Open Access Highly Accessed Open Badges Research article

Cross-sectional assessment of prevalence and correlates of blood-borne and sexually-transmitted infections among Afghan National Army recruits

Catherine S Todd1*, Abdul Nasir2, G Farooq Mansoor2, Sayed M Sahibzada2, Linda L Jagodzinski3, Farzana Salimi4, M Naim Khateri5, Braden R Hale6, R Vincent Barthel7 and Paul T Scott8

Author Affiliations

1 Department of Obstetrics & Gynecology, Columbia University, 622 West 168th Street PH 16-69, New York, NY, 10032, USA

2 Health Protection and Research Organization, House P-860, Street 10, Taimany, Kabul, Afghanistan

3 U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD, 20910, USA

4 Afghan Public Health Institute, Ministry of Public Health, Masoud Circle, Kabul, Afghanistan

5 Ministry of Defense, Shash Darak, Kabul, Afghanistan

6 Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, Naval Health Research Center, 140 Sylvester Rd, San Diego, CA, 92106-3521, USA

7 U.S. NAMRU-3, Ramses Extension Street near Abbasia Fever Hospital, Cairo, Egypt

8 U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD, 20910, USA

For all author emails, please log on.

BMC Infectious Diseases 2012, 12:196  doi:10.1186/1471-2334-12-196

Published: 21 August 2012



Few data are available in Afghanistan to shape national military force health practices, particularly with regard to sexually-transmitted infections (STIs). We measured prevalence and correlates of HIV, syphilis, herpes simplex 2 virus (HSV-2), and hepatitis C virus (HCV) among Afghan National Army (ANA) recruits.


A cross-sectional sample of male ANA recruits aged 18–35 years were randomly selected at the Kabul Military Training Center between February 2010 and January 2011. Participants completed an interviewer-administered questionnaire and serum-based rapid testing for syphilis and hepatitis C virus antibody on-site; HIV and HSV-2 screening, and confirmatory testing were performed off-site. Prevalence of each infection was calculated and logistic regression analysis performed to identify correlates.


Of 5313 recruits approached, 4750 consented to participation. Participants had a mean age of 21.8 years (SD±3.8), 65.5% had lived outside Afghanistan, and 44.3% had no formal education. Few reported prior marijuana (16.3%), alcohol (5.3%), or opiate (3.4%) use. Of sexually active recruits (58.7%, N = 2786), 21.3% reported paying women for sex and 21.3% reported sex with males. Prevalence of HIV (0.063%, 95% CI: 0.013- 0.19), syphilis (0.65%, 95% CI: 0.44 – 0.93), and HCV (0.82%, 95% CI: 0.58 – 1.12) were quite low. Prevalence of HSV-2 was 3.03% (95% CI: 2.56 - 3.57), which was independently associated with age (Adjusted Odds Ratio (AOR) = 1.04, 95% CI: 1.00 - 1.09) and having a television (socioeconomic marker) (AOR = 1.46, 95% CI: 1.03 – 2.05).


Though prevalence of HIV, HCV, syphilis, and HSV-2 was low, sexual risk behaviors and intoxicant use were present among a substantial minority, indicating need for prevention programming. Formative work is needed to determine a culturally appropriate approach for prevention programming to reduce STI risk among Afghan National Army troops.

Afghanistan; Military populations; HIV; Sexual risk behavior; Drug use