electronic medical records system from July 2017 to October 2019, primarily in the Pacific Northwest.

The researchers said that meeting screening, testing, treatment and reporting standards would improve efforts to detect and characterize health threats related to sexually transmitted diseases, while continued efforts to focus on risk reduction could further reduce diagnoses.

— Patricia Kime can be reached at [email protected] Follow her on Twitter @patriciakime

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