Background: Continued surveillance of the HIV epidemic is critical to monitor changes
in trends and risk behaviors. A 2005 study in the Cameroonian Armed Forces (CAF) found an HIV
prevalence of 11.3% among male and female service members. The purpose of the current study is
to determine the 5-year change in the HIV prevalence, estimate the prevalence of syphilis, and examine
factors associated with infection in the CAF.
Methods: Participants were male and female service members 18 years of age or older who were
stationed at one of the 10 military garrisons selected for participation. The military garrisons included
in this study were proportionally representative of the CAF by geographic region. Military
companies and individuals within the selected garrisons were randomly chosen to participate in the
study. Demographic and behavioral risk data were collected from September-November 2011 using
personal interviews. Blood was collected for HIV and syphilis testing.
Results: Of 2,523 participants tested, 6.0% screened positive for HIV [includes 5.3% who screened
positive for HIV only and 0.7% who screened positive for both HIV and syphilis], and 3.1% screened
positive for syphilis only. Analyses examining risk factors associated with HIV/syphilis infection (i.e.,
infected with HIV, infected with syphilis, or co-infected with both HIV and syphilis) were restricted to
2,255 men who reported ever having sex. In a multivariate logistic regression model, the odds of testing
positive for HIV/syphilis were higher among men who were separated, divorced, or widowed (adjusted
odds ratio [AOR]=3.13, 95% confidence interval [CI]: 1.24–7.89), had sex with sex workers
(AOR=1.64, 95% CI: 1.19–2.27), and reported a genital sore/ulcer in the past 12 months preceeding
the survey (AOR=1.73, 95% CI: 1.05–2.86). Higher HIV knowledge was protective against
HIV/syphilis infection (AOR=0.73, 95% CI: 0.54–0.99). While the overall HIV prevalence in this
sample of military personnel was lower than previously reported (6.0% [95% CI: 5.12–6.97] in 2011
vs. 11.3% [95% CI: 10.01–12.68] in 2005; confidence intervals do not overlap), several factors associated
with HIV/syphilis infection were identified including being separated, divorced, or widowed, having
sex with a sex worker, and reporting a genital sore/ulcer in the past 12 months.
Conclusion: HIV and syphilis education among all military personnel as they enter service and proceed
forward is important to reinforce prevention methods and practices.