3116.0: Monday, November 13, 2000 - Table 4

Abstract #11995

HIV-1 incidence trends in the U.S. Army, 1985-1998: Occupational clusters and seroconversion risk

Philip O. Renzullo, PhD, MPH1, Warren B. Sateren, MPH2, Robin P. Garner, MS1, Deborah L. Birx, MD2, and John G. McNeil, MD, MPH2. (1) Henry M. Jackson Foundation, U.S. Military HIV Research Program, 1 Taft Court, Suite 250, Rockville, MD 20850, (301) 251-8339, prenzullo@hiv.hjf.org, (2) Division of Retrovirology, WRAIR, U.S. Military HIV Research Program, 1 Taft Court, Suite 250, Rockville, MD 20850

Background: The U.S. Army routinely tests soldiers for HIV infection. The results of this program facilitate monitoring trends in the HIV epidemic in a young subgroup of the U.S. population. Methods: Annual HIV-1 incidence rates (IR) were calculated per 1,000 person-years (py) of follow-up. Demographics including age, race, gender, marital status, rank, and occupation were collected. Among enlisted personnel occupations included infantry, electronics, communications, health care, technical, administration, electrical/mechanical, craftwork, and supply. Among officers, occupations included tactical, intelligence, engineering, science, health care, administration and supply. Poisson regression was used to assess demographic correlates of HIV seroconversion. Results: From 1985 to 1998, 1,240 seroconverters were seen in 7,202,450 py of follow-up, for an IR of 0.17/1000 py. Of all seroconverters, 94.8% were enlisted personnel and 5.2% were officers compared to 84% and 16%, respectively in the total population. The relative risk of seroconversion among officers vs. enlisted personnel adjusting for other demographic variables was 0.40 (0.31-0.51). Within occupation, IRs ranged from 0.11 to 0.33 for enlisted personnel and 0.00 to 0.09 for officers. Among enlisted personnel, the highest IRs were seen in administration (0.33) and health care (0.30). Among officers, the highest IRs were seen in health care (0.09), administration (0.07) and supply (0.07). Conclusions: Despite low HIV-1 IRs, new HIV infections continue to occur. The Army testing program provides information on the evolving HIV epidemic. Demographic and occupational correlates of seroconversion provide valuable insight for HIV-1 prevention programs focussed on subgroups that might benefit from such intervention.

Learning Objectives:

  • At the conclusion of the session, participants will be able to
    1. Recognize the significance of HIV surveillance in military settings to an overall understanding of the evolving HIV epidemic.
    2. Identify demographic correlates of HIV seroconversion in the US Army.
    3. Identify occupational clusters associated with increased risk for HIV seroconversion in the US Army.

    • Keywords: Epidemiology, Surveillance

    Presenting author's disclosure statement:
    Organization/institution whose products or services will be discussed: None
    I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

    The 128th Annual Meeting of APHA