Airmen on HIV Drug Can Return to Flight Sooner After Change Championed by LGBTQ+ Advisory Group

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U.S. Army HIV awareness graphic.
U.S. Army HIV awareness graphic. (U.S. Army graphic by Spc. Woodlyne Escarne)

The Air Force is amending its policies regarding an anti-HIV drug, decreasing the time that pilots would be grounded after taking the medication and eliminating waivers altogether for aircrews.

In a press release Tuesday, the service announced it had updated the official Air Force Aerospace Medicine Approved Medication Lists and the Medical Standards Directory for HIV Pre-Exposure Prophylaxis, preventative medication known as PrEP taken by those who may be at an elevated risk of contracting the virus.

Under old policies, pilots who wanted to use HIV PrEP could not fly for 30 days when starting the medication. That has decreased to 14 days under the updated policy, the service said in the news release. The change was initiated by the Air Force's LGBTQ+ Initiative Team, which is examining barriers to service.

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"We have always been in alignment with CDC guidelines for PrEP, but by reducing the time on duty restriction, this change will enhance readiness and help retain service members," Col. Rich Kipp, chief of the Air Force medical standards division, said in the press release, citing guidelines from the federal Centers for Disease Control and Prevention.

The LGBTQ+ Initiative Team was created by the Department of the Air Force in 2021 under the service's Barrier Analysis Working Group with the aim to identify and resolve issues that affect lesbian, gay, bisexual and transgender airmen and Guardians.

HIV disproportionately affects men who are gay or bisexual and have sex with other men, according to HIV.gov. PrEP could dramatically reduce the risks of contracting the virus.

Additionally, the Air Force is stopping the waiver requirement for aircrew members who are taking PrEP. Pilots who are already taking the medication and are flying on a waiver do not need to renew their waiver, the service said.

"Members of the working group determined the waiver was not necessary, given Air Force review of safety data over the last five years demonstrated it was safe to reduce the duty restriction time," according to Kipp.

The Pentagon prevents anyone who has tested positive and been diagnosed with HIV from joining the military, but does allow service members to continue serving if they are diagnosed afterward.

Roughly 22% of active service members and 18% of reserve service members were at "high risk for HIV" based on their sexual health behavior, according to the 2018 Department of Defense Health Related Behaviors Survey.

Using HIV PrEP "reduces the risk of getting HIV from sex by about 99% when taken as prescribed," according to the Centers for Disease Control and Prevention.

Between January 2017 and June 2022, the Pentagon's Armed Forces Health Surveillance Division estimated that 1,581 service members were newly diagnosed with HIV, according to a 2023 report from the Congressional Research Service, or CRS.

Across the active components, the rate of newly diagnosed HIV infections per 100,000 service members in 2021 was "highest in the Army (28), followed by the Navy (25), Air Force (15), and the Marine Corps (12)," the CRS reported.

Among the reserve components, the rate was highest in the Air Force Reserve with 40 cases, followed by the Navy Reserve with 36, the data showed.

This marks the latest update the military has made in addressing HIV, or the human immunodeficiency virus. Those with HIV infection who are treated can live healthy and long lives, but HIV can lead to the disease AIDS if left untreated.

Last year, Defense Secretary Lloyd Austin said in a memo that commanders no longer will be allowed to involuntarily separate troops with asymptomatic HIV. They also may not restrict them from deploying or bar any currently serving enlisted personnel, cadets or midshipmen with HIV from seeking a commission as an officer.

-- Thomas Novelly can be reached at thomas.novelly@military.com. Follow him on Twitter @TomNovelly.

Related: HIV Status Will No Longer Automatically Disqualify Troops from Deployment, Retention

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