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HIV testing patterns for United States Air Force personnel, 2008-2012
R K Kugblenu1, P S Paulin2, K J Tastad2
1United States Air Force School of Aerospace Medicine, Public Health and Preventive Medicine Department, Epidemiology Consult Service, Wright-Patterson AFB, OH, USA; Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
Public Health
|January 23, 2016
Summary
This study analyzed human immunodeficiency virus (HIV) testing in the Air Force, finding higher HIV risk in Black/African American personnel. Transitioning to a 4th generation assay may improve testing efficiency.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Military Health Systems
Background:
- Human immunodeficiency virus (HIV) remains a significant public health concern.
- Accurate and efficient HIV testing is crucial for early detection and management, particularly in specific populations.
- Previous HIV testing strategies may have limitations in speed and accuracy.
Purpose of the Study:
- To evaluate the patterns of 3rd generation HIV testing and infection rates within the United States Air Force (USAF).
- To identify demographic factors associated with HIV risk in the USAF population.
- To assess the utility of current HIV diagnostic assays in a military setting.
Main Methods:
- A retrospective database study analyzing HIV enzyme-linked immunoassay (ELISA) and Western blot tests.
- Data collected from all USAF personnel between 2008 and 2012.
- Calculation of unadjusted and age-adjusted annual HIV incidence rates per 100,000 persons.
Main Results:
- Over 1.6 million tests were conducted on nearly 626,000 individuals.
- A significant proportion of Western blot tests yielded indeterminate results (15.0%), potentially delaying diagnosis.
- Black/African American personnel exhibited a substantially higher risk of HIV infection compared to White personnel (Risk Ratio 7.9).
Conclusions:
- The 3rd generation HIV assay demonstrated a notable rate of indeterminate Western blot results, impacting diagnostic timelines.
- A planned transition to a 4th generation assay is expected to address the limitations of the current testing strategy.
- Targeted HIV prevention efforts for young Black/African American individuals are recommended to reduce incidence within the USAF.