Skip main navigation

Military Health System

Clear Your Browser Cache

This website has recently undergone changes. Users finding unexpected concerns may care to clear their browser's cache to ensure a seamless experience.

Surveillance Snapshot: HIV Pre-Exposure Prophylaxis (PrEP) Prescriptions Within the Active Component of the U.S. Military, 2023

Image of 36019063. HIV Pre-Exposure Prophylaxis is a highly effective medicine for preventing HIV when used as prescribed.

Click on the table to access a 508-compliant PDF versionHIV Pre-Exposure Prophylaxis is a highly effective medicine for preventing HIV when used as prescribed, reducing the risk of HIV from sex by around 99% and the risk of HIV from injection drug use by at least 74%.1 The Department of Defense follows the U.S. Centers for Disease Control and Prevention HIV PrEP guidelines for identification of individuals eligible for HIV PrEP and their evaluation and monitoring.2 This Surveillance Snapshot was created to determine the number of active component service members prescribed PrEP during 2023. 

Data from the Defense Medical Surveillance System were used for this analysis.3 The population was restricted to ACSMs who received a PrEP prescription between January 1, 2023 and December 31, 2023. A PrEP prescription was defined as a record in the Pharmacy Data Transaction System or Theater Medical Data Store medication files within DMSS containing the drug name Truvada, Descovy, Emtricitabine, Tenofovir, Apretude, or Cabotegravir. Records with the names Disoproxil, Viread, or Emtricitabine or listing a therapeutic class of 081808 (antiretrovirals) were excluded, as those are HIV treatment medications. Additionally, a prescription record was excluded if an individual had a diagnosis of chronic hepatitis B or HIV on or before the prescription date, or a needlestick diagnosis within 30 days before or after the prescription date. 

An individual was counted once during the surveillance year. Counts were summarized by pharmacy type, demographic characteristics, service-related variables, and self-assessed sexually-transmitted infection risk (defined from the Periodic Health Assessment if completed within one year prior to the prescription date) (Table). 

There were 4,495 ACSMs with a prescription for HIV PrEP in 2023 (Table). The majority of prescriptions (79%) were obtained directly from a military clinic. The demographic groups with the highest numbers of prescriptions were 25-29 year olds (1,307), males (4,155), non-Hispanic Whites (1,772), and single, never married (2,865) ACSMs. In evaluating service-related characteristics, the highest number of prescriptions were among Army and Navy service members (1,526 and 1,452, respectively), enlisted (1,664 junior and 1,695 senior), communications/intelligence occupations (1,287), stationed in the U.S. (3,483), and in service for 3-10 years (2,164). The majority of service members with a prescription had a self-assessed risk for a STI (46%), but this information was unknown for 31% of the total PrEP recipients. 

These data provide an overview of ACSMs receiving HIV PrEP in 2023 and can be used to further evaluate subpopulations within the ACSM population that may have a missed opportunity for receiving HIV PrEP. 

Authors’ Affiliation

Epidemiology and Analysis Branch, Armed Forces Health Surveillance Division, Defense Health Agency: Dr. Eick-Cost, Dr. Mabila, and Dr. Ying 

Disclaimer

The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views, assertions, opinions, nor policies of the Defense Health Agency or the Department of Defense. 

References

  1. Centers for Disease Control and Prevention. Pre-Exposure Prophylaxis (PrEP). Accessed Feb. 26, 2024. https://www.cdc.gov/hiv/risk/prep/index.html
  2. Defense Health Agency. Defense Health Agency Procedural Instruction 6025.29: Provision of Human Immunodeficiency Virus (HIV) Pre-Exposure Prophylaxis (PrEP) for Persons at High Risk of Acquiring HIV Infection. Department of Defense. Updated Dec. 20, 2019. Accessed Feb. 26, 2024. https://www.health.mil/Reference-Center/DHA-Publications/2019/12/20/DHA-PI-6025-29 
  3. Rubertone MV, Brundage JF. The Defense Medical Surveillance System and the Department of Defense serum repository: glimpses of the future of public health surveillance. Am J Public Health. 2002;92(12):1900-1904.

You also may be interested in...

Article
May 1, 2019

Absolute and relative morbidity burdens attributable to various illnesses and injuries, active component, U.S. Armed Forces, 2018

A U.S. naval officer listens through his stethoscope to hear his patient’s lungs at Camp Schwab in Okinawa, Japan in 2018. (Photo courtesy of U.S. Marine Corps) photo by Lance Cpl. Cameron Parks)

In 2018, mental health disorders accounted for the largest proportions of the morbidity and healthcare burdens that affected the pediatric and younger adult beneficiary age groups. Among adults aged 45–64 years, musculoskeletal diseases accounted for the most morbidity and healthcare burdens, and among adults aged 65 years or older, cardiovascular ...

Article
Apr 1, 2019

Update: Exertional Hyponatremia, Active Component, U.S. Armed Forces, 2003–2018

Drink water the day before and during physical activity or if heat is going to become a factor. (Photo Courtesy: U.S. Air Force)

From 2003 through 2018, there were 1,579 incident diagnoses of exertional hyponatremia among active component service members, for a crude overall incidence rate of 7.2 cases per 100,000 person-years (p-yrs). Compared to their respective counterparts, females, those less than 20 years old, and recruit trainees had higher overall incidence rates of ...

Article
Apr 1, 2019

Update: Exertional Rhabdomyolysis, Active Component, U.S. Armed Forces, 2014–2018

U.S. Marines sprint uphill during a field training exercise at Marine Corps Air Station Miramar, California. to maintain contact with an aviation combat element, teaching and sustaining their proficiency in setting up and maintaining communication equipment.  (Photo Courtesy: U.S. Marine Corps)

Among active component service members in 2018, there were 545 incident diagnoses of rhabdomyolysis likely due to exertional rhabdomyolysis, for an unadjusted incidence rate of 42.0 cases per 100,000 person-years. Subgroup-specific rates in 2018 were highest among males, those less than 20 years old, Asian/Pacific Islander service members, Marine ...

