December 14, 2006

HIV Rates Rising In Some African American Army Personnel
(Reuters Health)

Despite an overall downward trend in the incidence of HIV infection among active duty US army personnel, HIV incidence has increased in two subgroups of African American personnel -- those who are not married and those working in health care.

That's according to a study analyzing changes in HIV incidence among white and African American active duty US army personnel between 1986 and 2003. The cohort comprised 1280 incident HIV infections among 1.5 million persons with 8.4 million person-years of follow-up.

Results indicate a dramatic overall decline in HIV incidence for white and African American personnel in the early years (1986-1992) of the Department of Defense HIV testing program.

Among whites, there have been significant steady declines in HIV incidence for men, married persons, individuals with less than or more than 3 years of service, enlisted personnel, and personnel in occupations other than health care.

Among African Americans, the greatest decline in HIV incidence occurred between 1986 and 1991 through 1993; "however, the only statistically significant steady decline was among personnel serving less than 3 years.

Christian T. Bautista from the US Military HIV Research Program at Walter Reed Army Institute of Research in Rockville, Maryland and colleagues are at a loss to explain the increased rate among healthcare workers. They don't think occupational injury is to blame for the rising rates among active duty African American health care workers.

"Our a priori assumption had been that health care professionals would have a better knowledge of HIV prevention and thus would have been shown to have a declining risk of HIV infection," they write in the Journal of Acquired Immune Deficiency Syndromes for November 1st. Unfortunately, they do not have individual behavioral risk factor information for the subjects.

Additional studies are underway to identify risk factors for HIV infection among army personnel. "These data should contribute to the development of targeted preventive interventions in specific subpopulations at risk for HIV infection in the US Army," the authors note.

J Acquir Immune Defic Syndr 2006;43:351-355.

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