November 25, 2002
Education has been key to the U.S. military's strategy, said Capt. Glenn A. Schnepf of the National Naval Medical Center HIV Program in Bethesda. Under Defense Department rules, everyone in the military must have at least an hour of HIV education a year.
The HIV infection rate in the U.S. military has dropped by about 30 percent in the past year, after five years of little change, Schnepf said at a Naval Postgraduate School-sponsored conference. HIV testing started in the military in the mid-1980s, when the rates were much higher. Then, doctors thought that anyone infected with HIV would die within two years, and people who tested positive had to leave the military. That policy was changed by 1990. Now, HIV-positive people are allowed to stay in the military unless they develop AIDS.
Of the 900 to 1,000 HIV-positive people known to be in the military today, only 4 percent to 8 percent are likely to leave the service because of developing AIDS, Schnepf said. More will leave simply because they will have finished their terms.
Schnepf attributes the recent decline mostly to the education program but said he worries that it is not reaching the new high-risk group for HIV infection. About 60 percent of the new HIV infections in the military are from homosexual contact, he said, but infections from heterosexual contact are increasing, particularly among young, inner-city black men. Prevention messages for military personnel must be culturally appropriate, Schnepf said.
In the United States, the rate of HIV infection is lower in the military than in the general population -- one to two people per 10,000 compared with 10 to 20 per 10,000.