Virologic Suppression in U.S. Navy Personnel Living with HIV Infection and Serving in Operational Assignments

Abstract

Introduction: Current United States Navy policy supports the continuation of duty for active duty (AD) service members living with HIV infection. The creation of this policy is instrumental to prevent exclusion and to promote career expansion and promotional opportunities for AD service members infected with HIV. The established instruction parallels the HIV care continuum, a widely accepted public health model. No studies have been done to determine whether allowing service members to fill operational and Outside the Continental United States (OCONUS) assignments disrupts this continuum of care. This retrospective study aims to evaluate how an operational or OCONUS assignment impacts the ability of an HIV AD service members to receive the standard of care HIV medical treatment and maintain viral suppression.

Materials/methods: A retrospective chart review was performed on the health records of 20 United States AD Navy service members with HIV who were placed in OCONUS or large ship assignments per current U.S. Navy policy. Health records were reviewed during the service member's assignment. Viral loads were documented immediately prior and at 6 months after starting their new assignment. Changes to anti-retroviral medications and the medical treatment facility, including the specialty of the treating provider were recorded.

Results: The results demonstrate no significant change in the service member's viral load during the first 6 months in an operational or OCONUS assignment. Members still had access to care including medications and specialty providers based on the locality.

Conclusion: All service members within this review were able to maintain viral suppression despite the location of their assignments. This limited study suggests that care is accessible and the standard HIV care continuum is maintained while deployed or stationed overseas.

Keywords: HIV; Navy; Virologic suppression; operational assignment.