Policy and prevention as competing imperatives in US Navy life and medicine

On the face of it, US Navy sexual health initiatives face a challenge similar to those on college and university campuses: how to prepare individuals coming into adulthood for both the positive and less positive health consequences of sexual intimacy. However, rules unique to military settings that forbid relationships between certain categories of personnel and that delimit the appropriate context and content of sexual expression have special implications for Navy safer sex programmes. Guided by in-depth interviews with 58 Navy officers and enlisted members, this paper examines how official policies regulating sexual behaviour sometimes hinder the effective prevention and medical management of sexually transmitted infections and unplanned pregnancies. Two findings in particular are worthy of note: first, perceptions of sexual risk are often displaced from concerns about health to concerns about 'getting caught' for violating Navy rules; and second, official prevention efforts do not adequately reflect the realities of sexual life (especially on deployments). Current US Navy rules governing sex may therefore have the inadvertent effects of contributing to sexual health risk and of preventing the occurrence not of sex, but of safer sex.