Diseases, Sexually Transmitted

Diseases, Sexually Transmitted. Venereal diseases, or as the military currently defines them, sexually transmitted diseases (STDs), occur most often in sexually active people less than twenty‐four years of age. Because military forces historically have consisted of mostly young people, predominantly young men, often sexually active, the incidence of STD in military personnel has always been two to three times that of a similar matched group of civilians. This rate can rise five to eight times higher during wartime.

Some form of STDs seems to have plagued military forces from earliest recorded history. Herodotus in the fifth century B.C.E. wrote that Scythian soldiers who pillaged the Celestial Temple of Venus were infected with a “female disease” that afflicted all of their descendants. The first recorded cases of syphilis appeared in Europe in 1493 supposedly among Spanish sailors returning from the New World. Spanish and French armies soon spread what was called the “Neapolitan disease” or the “French pox” throughout Europe.

Historically, two methods have been advocated for controlling rates of STDs in the U.S. military: punishment of soldiers and support for regulation of civilian conveyors of the disease through regular examination and treatment of prostitutes. Traditionally when rates became high, particularly in wartime, regulation was enforced; when rates returned to baseline levels, the military either ignored the problem or relied upon punitive action. Such shifts in policy occurred during the Civil War, the Spanish‐American War, and World War I. The primary reason was that the methods of treatment, which consisted chiefly of local applications of antiseptics (containing arsenic, mercury, and bismuth), were only marginally effective. In addition, infected soldiers often did not develop a persistent and immediately debilitating illness, although they often became asymptomatic and infectious carriers. During World War I, the military public health authorities sought to eliminate prostitution in the areas around U.S. military and naval bases.

During World War II, the public health authorities encouraged publicity about venereal disease, breaking a long taboo on public discussion. The advent of antibiotics, especially penicillin, had a dramatic impact on STDs, primarily gonorrhea and syphilis. Another effective preventive measure was the use of condoms, which were distributed to all members of the armed forces.

STDs reemerged as a major problem in the military in the 1960s and 1970s as a result of several new developments. In the wider society, the “sexual revolution” in attitudes and behavior meant that sexual encounters were more readily accepted as a social norm. There was also indiscriminate use of antibiotics, thus reducing their effectiveness. And in 1976, new resistant strains of gonorrhea emerged first in the Far East, then in the United States which within a decade rendered many antibiotic treatments useless. Further, new sexually‐transmitted viral agents emerged: herpes; venereal warts (Papilloma virus); hepatitis B; and the deadly AIDS virus, HIV.

STDs have always been a problem for the military. Attempts to control them by changing behavior have had a significant, if temporary, impact. But recent resistant microorganisms and new STDs threaten to bring back the high prevalence rate that existed before antibiotics.
[See also Casualties; Demography and War.]

Bibliography

U.S. Army, Medical Department , Preventive Medicine in World War II, Vol. V: Communicable Diseases, ed. John B. Coates, Ebbe C. Haff, and Phebe M. Hoff, 1960.
Stanhope Bayne‐Jones , The Evolution of Preventive Medicine in the United States Army, 1606–1939, 1968.
Edmund C. Tramont , AIDS and Its Impact on Medical Readiness, Military Review, 6 (1990), pp. 48–58.

Edmund C. Tramont