The Challenge of Sexually Transmitted Diseases for the Military: What Has Changed?

Sexually transmitted diseases (STDs) have been traditionallyconsidered a challenge to military leaders [1]. Historically,women were considered the source of STDs for soldiers,sailors,and marines, and prostitution ourished around military set-tlements. In 1632, there were reported to be 15,000 “loosewomen” in camp at the siege of Nuremberg; in 1648, theImperial and Bavarian Armies consisted of 40,000 soldiers and140,000 prostitutes and camp-followers [2]. In 1793, Carotdrove away 3000 women from his troops at Douai, France,and commented that the diseases transmitted by these women“killed ten times as many men as enemy re” [2].Today, women have assumed a great and important role inthe military. In 1996–1997, »17% of all new recruits to all mil-itary services of the United States were women[3].Interventionsto prevent or control STDs can no longer be aimed only atrelationships between male military personnel and female sexworkers. A complex environment exists in which sexually activeyoung people enter the military and bring their community’sSTDs with them. They have the opportunity to interactsexuallywith others in the military and with civilians near their militaryinstallations, at overseas locations, and in their hometowns.In 1972, Greenberg [2] divided the history of STDs in themilitary into 3 periods. The rst, beginning during the Amer-ican Revolution and lasting until 1909, was a time when STDswere deplored but ignored. The second, from 1909 to 1945, wasan era of gain in scientic knowledge and the use of punitive