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HIV / AIDS and the Issue
of Gays in the Military

Alan M. Steinman, MD, MPH

The issue of HIV and AIDS is occasionally raised as a reason for maintaining the current Don’t Ask, Don’t Tell (DADT) policy. The underlying assumption in this reasoning is that allowing gay, lesbian and bisexual (GLB) troops to serve in the military would increase the number of HIV+ service members and create an unacceptable risk for HIV- (and presumably heterosexual) service members. A corollary to this assumption is that a significant number of current and future GLB troops are or would be become sero-positive for HIV, and the risk of transmission of HIV through emergency battlefield transfusions of fresh whole blood would increase if GLB troops were allowed to serve. So strong were these assumptions in the early years of DADT that the FY96 Defense Appropriations Act included legislation that required the discharge of any HIV+ troops; but Congress repealed that provision the next year as unnecessary. Since that time, none of the dire assumptions about GLB troops has been supported by factual evidence.

GLB troops have been legally serving in the military under DADT since 1993. If their presence in the workforce created a risk for the increased incidence of HIV+ military troops, the Department of Defense (DoD) would have already seen evidence of such an increase in the seventeen years since the DADT law was enacted. Since all recruits and officer accessions are tested for HIV, and since all troops are tested every two years for the HIV virus, DoD medical data on sero-conversion of troops from HIV- to HIV+ should have shown an increase in HIV prevalence in the active duty workforce. Such an increase has not occurred. In fact, the U.S. Military HIV Research Program (USMHRP) published a paper in December 2007 that stated the following: “The incidence of new infections in all three services has remained constant over the past decade at approximately 350 each year.” Thus, despite the legal presence of GLB troops in the military for the past 17 years, no significant increase in HIV infections has occurred.

The assumption that GLB troops would be the predominant source of new HIV infections is also false. The USMHRP stated the following in the paper previously cited: “The primary risk for deployment-associated infection is heterosexual exposure with the endemic population. These infections are occurring in the militaries’ highly trained troop population in senior enlisted and junior officers.” Since HIV+ troops (either GLB or heterosexual) are not eligible for deployment, the risk of new infections as a result of battlefield transfusions of fresh whole blood is exceedingly small. And since most new HIV infections are occurring during deployments, and that heterosexual troops are the predominant source of these new infections, the assumption that GLB troops would disproportionately increase the risk of battlefield transfusion-related sero-conversion is false.

Finally, it is also worth noting that the U.S. population with the lowest level of HIV infections and HIV sero-conversions are lesbian women. Lesbian military troops are thus at a far lower risk of HIV infection than any other category of military personnel.

HIV / AIDS is a risk to anyone, GLB or heterosexual, who engages in sexual activity known to be associated with increased risk of infection. The military routinely screens its troops for HIV infection, and HIV+ troops are not eligible for overseas deployment; many are medically discharged. Thus HIV / AIDS is not a rational argument for retaining the DADT law. GLB troops have served their nation under DADT for over 17 years, yet the incidence of HIV infections has remained stable. Allowing these GLB troops to serve with the same honor and dignity afforded their heterosexual counterparts by repealing DADT would be exceedingly unlikely to alter HIV incidence rates.

  2010 Gay Military Signal