title: HIV incidence trends among white and african-american active duty United States Army personnel (1986-2003).
abstract: OBJECTIVE
  To analyze HIV incidence rate (IR) trends among white and African-American active duty US Army personnel between 1986 and 2003.
  
  
  METHODS
  Joinpoint regression was applied to identify time periods when significant changes in HIV IRs occurred, along with the corresponding annual percentage changes (APCs).
  
  
  RESULTS
  African-Americans had a higher IR than white personnel (0.34/1,000 vs. 0.07/1,000; P < 0.001). Among white personnel, 2 significant time periods of changing HIV IRs were found: between 1986 and 1989 (APC = -31.1; P = 0.006) and between 1989 and 2003 (APC = -5.7; P = 0.003). Among African-Americans, a significant decline in HIV IRs was observed only between 1986 and 1991 (APC = -19.4; P < 0.001). This study revealed that the HIV IRs seem to have increased in 2 African-American groups: unmarried personnel and health care professionals.
  
  
  CONCLUSIONS
  This cohort study (1,280 incident HIV infections among 1.5 million persons with 8.4 million person-years of follow-up) provides invaluable information on HIV trends in the United States Army. Despite an overall decline in HIV IRs, certain subpopulation among African-American personnel were observed to have increasing HIV IRs. Future research is needed to identify the current behavioral risk factors associated with HIV infection among US Army personnel.
authors.affiliation: Division of Retrovirology, US Military HIV Research Program at the Walter Reed Army Institute of Research, Rockville, MD 20850, USA. cbautista@hivresearch.org
authors.forename: Christian T
authors.initials: CT
authors.lastname: Bautista
authors.forename: Warren B
authors.initials: WB
authors.lastname: Sateren
authors.forename: Jose L
authors.initials: JL
authors.lastname: Sanchez
authors.forename: Zahid
authors.initials: Z
authors.lastname: Rathore
authors.forename: Darrell E
authors.initials: DE
authors.lastname: Singer
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Birx
authors.forename: Paul T
authors.initials: PT
authors.lastname: Scott
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000208:ethnology / Q000821:virology; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000208:ethnology*; D015497:HIV-1; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel; D014481:United States / Q000453:epidemiology; D044465:White People; D001741:Black or African American