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Study Suggests Male Veterans at Greater Risk of Sexually Transmitted Infections Compared to Non-Veterans


BACKGROUND:
Sexually transmitted infections (STIs) are a serious health issue in the U.S., with an estimated 20 million new STI cases each year that result in roughly $16 billion in direct annual medical costs. Understanding more about STIs and the sexual health behaviors and risks of men could not only help prevent and contain infections in men, but also prevent infections in women. Currently, there are no published studies directly comparing sexual risk behaviors and incidence of STIs in male Veterans and non-Veterans. This study sought to address this gap. Using data from the 2011-2013 National Survey of Family Growth (NSFG), investigators compared sexual behaviors and history of STIs between male Veterans (n=409) and non-Veterans (n=3,451), including men aged 18-44 who had reported ever having sex with a man or woman. Sexual behavior outcomes included: >6 lifetime female partners, >10 lifetime partners of either sex, >2 past-year partners of either sex, having past-year partners of both sexes, and condom non-use during last vaginal sex. STI outcomes included: past-year history of chlamydia, gonorrhea, or receiving any STI treatment, in addition to lifetime history of herpes, genital warts or syphilis. Investigators also examined demographics.

FINDINGS:

  • Male Veterans were significantly more likely than male non-Veterans to have STI risk factors. In models adjusted for age, race/ethnicity, education, income, and marital status, Veterans had greater odds than non-Veterans of having ≥6 lifetime female partners, of having had sex with both female and male partners in the past year, and of having had gonorrhea in the past 12 months.
  • For other sexual behaviors and STIs examined in the study, Veterans trended toward greater risk, although associations were statistically non-significant.

IMPLICATIONS:

  • Findings indicate that healthcare providers need to be aware that male Veterans may be at higher risk for STIs and routinely assess their sexual behaviors, screen for STIs accordingly, and perform risk reduction counseling during clinical encounters.

LIMITATIONS:

  • The NSFG is a cross-sectional study, so does not include data about sexual behaviors across the life course – or in relation to the timing of military service.
  • The study sample includes only men under age 45, who comprise about 19% of all Veterans.
  • Outcomes are based on self-report, which may lead to under-reporting of the number of sexual partners or STI histories.

AUTHOR/FUNDING INFORMATION:
Drs. Borrero and Rosenfeld are part of HSR&D's Center for Health Equity Research & Promotion, (CHERP), Pittsburgh, PA.


Evans M, Borrero S, Yabes J, and Rosenfeld E. Sexual Behaviors and Sexually Transmitted Infections among Male Veterans and Non-Veterans. American Journal of Men’s Health. March 22, 2017;e-pub ahead of print.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.