Culture, Medicine, and Psychiatry

, Volume 37, Issue 4, pp 737–755 | Cite as

Toward a Social Theory of Sexual Risk Behavior Among Men in the Armed Services: Understanding the Military Occupational Habitus

  • Michael P. Anastario
  • Rachel Hallum-Montes
  • Elfryn Reyes
  • Russell Manzanero
  • Helen Chun
Original Paper


Worldwide, military personnel have been recognized as a population at elevated risk for sexually transmitted infections (STIs) and HIV; however, it is not well understood how the military occupation itself is implicated in the production of sexual risk behavior. Using qualitative and quantitative data collected from the Belize Defense Force (BDF), we employed a grounded theoretical framework and the Bourdieusian concept of the field and habitus to clarify how the military occupation is implicated in structuring aspects of sexual risk behaviors among personnel. We focus results on in-depth qualitative interviews conducted with 15 male-identified BDF personnel. We identify and describe how two field elements, namely operational tempo and ongoing exposure to occupational hazards, are occupationally specific field elements implicated in the production of sexual risk behavior through the mediating matrix of the military class habitus. Our findings demonstrate a conceptual clarity regarding the institutional field and habitus through which military personnel make sense of and act on the risk of bodily harm with regard to their own sexual behaviors. We conclude by outlining our theoretical concept so that it can be directly applied in public health efforts in order to leverage military occupational field elements for the purpose of HIV and STI prevention.


Belize HIV/AIDS Military Sexual risk Bourdieu 



Support for this work was provided by the United States Department of Defense HIV/AIDS Prevention Program (DHAPP). The opinions or assertions contained herein are the private views of the authors, and are not to be construed as official, or as reflecting the views of the Departments of Navy or the Department of Defense.

Conflict of interest

The authors have no commercial or other association that might pose a conflict of interest.


