{"id":740,"date":"2012-11-06T13:04:24","date_gmt":"2012-11-06T13:04:24","guid":{"rendered":"https:\/\/blogs.bmj.com\/sti\/?p=740"},"modified":"2012-11-06T13:05:27","modified_gmt":"2012-11-06T13:05:27","slug":"impact-on-sexual-behaviour-of-dont-ask-dont-tell-policy-in-us-navy","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/sti\/2012\/11\/06\/impact-on-sexual-behaviour-of-dont-ask-dont-tell-policy-in-us-navy\/","title":{"rendered":"Impact on sexual behaviour of \u201cDon\u2019t Ask, Don\u2019t Tell\u201d policy in US navy"},"content":{"rendered":"<p>Epidemiological research has sometimes addressed\u00a0the impact on men who have sex with men (MSM) sexual behaviour of being \u201cnon-gay identifying\u201d (NGI) (Yun, Wang et al. (<a href=\"http:\/\/sti.bmj.com\/content\/87\/7\/563.full?sid=a367a77d-f830-46ee-b761-eec8d9e22da2\">http:\/\/sti.bmj.com\/content\/87\/7\/563.full?sid=a367a77d-f830-46ee-b761-eec8d9e22da2<\/a> ); Mercer &amp; Cassell (<a href=\"http:\/\/ijsa.rsmjournals.com\/content\/20\/2\/87.full\">http:\/\/ijsa.rsmjournals.com\/content\/20\/2\/87.full<\/a>) or of belonging to a culture in which openness about sexuality by MSM is sometimes difficult and personally costly (Lane, Kegeles et al. (<a href=\"http:\/\/sti.bmj.com\/content\/84\/6\/430.full?sid=ab090fad-0769-479b-a7d5-e6ba10da5609\">http:\/\/sti.bmj.com\/content\/84\/6\/430.full?sid=ab090fad-0769-479b-a7d5-e6ba10da5609<\/a>).<\/p>\n<p>The position of MSM in the US military under the recently abolished \u201cDon\u2019t Ask, Don\u2019t Tell\u201d (DADT) policy was an extreme case \u2013 possibly a limit-case \u2013 of this situation:\u00a0 up until September 2011, an admission of sexual orientation by MSM, or evidence such as hand-holding, could result in ejection from the military.<\/p>\n<p>How does this kind of situation influence patterns of HIV transmission among MSM, and what is the impact on the sexual behaviour of those MSM who engage in relationships with men regardless?\u00a0 Would we expect the repressive effects of DADT to result in a relatively lower proportion of total HIV infection due to MSM sexual contact than in the general population \u2013 or the reverse?<\/p>\n<p>Results of a recent online survey of the sexual behaviour prior to forced HIV testing of\u00a0 US Navy and Marine Corps personnel who sero-converted under DADT intriguingly lifts the lid on this formerly closed epidemiological world \u2013 and perhaps, to some degree, on other similarly closed worlds.\u00a0 Of course, the survey itself has major limitations: most importantly its restriction to a minority (64 (524): 26%), and an apparently not very representative minority, who responded to the survey; also the often considerable lapse of time since the behaviours reported.\u00a0 Despite all these limitations the forced imposition of an HIV test on the whole group allows the survey to capture HIV prevalence at a moment in time.<\/p>\n<p>Among the men who became HIV-infected\u00a0 84% had had sex with men in the 3-year period prior to diagnosis: 55% reporting sex with just men, and\u00a030% reporting sex with both men and women.\u00a0 DADT would not then appear to have had much impact on reducing the burden of MSM infection as a proportion of total burden.\u00a0 This higher figure relative to earlier surveys of the US military (84% as opposed to 59% reporting sex with men) probably reflects the liberalizing effects of DADT repeal.\u00a0 The frequency of inconsistent condom use with anal sex was 65%, and more than three quarters expressed surprise at their HIV diagnosis.<\/p>\n<p>The story these figures tell mirrors\u00a0other \u201crepressive\u201d settings such as those with which we began our blog.\u00a0\u00a0On the whole, a culture of repression drives the unwelcome sexual behaviour underground rather than eliminating it, while, at the same time, discouraging responsible behaviour and the adoption of risk-reduction strategies.\u00a0 As the authors note, \u00a0\u201cSeveral opportunities for primary prevention messaging now possible after DADT repeal are evident\u201d.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Epidemiological research has sometimes addressed\u00a0the impact on men who have sex with men (MSM) sexual behaviour of being \u201cnon-gay identifying\u201d (NGI) (Yun, Wang et al. (http:\/\/sti.bmj.com\/content\/87\/7\/563.full?sid=a367a77d-f830-46ee-b761-eec8d9e22da2 ); Mercer &amp; Cassell (http:\/\/ijsa.rsmjournals.com\/content\/20\/2\/87.full) or of belonging to a culture in which openness about sexuality by MSM is sometimes difficult and personally costly (Lane, Kegeles et al. (http:\/\/sti.bmj.com\/content\/84\/6\/430.full?sid=ab090fad-0769-479b-a7d5-e6ba10da5609). [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/sti\/2012\/11\/06\/impact-on-sexual-behaviour-of-dont-ask-dont-tell-policy-in-us-navy\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":152,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2043,2783,2274],"tags":[],"class_list":["post-740","post","type-post","status-publish","format-standard","hentry","category-behaviour","category-historical","category-hiv-epidemiology"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Impact on sexual behaviour of \u201cDon\u2019t Ask, Don\u2019t Tell\u201d policy in US navy - Sexually Transmitted Infections<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/sti\/2012\/11\/06\/impact-on-sexual-behaviour-of-dont-ask-dont-tell-policy-in-us-navy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Impact on sexual behaviour of \u201cDon\u2019t Ask, Don\u2019t Tell\u201d policy in US navy - Sexually Transmitted Infections\" \/>\n<meta property=\"og:description\" content=\"Epidemiological research has sometimes addressed\u00a0the impact on men who have sex with men (MSM) sexual behaviour of being \u201cnon-gay identifying\u201d (NGI) (Yun, Wang et al. (http:\/\/sti.bmj.com\/content\/87\/7\/563.full?sid=a367a77d-f830-46ee-b761-eec8d9e22da2 ); Mercer &amp; Cassell (http:\/\/ijsa.rsmjournals.com\/content\/20\/2\/87.full) or of belonging to a culture in which openness about sexuality by MSM is sometimes difficult and personally costly (Lane, Kegeles et al. (http:\/\/sti.bmj.com\/content\/84\/6\/430.full?sid=ab090fad-0769-479b-a7d5-e6ba10da5609). 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