title: HIV testing patterns for United States Air Force personnel, 2008-2012.
abstract: OBJECTIVE
  This study evaluated 3rd generation human immunodeficiency virus (HIV) test patterns and HIV infection rates in the United States Air Force (USAF).
  
  
  METHODS
  Retrospective database study.
  
  
  METHODS
  HIV enzyme-linked immunoassay (ELISA) and Western blot tests were analysed for all USAF personnel from 2008 to 2012. For new HIV cases, unadjusted and adjusted annual rates were calculated per 100,000 persons.
  
  
  RESULTS
  In total, 1,608,665 tests were performed in 626,298 individuals, with a reactive ELISA observed in 809 (0.001%) persons. Western blot (n = 1949) results included 378 (19.4%) positive, 1283 (65.8%) negative, and 288 (15.0%) indeterminate (WBi). Unadjusted annual HIV rates were between 16.7 and 20.6 per 100,000 persons during the study period. The overall age-adjusted rate was 14.8 cases per 100,000 persons tested. Blacks/African Americans had the highest risk of HIV (risk ratio 7.9 [95% confidence interval 5.78, 9.95] compared to Whites).
  
  
  CONCLUSIONS
  WBi results, which can cause delays in determining HIV status, were relatively common with the 3rd generation assay. However, this will be mitigated by a planned transition to a 4th generation assay. Although the overall rate of HIV in the USAF is lower than US civilian adults, HIV prevention efforts targeting young Blacks/African Americans may help to reduce HIV incidence in the USAF.
authors.affiliation: United States Air Force School of Aerospace Medicine, Public Health and Preventive Medicine Department, Epidemiology Consult Service, Wright-Patterson AFB, OH, USA; Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Kugblenu
authors.affiliation: United States Air Force School of Aerospace Medicine, Public Health and Preventive Medicine Department, Epidemiology Consult Service, Wright-Patterson AFB, OH, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Paulin
authors.affiliation: United States Air Force School of Aerospace Medicine, Public Health and Preventive Medicine Department, Epidemiology Consult Service, Wright-Patterson AFB, OH, USA.
authors.forename: K J
authors.initials: KJ
authors.lastname: Tastad
authors.affiliation: Infectious Disease Service, San Antonio Military Medical Center, Fort Sam Houston, TX, USA. Electronic address: jason.f.okulicz.mil@mail.mil.
authors.forename: J F
authors.initials: JF
authors.lastname: Okulicz
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D015153:Blotting, Western / Q000706:statistics & numerical data; D016208:Databases, Factual; D004797:Enzyme-Linked Immunosorbent Assay / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008889:Military Personnel / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: ELISA; HIV incidence; HIV infection; Indeterminate western blot