By Michael R. (Bob) MacDonald, MS, CHES,
Manager, Sexual Health and Responsibility Program (SHARP)
Navy and Marine Corps Public Health Center
In July 2015, the National HIV/AIDS Strategy for the U.S. was updated for 2020 by the Office for National AIDS Policy.
The strategic vision is that our United States “will become a place where new HIV infections are rare, and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity, or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination”.
The strategy features four goals with Goal 1 “Reduce New HIV Infections” being the most immediately imperative to the Navy, in my view. Step 1a of the strategy is to “intensify HIV prevention efforts in communities where HIV is most heavily concentrated”. In the U.S. these communities include men who have sex with men, black and Latino men and women, people who inject drugs, young people (aged 13-24), people in the southern U.S., and transgender women. The goal is to reduce HIV infections by 25% by 2020.
This national policy has implications for HIV prevention efforts for the Navy because the HIV epidemic among Sailors has continued at a steady and concerning level for the past 2 decades, with another active Sailor diagnosed with HIV about every 5 days. Among active duty Sailors, the members most likely to be diagnosed with HIV are, like the general U.S. population, men who have sex with men, who constitute about 7 of 10 new HIV infections. Also reflecting the national experience, HIV rates are highest among young, black, enlisted male Sailors. The 2011 repeal of “Don’t Ask Don’t Tell” provides Navy Medicine with a new opportunity to reach out to these vulnerable men and help them better understand and avoid HIV.
In support of this national effort and to ensure the health and readiness of the force, the Navy and Marine Corps Public Health Center (NMCPHC), through its Sexual Health and Responsibility Program (SHARP) continues to work toward this goal of protecting Sailors and Marines from HIV. For example, in 2015, NMCPHC-SHARP, in collaboration with other partner organizations, has developed new HIV prevention posters and factsheets and will soon announce the release of a new web-based sailor –education module (voluntary general military training) that includes information about HIV risk, HIV testing and HIV pre-exposure prophylaxis (PrEP), a new HIV prevention all-hands film and webinar for the Navy health care team on HIV PrEP.
NMCPHC-SHARP also maintains a web page for gay and bisexual men’s health and a page on general HIV prevention resources. NMCPHC-SHARP advocates, and has created a tool for, annual screening of sexual health risks during the Periodic Health Assessment during which HIV risk may be identified and mitigated. For example, men who have sex with men should be offered HIV testing at least annually and should be offered personalized risk reduction options such as HIV PrEP.
Navy Medicine can help achieve the 25% reduction in HIV infections by utilizing these ready-to-use tools. Similarly, every Navy organization can, and should, contribute to the HIV prevention effort by including HIV prevention as part of their mandatory deck-plate health promotion program.
Read the National HIV/AIDS Strategy for the U.S. at: https://www.aids.gov/federal-resources/national-hiv-aids-strategy/nhas-update.pdf
Get HIV prevention resources from NMCPHC-SHARP at: http://www.med.navy.mil/sites/nmcphc/health-promotion/reproductive-sexual-health/Pages/hiv-prevention-resources.aspx
SHARP –‘ Chart a Safe Course’