Petrelis Files

US Army study: HIV Dramatically Declines

Here are two reports on HIV stats that I hope are of keen interest to the gay community, AIDS experts and reporters who cover health issues.

As far as I know, the first study shows a dramatic drop of HIV among U.S. Army recruits and received no media coverage when it was published and presented at a scientific conference in November 2004.

This is not surprising given that the study found HIV declines over an 18 year period and administrators at the Centers for Disease Control and Prevention and community-based HIV prevention groups are loathe to ever acknowledge and tout valid drops in new HIV transmissions. You can't get more funding from Congress if your HIV prevention programs are succeeding in reducing infections, if the misguided thinking of these bureaucrats.

On the other hand, I would have expected those bureaucrats and African American leaders to seize upon the finding showing black recruits had one of the highest incidence rates, but even this finding didn't catch their attention.

Missing from the abstract below, but included in the full report, is this statistic on how many people were tested: "1,140 incident HIV-1 infections were detected among 1,732,419 soldiers who were on active duty at any time between 1985 and 2003, contributing 9,582,252 PY of follow-up." (Source: Full study.)

That's a lot of U.S. Army personnel to test and study, lending much credence to the validity of the findings because so many people were involved in this research project. We're not talking about a handful of subjects studied over a short period of time, but a large number and over many years.

In their introduction to the full study, the authors report the following: "The thoroughness of military health records lends to a unique opportunity to collect data on, in this case, a young, racially/ethnically and geographically diverse, sexually active population whose characteristics parallel those in the general population who could be at risk for acquiring the HIV virus."

In other words, the fall of HIV transmissions among army personnel is reflective of overall declining HIV rates for high-risk individuals across America.

The second study was conducted by some of the same researchers and it documented that prior to the army's HIV numbers falling, the stats were stable in the 1990s.

We wouldn't want this good news to be reported on, now would we? Might undermine efforts to secure more federal funding and selling the country on alarmist fearful HIV statistics.
^^^



HIV-1 incidence among active duty United States Army personnel, 1985-2003

Zahid Rathore, MPH1, Warren B. Sateren, MPH2, Philip O. Renzullo, PhD, MPH3, Mark J. Milazzo3, Darrell E. Singer, MD2, and Jose L. Sanchez, MD2.

(1) Department of Epidemiology and Biostatistics, The George Washington University, School of Public Health & Health Services, 1901 Ingleside Terrace, NW, # 302, Washington, DC 20010, 202-986-4460, zrathore@alumni.bates.edu, (2) Division of Retrovirology, WRAIR, U.S. Military HIV Research Program, 1 Taft Court, Suite 250, Rockville, MD 20850, (3) Henry M. Jackson Foundation, U.S. Military HIV Research Program, 1 Taft Court, Suite 250, Rockville, MD 20850

Background: The purpose of this project is to evaluate HIV-1 infection trends among active duty United States Army personnel, tested between 1985 and 2003. Long term follow-up of cohorts offers the opportunity to determine the rate and risk of new HIV-1 infections. Young men and women from every area of the United States are continuously joining the U.S. Army and are tested for HIV-1 on a periodic basis. This testing program provides unique insights into HIV-1 infection in a group of racially and ethnically diverse, sexually active men and women from every area in the United States.

Methods: The U.S. Army routinely tests personnel for HIV-1 which allows for the characterization of demographic risk factors for infection (incidence rate calculations and unadjusted and adjusted relative risk [RR] estimates with 95% CI’s). Rates are calculated by age group, race/ethnicity, gender, marital status, length of service, education level, rank, and military job occupation. Geographic distribution will be analyzed by county of residence.

Results: Incidence declined between 1985 and 2003 from 0.46 cases / 1,000 person-years [py] to 0.07 cases / 1,000 py. After adjusting for all variables, males (RR = 3.18), blacks (RR = 4.63), personnel between 25 and 29 years old (RR = 1.58) and non-married personnel (RR = 1.82) were at greatest risk for HIV-1 infection.

Conclusion: U.S. Army personnel provide a unique cohort for characterizing long-term trends in HIV-1 incidence. Application of the results will assist in identifying and targeting high-risk populations in prevention efforts.

(Source: Abstract.)

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AIDS: Volume 15(12) 17 August 2001 pp 1569-1574
HIV-1 seroconversion in United States Army active duty personnel, 1985-1999
Renzullo, Philip O.; Sateren, Warren B.a; Garner, Robin P.; Milazzo, Mark J.; Birx, Deborah L.a; McNeil, John G.a

From the Henry M. Jackson Foundation, US Military HIV Research Program, and the aWalter Reed Army Institute of Research, US Military HIV Research Program, Rockville, Maryland, USA.

Received: 26 January 2001;

revised: 20 April 2001; accepted: 26 April 2001.

Requests for reprints to: P. O. Renzullo, US Military HIV Research Program, Henry M. Jackson Foundation, 1 Taft Court, Suite 250, Rockville, MD, USA 20850.

Note: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

[snip]

Conclusions: HIV-1 seroconversions in the US Army have been low and stable since the early 1990s. Continued HIV-1 incidence surveillance in the US Army provides information on the status of the epidemic in the Army, as well as important corroborative data on HIV-1 infections throughout the US.

[snip]

(Source: Full text.)