Background: U.S. military women are exposed to risks for unintended pregnancies and sexually transmitted infections, such as unwanted sexual contact (USC) and barriers to condom use. These can have important implications for public health.
Methods: Using existing data from the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel, we employed multiple logistic regression methods to investigate risk factors for reported USC since entering the military (includes touching of genitals) and lack of condom use at last sexual encounter among sexually active service women.
Results: The sample included N=6,779 sexually active female military personnel, of which 3,428 were unmarried. Almost 68% of unmarried women reported lack of condom use and 12.4% of all sexually active women reported USC. After adjusting for age, race/ethnicity, service branch, deployment within the past 12 months, and main partner at last sex, we found that positive reports of illicit substance use (Adjusted odds ratio [AOR]=1.85, 95% Confidence Interval [CI]=1.18, 2.89), unintended pregnancy (AOR=3.16, 95% CI=2.12, 4.71), family/personal-life stress (AOR=1.69, 95% CI=1.19, 2.40), and suicidal ideation (AOR=1.96, 95% CI=1.22, 3.17) were associated with lack of recent condom use among unmarried sexually active service women. USC was positively associated with screening positive for depression (AOR=1.69, 95% CI=1.34, 2.12) and elevated psychological distress (AOR=1.91, 95% CI=1.44, 2.52) after adjusting for age, race/ethnicity, and marital status (including whether or not the spouse was present in the military). In addition, we found that married women with their spouse present in the military were less likely than unmarried women to report USC (AOR=0.74, 95% CI=0.56, 0.98).
Conclusions: Indicators of current mental health status are associated with reports of recent lack of condom use and unwanted sexual contact among service women. Interventions could target unmarried sexually active female military personnel to improve sexual health.