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1 1 (March 21, 2023)

handle is hein.crs/govekyz0001 and id is 1 raw text is: Congressional Research Service informing the Iegislative debate since 1914 Updated March 21, 2023 HIV/AIDS in the Military In various chapters of Title 10, U.S. Code, Congress has codified a number of broad authorities for the Department of Defense (DOD) to establish certain accession and retention standards for servicemembers. These authorities allow DOD to create standards and set minimum thresholds in areas such as educational aptitude, physical fitness, and medical fitness that must be met for an individual to enter or remain in military service. DOD policies establish the medical fitness standards required to enter, or be retained in, the Armed Forces. In certain instances, applicants or current servicemembers may develop, present with, or have a history of a medical condition or physical defect that would be disqualifying for entry into or continued military service. There are approximately 434 disqualifying medical conditions, including human immunodeficiency virus (HIV) infection. While DOD policy prohibits the accession of any applicant who tests positive for HIV, current servicemembers who become infected may continue to serve. HIVAIDS in the Military The U.S. Centers for Disease Control and Prevention (CDC) describes HIV as a chronic viral infection that attacks an individual's immune system. HIV can be transmitted when an infected person's bodily fluids (e.g., semen, blood, breast milk) are injected into the blood stream or come into contact with mucus membrane or damaged tissue of another. Untreated HIV infections can lead to Acquired Immunodeficiency Disease Syndrome (AIDS). Between January 2017 and June 2022, DOD's Armed Forces Health Surveillance Division estimated that 1,581 servicemembers were newly diagnosed with HIV. Of those servicemembers, 981 (62%) were still serving in the military in 2022. The rate of newly diagnosed HIV infections (also called the seroprevalence rate) among servicemembers tested in 2021 was 23 per 100,000. This rate is lower than that of the general U.S. population, ages 25-34. Figure 1 illustrates trends in HIV incidence rates in the military since 1990. Across the active components, the seroprevalence rate (per 100,000 servicemembers) in 2021 was highest in the Army (28), followed by the Navy (25), Air Force (15), and the Marine Corps (12). Among the reserve components, the seroprevalence rate was highest in the Air Force Reserve (40), followed by the Navy Reserve (36), Army Reserve (28), Army National Guard (27) Marine Corps Reserve (26), and Air National Guard (13). Entry into Military Service In general, DOD policies prohibit applicants with laboratory evidence of HIV infection from entering military service. All applicants typically undergo a comprehensive medical examination, including HIV screening, at a military entrance processing station or military treatment facility (MTF). For applicants to the U.S. Service Academies, the Uniformed Services University of the Health Sciences, or other direct commissioning programs, HIV screenings occur prior to the program's commencement. DOD policies provide an exception for HIV+ individuals who are currently serving in the military and applying for an officer commission or participation in an officer accession program. These policies also allow applicants on HIV pre-exposure prophylaxis (PrEP) to enter military service if those medications are administered in compliance with CDC guidelines. Figure 1. Rates of New HIV Diagnoses Among Servicemembers, 1990-2017 40 199099 992199199 199 190 197 9981999200 20% 202 0032004 20Q5 2art 2Q07 20$8 2tX09 20¶0 2Ot1 20 2 20u 2014 2015 2010 2017 Can ar y w fnw 1NN diagncss Source: Defense Health Agency, Medical Surveillance Monthly Report, Review of the U.S. Military's Human Immunodeficiency Virus Program: a Legacy of Progress and Future of Promise, Vol. 24, No. 9, September 2017, https://go.usa.gov/xmQ6z.

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