title: Epidemiology of HIV among US Air Force Military Personnel, 1996-2011.
abstract: OBJECTIVE
  The objectives of this study were to describe the epidemiology of HIV in the United States Air Force (USAF) from 1996 through 2011 and to assess whether socio-demographic characteristics and service-related mobility, including military deployments, were associated with HIV infection.
  
  
  METHODS
  We conducted a retrospective cohort analysis of USAF personnel who were HIV-infected during the study period January 1, 1996 through December 31, 2011 and a matched case-control study. Cases were USAF personnel newly-diagnosed with HIV during the study period. Five randomly-selected HIV-uninfected controls were matched to each case by age, length of service, sex, race, service, component, and HIV test collection date. Socio-demographic and service-related mobility factors and HIV diagnosis were assessed using conditional logistic regression.
  
  
  RESULTS
  During the study period, the USAF had 541 newly diagnosed HIV-infected cases. HIV incidence rate (per 100,000 person-years) among 473 active duty members was highest in 2007 (16.78), among black/ African-American USAF members (26.60) and those aged 25 to 29 years (10.84). In unadjusted analysis restricted to personnel on active duty, 10 characteristics were identified and considered for final multivariate analysis. Of these single (adjusted odds ratio [aOR], 8.15, 95% confidence interval [CI] 5.71-11.6) or other marital status (aOR 4.60, 95% CI 2.72-7.75), communications/ intelligence (aOR 2.57, 95% CI 1.84-3.60) or healthcare (aOR 2.07, 95% CI 1.28-3.35) occupations, and having no deployment in the past 2 years before diagnosis (aOR 2.02, 95% CI 1.47-2.78) conferred higher odds of HIV infection in adjusted analysis.
  
  
  CONCLUSIONS
  The highest risk of HIV infection in the USAF was among young unmarried deployment-naïve males, especially those in higher risk occupation groups. In an era when worldwide military operations have increased, these analyses identified potential areas where targeted HIV prevention efforts may be beneficial in reducing HIV incidence in the USAF military population.
authors.affiliation: United States Military HIV Research Program, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, United States of America.
authors.forename: Shilpa
authors.initials: S
authors.lastname: Hakre
authors.affiliation: Preventive and Occupational Medicine Branch, National Guard Bureau, Arlington, Virginia, United States of America.
authors.forename: Dariusz G
authors.initials: DG
authors.lastname: Mydlarz
authors.affiliation: Biostatistics, The EMMES Corporation, Rockville, Maryland, United States of America.
authors.forename: Peter
authors.initials: P
authors.lastname: Dawson
authors.affiliation: Infectious Disease Service, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, Texas, United States of America.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Danaher
authors.affiliation: Air Force Medical Support Agency, Defense Health Headquarters, Falls Church, Virginia, United States of America.
authors.forename: Philip L
authors.initials: PL
authors.lastname: Gould
authors.affiliation: Air Force Medical Support Agency, Defense Health Headquarters, Falls Church, Virginia, United States of America.
authors.forename: Catherine T
authors.initials: CT
authors.lastname: Witkop
authors.affiliation: United States Military HIV Research Program, Walter Reed Army Institute of Research, Bethesda, Maryland, United States of America.
authors.forename: Nelson L
authors.initials: NL
authors.lastname: Michael
authors.affiliation: HIV Diagnostics and Reference Laboratory, United States Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America.
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Peel
authors.affiliation: United States Military HIV Research Program, Walter Reed Army Institute of Research, Bethesda, Maryland, United States of America.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Scott
authors.affiliation: Infectious Disease Service, San Antonio Military Medical Center, Fort Sam Houston, San Antonio, Texas, United States of America.
authors.forename: Jason F
authors.initials: JF
authors.lastname: Okulicz
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D009790:Occupations / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People