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HIV-1 infection risk and behavior change in a cohort of Thai men during and after military service.
Renzullo P; Nelson K; Celentano D; Beyrer C; Eiumtrakul S; Garner R;
January 30, 1997
Int Conf AIDS. 1996 Jul 7-12;11(1):177 (abstract no. Mo.D.1717). Unique

Objective: To determine the seroconversion rate (SR), changes in risk behavior and risk factors among male conscripts in the Royal Thai Army (RTA) during and after completion of their mandatory two-year service. Methods: The cohort was selected from among conscripts who participated in a study of HIV infection risk while in the RTA. Those who agreed to participate and returned for follow-up visits after discharge comprised the Ex-Service Cohort. Demographics, medical history, STDs, and sexual history were surveyed at 6-month intervals during service and at 3, 9, and 15 months after discharge. HIV serconversion rates and 95% confidence intervals were calculated over the 3 year period, during service and after discharge. Multiple regression techniques for repeated measures were used to determine relationships between potential risk factors and seroconversion. Change in risk was evaluated based on deviations from expected distributions of risk categories for sentinel behaviors. Differences were assessed with chi-square analyses. Results: A total of 546 (96.4%) men agreed to participate in the ex-service study. Of these, 380 returned for visits after discharge from the RTA. No significant differences were seen in demographic, medical and behavioral variables between Ex-Service participants and non-participants. A total of 23 men seroconverted during the follow-up period, 16 during military service and 7 after discharge. The overall SR and 95% confidence interval (CI) for the cohort was 2.14/100 person-years (py) (CI=1.36-3.21). The SR and 95% CI for within and ex-service periods were 2.56/100 py 1.46-4.15) and 2.01/100 py (0.81-4.13). Greatest change in risk over time was seen with 1) condom use with CSWs, girlfriends and wives and 2) alcohol use. Conclusions: HIV seroconversion rates during and after service were not significantly different. Despite the similiar SR, significant increases in risk were reported with the use of condoms with sex partners and with alcohol use. Longitudinal studies can provide important information on the maturing HIV infection epidemic in Thailand, as well as on the evaluation of interventions aimed at curbing the epidemic.

*HIV Seropositivity/EPIDEMIOLOGY *Military Personnel