HIV incidence trends among white and African-American active duty United States Army personnel (1986-2003)

OBJECTIVE: To analyze HIV incidence rate (IR) trends among white and African-American active duty US Army personnel between 1986 and 2003. METHODS: Joinpoint regression was applied to identify time periods when significant changes in HIV IRs occurred, along with the corresponding annual percentage changes (APCs). RESULTS: African-Americans had a higher IR than white personnel (0.34/1000 vs. 0.07/1000; P < 0.001). Among white personnel, 2 significant time periods of changing HIV IRs were found: between 1986 and 1989 (APC = -31.1; P = 0.006) and between 1989 and 2003 (APC = -5.7; P = 0.003). Among African-Americans, a significant decline in HIV IRs was observed only between 1986 and 1991 (APC = -19.4; P < 0.001). This study revealed that the HIV IRs seem to have increased in 2 African-American groups: unmarried personnel and health care professionals. CONCLUSION: This cohort study (1,280 incident HIV infections among 1.5 million persons with 8.4 million person-years of follow-up) provides invaluable information on HIV trends in the United States Army. Despite an overall decline in HIV IRs, certain subpopulation among African-American personnel were observed to have increasing HIV IRs. Future research is needed to identify the current behavioral risk factors associated with HIV infection among US Army personnel.