Malaria Incidence in US Military Families Is Related to Service Member's Birthplace.

Background: Foreign-born persons make up approximately 5% of the United States military active duty service members. Studies in the general population show that travelers visiting friends and relatives have an increased risk of malaria acquisition. We hypothesized a higher incidence of malaria within the Military Health System (MHS) for those with a familial connection to malaria-endemic countries.

Antiretroviral Therapy within Two Years of HIV Acquisition is Associated with Fewer Viral Blips: A Retrospective Analysis of Over 20 Years of Data from the U.S. Military HIV Natural History Study.

Introduction: Viral blips have been associated with larger reservoir size and slower decay. Earlier antiretroviral therapy (ART) initiation may decrease the risk of blips.

Methods: We analyzed participants from the U.

Low Level Viremia Is Associated With Serious non-AIDS Events in People With HIV.

Background: The consequences of low-level viremia in people with HIV are unclear. We used data from the US Military HIV Natural History Study to examine the association of low-level viremia (LLV) and serious non-AIDS events (SNAEs).

Methods: Included participants initiated antiretroviral therapy after 1996 and had ≥3 viral loads (VLs) measured, using an assay with a lower limit of detection of <50 copies/mL, ≥6 months after antiretroviral therapy initiation.

Mandated checkups, knowledge of own health status, and chronic care utilization: The effect of HIV medical evaluation mandates on healthcare quality and expenditure in a US-single payer system.

In an effort to improve military readiness, in 2014 the US Air Force reduced the frequency of mandated HIV medical evaluation visits from every 6 months to every 12 months. We employ this natural experiment using data for 2676 active-duty Military Health System beneficiaries living with HIV with a difference-in-differences empirical strategy using the Army, Navy, and Marines as a control group to estimate the causal effect of reducing the frequency of mandated evaluation visits on the quality and cost of medical care for active-duty military members living with HIV. We find that reducing the frequency of mandated HIV medical evaluation visits reduced the likelihood of regular HIV visits by 23 percentage points but did not affect the likelihood of receiving other preventive care, adhering to HIV therapy, or maintaining viral testing and suppression.

Patients with HIV-associated cancers have evidence of increased T cell dysfunction and exhaustion prior to cancer diagnosis.

Background: People living with HIV (PLWH) have increased risk of developing cancers after controlling traditional risk factors and viral suppression. This study explores whether T cells can serve as a marker of risk for cancer among HIV-infected virally suppressed patients.

Methods: A nested case control study design was pursued with 17 cancer cases and 73 controls (PLWH without cancer)ouidentified among the US Military HIV Natural History Study cohort, and were matched for CD4 + count, duration of HIV infection, and viral suppression.

Statin usage and cardiovascular risk among people living with HIV in the U.S. Military HIV Natural History Study.

Objectives: Using the American College of Cardiology/American Heart Association 2013 atherosclerotic cardiovascular disease (ASCVD) management guidelines, we conducted a retrospective cross-sectional analysis of people living with HIV in the US Military HIV Natural History Study to determine whether individuals were receiving statins when indicated.

Methods: Prescription data was taken from Military Health System data. Statin eligibility was defined by ASCVD guidelines.

The Intersection of HIV, Diabetes, and Race: Exploring Disparities in Diabetes Care among People Living with HIV.

In a setting of universal health care access, we compared diabetes control between Caucasians and African Americans (AA) living with HIV. This was a cross-sectional analysis of data from a cohort study among military members living with HIV and diabetes. Using adjusted logistic regression models, we compared proportions of Caucasians and AA meeting the following diabetes treatment goals: hemoglobin A <7.

The US Military HIV Natural History Study: Informing Military HIV Care and Policy for Over 30 Years.

Introduction: In October 1985, 4 years after the initial descriptions of the acquired immunodeficiency syndrome (AIDS), the U.S. Department of Defense (DoD) began routine screening for human immunodeficiency virus (HIV) infection to prevent infected recruits from exposure to live virus vaccines, implemented routine active-duty force screening to ensure timely care and help protect the walking blood bank, and initiated the U.

Refractive surgery in the HIV-positive U.S. Military Natural History Study Cohort: complications and risk factors.

Purpose: This study sought to assess the frequency of refractive surgery complications in HIV+ individuals and related risk factors.

Settings: Multiple centers in the United States.

Design: Prospective observational cohort study.