Article
Apr 1, 2019

Update: Heat Illness, Active Component, U.S. Armed Forces, 2018

Drink water the day before and during physical activity or if heat is going to become a factor. (Photo Courtesy: U.S. Air Force)

In 2018, there were 578 incident diagnoses of heat stroke and 2,214 incident diagnoses of heat exhaustion among active component service members. The overall crude incidence rates of heat stroke and heat exhaustion diagnoses were 0.45 cases and 1.71 cases per 1,000 person-years, respectively. In 2018, subgroup-specific rates of incident heat stroke ...

Article
Apr 1, 2019

Modeling Lyme Disease Host Animal Habitat Suitability, West Point, New York

A deer basks in the morning sun at Joint Base San Antonio-Fort Sam Houston, Texas.  (Photo Courtesy: U.S. Air Force)

As the most frequently reported vector-borne disease among active component U.S. service members, with an incidence rate of 16 cases per 100,000 person-years in 2011, Lyme disease poses both a challenge to health care providers in the Military Health System and a threat to military readiness. Spread through the bite of an infected blacklegged tick, ...

Article
Apr 1, 2019

Incidence, Timing, and Seasonal Patterns of Heat Illnesses During U.S. Army Basic Combat Training, 2014–2018

U.S. Marines participate in morning physical training during a field exercise at Marine Corps Base Camp Pendleton, California. (Photo Courtesy: U.S. Marine Corps)

Risk factors for heat illnesses (HIs) among new soldiers include exercise intensity, environmental conditions at the time of exercise, a high body mass index, and conducting initial entry training during hot and humid weather when recruits are not yet acclimated to physical exertion in heat. This study used data from the Defense Health Agency’s ...

Article
Mar 1, 2019

Vasectomy and Vasectomy Reversals, Active Component, U.S. Armed Forces, 2000–2017

Sperm is the male reproductive cell  Photo: iStock

During 2000–2017, a total of 170,878 active component service members underwent a first-occurring vasectomy, for a crude overall incidence rate of 8.6 cases per 1,000 person-years (p-yrs). Among the men who underwent incident vasectomy, 2.2% had another vasectomy performed during the surveillance period. Compared to their respective counterparts, the ...

Article
Mar 1, 2019

Testosterone Replacement Therapy Use Among Active Component Service Men, 2017

Image of Marines carrying a wooden log for physical fitness. Click to open a larger version of the image.

This analysis summarizes the prevalence of testosterone replacement therapy (TRT) during 2017 among active component service men by demographic and military characteristics. This analysis also determines the percentage of those receiving TRT in 2017 who had an indication for receiving TRT using the 2018 American Urological Association (AUA) clinical ...

Article
Mar 1, 2019

Brief Report: Male Infertility, Active Component, U.S. Armed Forces, 2013–2017

Sperm is the male reproductive cell  Photo: iStock

Infertility, defined as the inability to achieve a successful pregnancy after 1 year or more of unprotected sexual intercourse or therapeutic donor insemination, affects approximately 15% of all couples. Male infertility is diagnosed when, after testing both partners, reproductive problems have been found in the male. A male factor contributes in part ...

Article
Mar 1, 2019

Sexually Transmitted Infections, Active Component, U.S. Armed Forces, 2010–2018

Anopheles merus

This report summarizes incidence rates of the 5 most common sexually transmitted infections (STIs) among active component service members of the U.S. Armed Forces during 2010–2018. Infections with chlamydia were the most common, followed in decreasing order of frequency by infections with genital human papillomavirus (HPV), gonorrhea, genital herpes ...

Article
Feb 1, 2019

Update: Incidence of Glaucoma Diagnoses, Active Component, U.S. Armed Forces, 2013–2017

Glaucoma

Glaucoma is an eye disease that involves progressive optic nerve damage and vision loss, leading to blindness if undetected or untreated. This report describes an analysis using the Defense Medical Surveillance System to identify all active component service members with an incident diagnosis of glaucoma during the period between 2013 and 2017. The ...

Article
Feb 1, 2019

Re-evaluation of the MSMR Case Definition for Incident Cases of Malaria

Anopheles merus

The MSMR has been publishing the results of surveillance studies of malaria since 1995. The standard MSMR case definition uses Medical Event Reports and records of hospitalizations in counting cases of malaria. This report summarizes the performance of the standard MSMR case definition in estimating incident cases of malaria from 2015 through 2017. ...

Article
Feb 1, 2019

Update: Malaria, U.S. Armed Forces, 2018

Anopheles merus

Malaria infection remains an important health threat to U.S. service mem­bers who are located in endemic areas because of long-term duty assign­ments, participation in shorter-term contingency operations, or personal travel. In 2018, a total of 58 service members were diagnosed with or reported to have malaria. This represents a 65.7% increase from ...

Article
Feb 1, 2019

Outbreak of Acute Respiratory Illness Associated with Adenovirus Type 4 at the U.S. Naval Academy, 2016

Malaria case definition

Human adenoviruses (HAdVs) are known to cause respiratory illness outbreaks at basic military training (BMT) sites. HAdV type-4 and -7 vaccines are routinely administered at enlisted BMT sites, but not at military academies. During Aug.–Sept. 2016, U.S. Naval Academy clinical staff noted an increase in students presenting with acute respiratory ...

Skip subpage navigation
Refine your search
Last Updated: May 07, 2024
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery