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For Sexually Transmitted Infections, Young People are at Higher Risk

Image of Protect yourself in the war against sexually transmitted infections. If you have questions about where to find free condoms, STI testing, or treatment, contact your health care provider or local installation clinic. Protect yourself in the war against sexually transmitted infections. If you have questions about where to find free condoms, STI testing, or treatment, contact your health care provider or local installation clinic. (Graham Snodgrass, Army Public Health Center)

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Every year, thousands of service members are diagnosed with at least one sexually transmitted infection. Topping the list of the most common are chlamydia, gonorrhea, and genital herpes, military health data shows.

For individuals, sexually transmitted infections, known as STIs, can have long term negative effects on your fertility and reproductive health. They can damage your motor and cognitive control, and harm the unborn babies of pregnant mothers, health experts say.

For example, "congenital syphilis, which occurs when a pregnant patient has untreated syphilis that is passed to the fetus before birth, can cause many problems in pregnancy such as miscarriage and prematurity as well as blindness or deafness in the newborn," said Navy Cmdr. (Dr.) Jacqueline Lamme, a gynecologist at Naval Hospital Bremerton, in Washington.

"The number of cases of congenital syphilis tripled from 2016 to 2020, and 2021 data shows a continued upward trend," Lamme said.

Other STIs, including gonorrhea and chlamydia, can lead to scarring in the uterus and pelvis that can cause infertility, Lamme said.

"Other infections can increase the risk of fetal anomalies, miscarriage, or fetal death and infections in the newborn that can lead to blindness or deafness and many other negative impacts on the newborn."

Collectively across the military, STIs can have a negative impact on readiness and the health of the force, according to a report from the Defense Health Agency's Armed Forces Health Surveillance Division.

STIs "can adversely impact service members' availability and ability to perform their duties and can result in serious medical [consequences] if untreated," according to the report.

Chlamydia is the most common

Between 2012 and 2020, the AFHSD conducted a study on the five most common STIs among active-duty service members: chlamydia, genital human papillomavirus (HPV), gonorrhea, genital herpes simplex virus (HSV), and syphilis.

Chlamydia is by far the most widespread problem in the military. The report found that the incidence of chlamydia infections among active-duty service members in the surveillance period was higher than the sum of the four other STIs combined.

The study also found that, in general, younger service members, non-Hispanic Black service members, soldiers, and enlisted members had higher incidences of STIs.

While chlamydia and gonorrhea infections generally increased among male and female service members since 2017, they decreased slightly in 2020 during the start of the pandemic.

Overall, the research shows that "soldiers are sleeping with each other," said Toni Pritchard, a registered nurse at the Bayne-Jones Army Community Hospital in Fort Polk, Louisiana.

Most importantly, Pritchard said that "locally, over 80% of the STI cases are active duty and [age] 34 and under, with 18-25-year-olds being the highest group that carries STIs."

That age group makes up 25% of the population, yet carries 50% of STIs nationally, she said.

Encouraging Openness

Pritchard said it's important for service members to be open and honest with medical providers.

"If there is a positive STI, we do contact tracing," she said, referring to the process of asking for patients' personal information and identifying people involved in the spread of the infection so they can be made aware of the risk and seek treatment.

"But the problem is no one wants to give up the information," she said. "They don't want to give the names of people they had sexual relations with."

Prevention and protection efforts are hindered by this lack of transparency, especially among some young people who have as many as 15 partners, Pritchard said.

One way to encourage young service members to come forward for treatment and to provide information for contact tracing is to assure them their information is confidential, she said.

That makes it "less embarrassing," she said.

Another important way to reduce STIs across the force is to ensure that STI tests and information about STIs and prevention are always available.

At the BJACH, condoms are on the counter "for all to take," she added.

Likewise, it's key to make information about treatment and prevention readily available. For example, she pointed to the 2019 Ready, Set, PrEP (pre-exposure prophylaxis) treatment program to prevent a person from getting HIV from sex or drug use.

The U.S. Department of Health and Human Services launched the program in 2019 to make medication available at no cost to people without insurance coverage, regardless of income.

"But no one advertises that we have it," Pritchard said. "It's a pill for use in high-risk populations, especially men who have sex with men, that is 90% effective in preventing the transmission of HIV through sexual contact."

Lamme recommends people not only talk honestly with their health care providers but to their partner(s) about STIs and safer sex practices.

"If you or your partner(s) have had any new partners, it's important for you both to get tested and treated, especially if you are pregnant or planning on becoming pregnant," she explained.

However, she noted that anyone can get an STI at any age.

"If you have a new partner or are non-monogamous, it's important to talk to your primary care provider about testing.

"Over half of all new STIs are in 15-24-year-olds, and annual screening for gonorrhea and chlamydia is recommended for 13-24-year-olds," she said.

"Screening of patients 25 and older and for other STIs is based on an individual's risk, so it's important to talk honestly with your healthcare provider about your personal risk factors.

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