title: Military HIV policy assessment in sub-Saharan Africa.
abstract: While HIV/AIDS continues to inflict a heavy toll on African militaries, the military commitment and leadership response has been inconsistent, as reflected by variable presence of a written HIV policy. The Department of Defense HIV/AIDS Prevention Program collaborates with most sub-Saharan military HIV/AIDS programs. In 2010, 28 invited countries (80%) completed a self-administered survey describing their program, including policy. Descriptive and nonparametric measures were calculated. The majority (57%) of respondents reported having a written military HIV policy. Of these, 86% included HIV testing, 88% required recruit testing, and 96% denied entry for those testing HIV-positive. Mandatory HIV testing was reported by 71%, occurring before deployments, peacekeeping missions, foreign training, and when clinically indicated. Southern African militaries were most likely to require HIV testing. The majority of militaries allowed deployment of HIV-positive personnel in-country, whereas few allowed foreign deployment. Most sub-Saharan militaries screen applicants for HIV and other diseases to determine duty fitness, resulting in near universal HIV negative recruit cohorts. No militaries discharge personnel from service if they acquire HIV. Legal challenges to military HIV policies may hinder finalization and dissemination of policies. Lack of HIV policies impedes routine testing and earlier care and treatment for HIV-infected personnel.
authors.affiliation: Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106.
authors.forename: Anne Goldzier
authors.initials: AG
authors.lastname: Thomas
authors.affiliation: Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Grillo
authors.affiliation: Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106.
authors.forename: Djeneba Audrey
authors.initials: DA
authors.lastname: Djibo
authors.affiliation: Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106.
authors.forename: Braden
authors.initials: B
authors.lastname: Hale
authors.affiliation: Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Shaffer
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D003141:Communicable Diseases / Q000453:epidemiology*; D003906:Developing Countries; D006678:HIV; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D018580:Mandatory Testing / Q000379:methods*; D008403:Mass Screening / Q000458:organization & administration*; D008887:Military Medicine / Q000331:legislation & jurisprudence*; D008889:Military Personnel