The Challenge of Sexually Transmitted Diseases for the Military: What Has Changed?

Sexually transmitted diseases (STDs) have been traditionally considered a challenge to military leaders [1]. Historically, women were considered the source of STDs for soldiers, sailors, and marines, and prostitution flourished around military settlements. In 1632, there were reported to be 15,000 “loose women” in camp at the siege of Nuremberg; in 1648, the Imperial and Bavarian Armies consisted of 40,000 soldiers and 140,000 prostitutes and camp-followers [2]. In 1793, Carot drove away 3000 women from his troops at Douai, France, and commented that the diseases transmitted by these women “killed ten times as many men as enemy fire” [2]. Today, women have assumed a great and important role in the military. In 1996–1997, ∼17% of all new recruits to all military services of the United States were women [3]. Interventions to prevent or control STDs can no longer be aimed only at relationships between male military personnel and female sex workers. A complex environment exists in which sexually active young people enter the military and bring their community's STDs with them. They have the opportunity to interact sexually with others in the military and with civilians near their military installations, at overseas locations, and in their hometowns.