Sexually Transmitted Infections in the U.S. Military: How Gender Influences Risk
Rates of sexually transmitted infections (STIs) in the U.S. military have historically been higher than those of civilians. One likely contributor to high military STI rates is the high prevalence of behaviors that correspond with transmission of STIs, including binge drinking, lack of condom use, and multiple sexual partnerships. Other potential contributors include the high prevalence of mental health conditions as well as unwanted sexual contact (i.e., sexual assault). In particular, women in the military tend to have higher rates of STIs than both their male colleagues in the military and their female peers in the general population. This dissertation aims to better understand the differences in sexual risk behaviors and risk for STIs between men and women in the military, and between women in the military and women in the general U.S. population. It also aims to describe the factors associated with unwanted sexual contact and mental health among service women in particular.
This dissertation utilizes data from the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Personnel (HRBS) in order to estimate the prevalence of STIs and sexual risk behaviors among military personnel. Chapter 1 identifies and provides background information on women in the military as well as STI risk factors. Chapter 2 compares STI risk behaviors between men and women in the military and describes the factors that are associated with report of an STI and with report of multiple sexual partners, among both genders. Chapter 3 examines the relationships between unwanted sexual contact, sexual risk behaviors, mental health, and substance use among women in the military. Finally, Chapter 4 utilizes data from the 2007-2010 National Health and Nutrition Examination Survey (NHANES) in order to estimate the prevalence of STIs and sexual risk behaviors among women in the general population. These estimates are then compared to those of service women in the 2008 HRBS. Findings from this dissertation expand the current understanding of sexual risk behaviors among women in the military, and have implications for the development of interventions that promote sexual health among female service members in the United States.