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    Area of Science:

    • Andrology
    • Military Medicine
    • Public Health

    Background:

    • Testosterone replacement therapy (TRT) is increasingly prescribed.
    • Understanding TRT prevalence and appropriate use in specific populations is crucial.
    • The US military represents a unique demographic for studying healthcare trends.

    Purpose of the Study:

    • To determine the prevalence of TRT use among active component service men in 2017.
    • To identify demographic and military characteristics associated with TRT use.
    • To assess the proportion of TRT recipients who met 2018 American Urological Association (AUA) guidelines for treatment indication.

    Main Methods:

    • Analysis of prescription data for TRT among active component service men in 2017.
    • Stratification of TRT prevalence by demographic (age, race/ethnicity, marital status) and military (branch, rank, occupation) characteristics.
    • Comparison of TRT recipients against 2018 AUA clinical practice guidelines to determine treatment indication.

    Main Results:

    • A total of 5,093 service men received TRT in 2017, yielding a period prevalence of 4.7 per 1,000.
    • TRT use was highest among Army members, senior enlisted personnel, warrant officers, non-Hispanic whites, American Indians/Alaska Natives, those in combat roles, healthcare workers, and married individuals.
    • Only 44.5% of male service members receiving TRT in 2017 met the 2018 AUA guidelines for its use.

    Conclusions:

    • TRT prevalence in active component service men was 4.7 per 1,000 in 2017.
    • Specific demographic and military factors were associated with higher TRT utilization.
    • A significant proportion of TRT prescriptions in this cohort did not align with established clinical guidelines, suggesting a need for further review of prescribing practices.