Perceptions of the Military Health System: Differences in Sexual and Reproductive Health Burden Among Males and Females

Introduction: Access to timely and convenient sexual and reproductive health (SRH) care is essential to force readiness and depends in part on service member’s comfort and confidence in addressing these topics with a healthcare provider. Although SRH is a total force responsibility, the burden of reducing risk of unintended pregnancy and sexually transmitted infections (STIs) may disproportionally fall on female service members, further exacerbating this challenge. The current study explores service members’ experiences of SRH care within the Military Health System (MHS). Materials and Methods: Active duty service members were recruited as part of a broader study on SRH in the U.S. military. A total of 263 service members (43% female; 57% male) participated and completed measures assessing engagement with and perception of the MHS. Participants identified if they had discussed various SRH topics with a healthcare provider ever or in the past 12 months. They also rated their perceptions of the military system (e.g., quality, wait times) and communication MHS providers. Results: Approximately 40% of male service members report never having discussed a variety of SRH topics with MHS healthcare providers. Female service members were significantly more likely to have discussed STI testing and pregnancy prevention and, among those who had not discussed these topics, females were more likely to desire to do so. In addition, perceptions of general health encounters within the MHS were rated lower among females than males. Conclusions: Female service members receive more regular counseling on SRH topics; however, many still do not report receiving critical SRH care. Furthermore, despite feeling less comfortable in these interactions, they are disproportionally responsible for the management of this total force issue. Although some differential counseling on these topics between males and females is appropriate, a more holistic approach to SRH care is vital to the readiness of the force.