Military STD Rates Rise, Mostly Because of the Navy and Marines

The U.S. military is trying to figure out what is causing an alarming rise in sexually-transmitted diseases, according to the the Pentagon’s Medical Surveillance Monthly Report.

Last year, we learned that transmissions of syphilis within the military doubled since 2010. Now the MSMR has reported a 23 percent rise in chlamydia infections since 2012. The good news is that gonorrhea infections declined among women in the military by more than 28 percent, although the overall rate remained stable due to an increase among men.

It would be easy to scaremonger about an epidemic of sex diseases plaguing the military. But the fact is that the military is, ahem, intimately connected with the civilian population, where rates of STDs have risen to “record levels,” according to the Centers for Disease Control and Prevention.

It stands to reason that when more civilians contract STDs, so will troops. But it’s not that simple.

That we can treat STDs in the modern era means they’re largely an embarrassment for many people, and not given much further thought. If left untreated, however, STDs can lead to serious health problems. Chlamydia, for example, can cause blindness and sterility.

For obvious reasons, the military takes disease seriously — which also owes to the historical struggle between armies and infection.

In World War I, the military discharged more than 10,000 soldiers because of STDs, according to a 2005 report in Military Medicine. During World War II, the War Department wised up, distributed condoms to troops and embarked on a massive (and jaw-dropping) propaganda campaign.

That helped, but the invention of penicillin and better screening were the main reasons why STDs ceased to be a significant threat to the military. Between 2004 and 2009, the U.S. Army evacuated 26 troops from Iraq for pelvic inflammatory diseases like chlamydia and gonorrhea, according to a 2010 CDC briefing.

Not good, but an enormous decline compared to the wars of the past.

Above — it goes without saying, World War II-era illustrators had a sense of humor. At top — ‘Syphilis: All of these men have it.’ From a 1940s-era poster. U.S. War Department illustrations

Yet rising rates in recent years have added a “significant clinical and public health burden on the Military Health System,” the MSMR stated. The Military Health System, which is separate from the Veterans Health Administration, has struggled to accommodate rising demand and healthcare costs.

We can only speculate as to the causes behind the rise in chlamydia. To be sure, while the military tends to mirror society, the military generally has higher STD infection rates than the civilian population, according to the CDC. Medical experts have suggested that the particular social dynamics of military life could make matters worse.

Living in a high-risk environment could lead to more risky behaviors. The fact that military personnel deploy globally, and to countries with weak or non-existent health systems, doesn’t help.

Then there are simple demographics. The military is largely an organization full of young people who tend to be single and more sexually active, as a group, than the population at large.

Take thousands of twenty-somethings — with hormones raging — away from their hometowns and pack them onto military bases. Now occasionally unleash them on the weekends. And within the past few years, hand them smartphones loaded with hookup apps like Tinder and Grindr.

But numerous studies on sexual behavior among millennials have found they have less sex than their parents did decades ago … maybe. If true, the STD rate should fall, not rise. The increase within the military might reflect more thorough screening, which the MSMR suggested could account for some of the rise, but stated the numbers add up to an “actual increase” in chlamydia infections.

The climb in chlamydia is also concentrated in two services — the Navy and Marines.

The Army has the highest overall infection rate, but this has largely remained steady, while the “initial chlamydia rates more than doubled among Navy and Marine Corps branches over the period, and appeared to drive the overall active component rate increase between 2010 and 2011,” the MSMR reported.

The Navy rate not only spiked, but kept spiking. The Marine rate spiked them leveled off. The Army rate declined then went back to up where it was in 2010. The Air Force rate fell.

The MSMR notes solutions should include more screening and prevention efforts, particularly with high-risk groups. Among those at greatest risk are “individuals less than 25 years old, females, ethnic minorities, those in low socioeconomic status, residents of the Southern U.S., and persons engaging in high-risk behaviors such as drug use,” the report stated.

Removing medical barriers to LGBT troops should help, too. Not only are the risks for this group higher than the general population, “military healthcare providers do not routinely ask about sexual risk behavior, or lack knowledge of the treatment guidelines for the sexual health of [men who have sex with men],” the MSMR stated.

This is one of the lingering consequences of the Don’t Ask, Don’t Tell policy which barred gays, lesbians and bisexuals from serving openly. If you were not allowed to ask someone if he or she is gay or lesbian, then you could hardly learn about a patient’s sexual history.

Or provide adequate medical care.

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