Condom Use by Male, Enlisted, Deployed Navy Personnel with Multiple Partners

Military Medicine, Oct 2005 by Norris, Anne E, Phillips, Raymond E, Statton, Morgan A, Pearson, Timothy A

Study Question: Condom use by male enlisted personnel deployed on an aircraft carrier in spring 2002 who reported having casual sex partners in foreign ports and (1) only a steady partner, (2) only casual sex partners, or (3) both steady and casual sex partners in the home port. Study Design: Cross-sectional survey, with analysis of the subsample reporting multiple partners (n = 378). Results: Sexual behavior was less frequent and condom use was higher in foreign ports (p

Introduction

Human immunodeficiency virus (HIV) seroconversion rates among active duty Navy personnel have increased since 1999, with rates in 2002 being the highest since 1994.1 Certain individuals within the military may be at high risk for HIV and other sexually transmitted diseases (STDs) because of their youth and frequent deployments.2 Unfortunately, little is known about the condom use or sexual behavior of enlisted personnel, particularly when such personnel are deployed. Deployed Navy personnel travel between home and foreign ports, increasing the opportunity for those engaging in risky sexual behavior to be exposed to and spread HIV and other STDs at home and abroad.

Condoms decrease the spread of HIV and other STDs,3-4 but their use typically varies with the type of partner.5 Rates of condom use tend to be lower with steady partners, relative to casual sex partners.5"7 However, it is not clear how involvement with multiple partners influences condom use, particularly under conditions of deployment. It is possible that men involved with both casual and steady partners are more vigilant about condom use, because they do not want their steady partner to know that they have been with another partner. Also, deployed men in a foreign port may be on guard for risks and hazards in their environment and thus may be motivated to use condoms for self-protection. Alternatively, men may become involved with multiple partners as part of a risk-seeking personality8 and, if so, may be less likely to use condoms, regardless of setting. This study of deployed personnel offers a unique opportunity to study how condom use varies with both type of partner and setting (home vs. foreign port).

The purpose of this study was to examine the demographic characteristics, sexual history, and behavior with casual partners of enlisted male Navy personnel, deployed on an aircraft carrier, who reported having (1) a steady partner in their home port and at least one casual partner in a foreign port, (2) casual partners in both home and foreign ports, or (3) a steady partner in their home port and casual partners in both home and foreign ports. Of interest was how demographic characteristics, sexual history, sexual behavior, and condom use varied among the three groups and whether behavior varied with type of partner or port.

Methods

Sample

All Navy, male, enlisted sailors in pay grades E-I to E-4 who were deployed on the ship in May 2002 were invited to participate in the study. The total number of eligible subjects was estimated to be 2,100 (the ship's company numbered 1,500 but the exact number for the airwing was not known), resulting in a response rate of 65% (JV = 1,316). The ship was an aircraft carrier in the Pacific Fleet.

Results are presented here for respondents (n = 348) who reported engaging in casual sex in a foreign port during current deployment and (1) having a single steady partner back home (n = 29), (2) engaging in casual sex back home and having no steady partner back home (n = 147), and (3) both engaging in casual sex and having a steady partner back home (n = 161). The median age of these respondents was 21.5 years (range, 18.5-33.4 years). As can be seen from the data in Table I, respondents came from a variety of ethnic backgrounds, with slightly more than one-half classifying themselves as Caucasian (53%). These respondents were fairly similar to those in the rest of the sample except that they were significantly less likely to have ever been married (11% vs. 25%; χ^sup 2^ = 57.62, df = l, p

The ethnicity of these study respondents was fairly similar to that reported as of March 31, 2002, for Navy enlisted personnel in these same pay grades (http://www.bupers.navy.mil/mentor/demographics.html). Exact comparisons in terms of ethnicity are difficult because we allowed respondents to indicate membership in multiple ethnic groups and separated Asian American subjects from Pacific Islanders. Ethnicity distribution for all Navy enlisted personnel as of March 31, 2002, was as folio,vs: 53% Caucasian, 13% Hispanic, 20% African American, 6% Aidan American, and 4% other. Several African American subjects and Hispanic subjects in our sample described themselves as biracial, possibly contributing to the smaller percentages in our study subsample. Adding Pacific Islanders back into our Asian American group increased this group's percentage to 5%, which compares favorably with the 6% reported for all enlisted personnel in pay grades E-I to E-4. Unfortunately, other demographic information regarding the enlisted personnel (e.g., marital status and age) is not publicly available.