2011 Issues   /   July 2011

Sexually-Transmitted Diseases Rise Among Deployed Troops, In Line with Civilian Rates

By U.S. Medicine

WASHINGTON — Sexually-transmitted diseases are on the rise in troops in Iraq and Afghanistan, according to a study which recommends more screening and health education.

Gonorrhea rates ranged from 5 per 100,000 deployed personnel in 2005 to 17.6 per 100,000 deployed personnel in 2008 and 2009. Despite the increase, the rates of gonorrhea in the deployed troops to Iraq were either lower than or not statistically different from U.S. rates reported by the Centers for Disease Control and Prevention (CDC).

Chlamydia rates were highest among those who deployed to Iraq and peaked in 2009 with a total rate of 246.3 per 100,000 deployed personnel with higher rates in women (770.9 per 100,000), than in men (192.6 per 100,000). According to the CDC, chlamydia is the most commonly reported STD in the U.S.

While the incidence rates in male troops were statistically lower than the U.S. rates of chlamydia, rates in troops have been increasing since 2006. For women, during and after 2007, the chlamydia rates among female troops approximated U.S. infection rates.

“Each year of the analysis reveals an increasing number of infections with more  chlamydia than gonorrhea infections and more males than females being positive, in large part due to the small numbers of females deployed,” the study authors stated.

The study of the rates was performed “to relate this information to deploying and deployed military health-care personnel and medical leaders in the combat zone.”

The data was collected by reviewing an electronic laboratory record review of the Composite Health Care System in order to identify patient specimens tested at Landstuhl Regional Medical Center for gonorrhea and/or chlamydia received from Iraq and Afghanistan on Jan. 1, 2004, through Sept. 18, 2009.

The study noted that it is not clear whether the patients were infected with STIs during their deployments or at another time, because patients might have been harboring the infection at the time of deployment or upon returning from rest and relaxation tours, rather than acquiring the infection in the combat zone.

“For males, there are no formal recommendations for routine STI screening, making the possibility of pre-existing infection higher. For female servicemembers deploying to a combat zone at the time of this study, all services required a pelvic exam and pap smear before departing,” the study stated.

An assessment should be performed in theater to define specific STI rates and risk factors associated with STIs in combat zones, the study concluded.

“Earlier wars have seen the implementation of various strategies to decrease the STI rates; however, unless specific risk factors can be identified, the primary focus should be on education, prevention, and appropriate screening and therapy following national guidelines,” the authors wrote.

The study, “Rates of Gonorrhea and Chlamydia in U.S. Military Personnel Deployed to Iraq and Afghanistan (2004-2009),” was published in the June issue of Military Medicine.

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