  1. Allen, E.S., G.K. Rhoades, S.M. Stanley, and H.J Markman 2010 Hitting Home: Relationships Between Recent Deployment, Posttraumatic Stress Symptoms, and Marital Functioning for Army Couples. Journal of Family Psychology 24(3): 280–288.CrossRefGoogle Scholar
  2. Anastario, M., R. Manzanero, R. Blanco, E. Reyes, R. Jaramillo, and L. Black et al 2011 HIV Infection, Sexual Risk Behaviour and Condom Use in the Belize Defense Force. International Journal of STD and AIDS 22(2): 73–79.CrossRefGoogle Scholar
  3. Anastario, M.P., M.I. Tavarez, and H. Chun 2010 Sexual Risk Behavior Among Military Personnel Stationed at Border-Crossing Zones in the Dominican Republic. Revista Panamericana de Salud Publica 28(5): 361–367.Google Scholar
  4. ATLAS.ti Qualitative Analytic Software 2008 ATLAST.ti Scientific Software Development. GmbH, Berlin.Google Scholar
  5. American Psychiatric Association 2000 Diagnostic and Statistical Manual of Mental Disorders. 4th Edition. Text Revision. Arlington, VA: American Psychiatric Association.Google Scholar
  6. Bergman, M.E., ed. 2008 Advances in Mixed Methods Research: Theories and Applications. London: Sage.Google Scholar
  7. Bleiberg K.L., and J.C. Markowitz 2005 A Pilot Study of Interpersonal Psychotherapy for Posttraumatic Stress Disorder. The American Journal of Psychiatry 162(1):181–3.CrossRefGoogle Scholar
  8. Bourdieu, P. 1977 Outline of a Theory of Practice. New York: Cambridge University Press.CrossRefGoogle Scholar
  9. Bourdieu, P. 1992 The Logic of Practice. Palo Alto, CA: Stanford University Press.Google Scholar
  10. Breslau, N., E.L. Peterson, R.C. Kessler, and L.R. Schultz 1999 Short Screening Scale for DSM-IV Posttraumatic Stress Disorder. American Journal of Psychiatry 156(6): 908–911.CrossRefGoogle Scholar
  11. Brodine, S.K., M.J. Starkey, R.A. Shaffer, S.I. Ito, S.A. Tasker, and A.J. Barile et al 2003 Diverse HIV-1 Subtypes and Clinical, Laboratory and Behavioral Factors in a Recently Infected US Military Cohort. AIDS 17(17): 2521–2527.CrossRefGoogle Scholar
  12. Charmaz, K. 2000 Grounded Theory: Objectivist, Constructivist Methods. Thousand Oaks, CA: Sage.Google Scholar
  13. Charmaz, K 2006 Constructing Grounded Theory: A Practical Guide through Qualitative Analysis. Thousand Oaks, CA: Sage.Google Scholar
  14. Cherpitel, C.J. 2002 Screening for Alcohol Problems in the U.S. General Population: Comparison of the CAGE, RAPS4, and RAPS4-QF by Gender, Ethnicity, and Service Utilization. Rapid Alcohol Problems Screen. Alcoholism, Clinical and Experimental Research 26(11): 1686–1691.CrossRefGoogle Scholar
  15. Coleman, P. 2007 Flashback: Posttraumatic Stress Disorder, Suicide, and the Lessons of War. Boston, MA: Beacon Press.Google Scholar
  16. Corbin, J.A.S. 2008 Basics of Qualitative Research. 3rd Edition. Los Angeles, CA: Sage.Google Scholar
  17. Corbin, J, and A Strauss 2008 Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks, CA: Sage.Google Scholar
  18. Costa A.C.H., M.C. Pupo, and M.F. Mello et al 2010 Efficacy of Interpersonal Therapy-Group Format Adapted to Post-traumatic Stress Disorder: And Open-Label Add-On Trial. Depression and Anxiety 27(1): 72–77.CrossRefGoogle Scholar
  19. Creswell J.W., and V.P. Clark 2007 Designing and Conducting Mixed Methods Research. Thousand Oaks, CA: Sage.Google Scholar
  20. Gammeltoft, T. 2002 Seeking Trust and Transcendence: Sexual Risk-Taking Among Vietnamese Youth. Social Science and Medicine 55(3): 483–496.CrossRefGoogle Scholar
  21. Gaydos, C.A., T.C. Quinn, and J.C. Gaydos 2000 The Challenge of Sexually Transmitted Diseases for the Military: What has Changed? Clinical Infectious Diseases 30(4): 719–722.CrossRefGoogle Scholar
  22. Hart, G. 1974 Factors Influencing Venereal Infection in a War Environment. British Journal of Venereal Diseases 50(1): 68–72.Google Scholar
  23. Hien, D.A., A.N. Campbell, T. Killeen, M.C. Hu, C. Hansen, and H. Jiang et al 2010 The Impact of Trauma-focused Group Therapy upon HIV Sexual Risk Behaviors in the NIDA Clinical Trials Network “Women and Trauma” Multi-site Study. AIDS and Behavior 14(2): 421–430.Google Scholar
  24. Hoff, R.A., J. Beam-Goulet, and R.A. Rosenheck 1997 Mental Disorder as a Risk Factor for Human Immunodeficiency Virus Infection in a Sample of Veterans. Journal of Nervous and Mental Disease 185(9): 556–560.CrossRefGoogle Scholar
  25. Hoge, C.W., J.L. Auchterlonie, and C.S. Milliken 2006 Mental Health Problems, Use of Mental Health Services, and Attrition from Military Service After Returning from Deployment to Iraq or Afghanistan. JAMA 295(9): 1023–1032.CrossRefGoogle Scholar
  26. Holmes, W.C., E.B. Foa, and M.D. Sammel 2005 Men’s Pathways to Risky Sexual Behavior: Role of Co-occurring Childhood Sexual Abuse, Posttraumatic Stress Disorder, and Depression Histories. Journal of Urban Health 82(1 Suppl 1): 89–99.CrossRefGoogle Scholar
  27. Hutton, H.E., G.J. Treisman, W.R. Hunt, M. Fishman, N. Kendig, and A. Swetz et al 2001 HIV Risk Behaviors and their Relationship to Posttraumatic Stress Disorder Among Women Prisoners. Psychiatric Services 52(4): 508–513.CrossRefGoogle Scholar
  28. Lowe, B., K. Kroenke, and K. Grafe 2005 Detecting and Monitoring Depression with a Two-Item Questionnaire (PHQ-2). Journal of Psychosomatic Research 58(2): 163–171.CrossRefGoogle Scholar
  29. Maguen, S., M. Stalnaker, and S. McCaslin et al 2009 PTSD Subclusters and Functional Impairment in Kosovo Peacekeepers. Military Medicine 174(8): 779–85.CrossRefGoogle Scholar
  30. MacQueen, K.M., T. Nopkesorn, M.D. Sweat, Y. Sawaengdee, T.D. Mastro, and B.G. Weniger 1996 Alcohol Consumption, Brothel Attendance, and Condom Use: Normative Expectations Among Thai military Conscripts. Medical Anthropology Quarterly 10(3): 402–423.CrossRefGoogle Scholar
  31. Miller, E. 2002 What’s in a Condom?—HIV and Sexual Politics in Japan. Culture, Medicine and Psychiatry 26(1): 1.CrossRefGoogle Scholar
  32. Risk Behavior Assessment Questionnaire. 1993 Rockville, MD: National Institute on Drug Abuse: Community Research Branch. pp. 16–44.Google Scholar
  33. Smit, J., L. Myer, K. Middelkoop, S. Seedat, R. Wood, and L.G. Bekker et al 2006 Mental Health and Sexual Risk Behaviours in a South African Township: A Community-Based Cross-Sectional Study. Public Health 120(6): 534–542.CrossRefGoogle Scholar
  34. Solomon Z, R. Dekel, G. Zerach 2008 The Relationships Between Posttraumatic Stress Symptom Clusters and Marital Intimacy Among War Veterans. Journal of Family Psychology 22(5): 659–66.CrossRefGoogle Scholar
  35. Stata 10. 2007 College Station. Texas: Stata Corporation.Google Scholar
  36. Stiffman, A.R., P. Dore, F. Earls, and R. Cunningham 1992 The Influence of Mental Health Problems on AIDS-Related Risk Behaviors in Young Adults. Journal of Nervous and Mental Disease 180(5): 314–320.CrossRefGoogle Scholar
  37. Tavarez, M.I., H. Chun, and M.P. Anastario 2011 Correlates of Sexual Risk Behavior in Sexually Active Male Military Personnel Stationed Along Border-Crossing Zones in the Dominican Republic. American Journal of Men’s Health 5(1): 65–77.CrossRefGoogle Scholar
  38. Teten, A.L., J.A. Schumacher, and C.T. Taft et al 2010 Intimate Partner Aggression Perpetrated and Sustained by Male Afghanistan, Iraq, and Vietnam Veterans with and without Posttraumatic Stress Disorder. Journal of Interpersonal Violence 25(9): 1612–30.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Michael P. Anastario
    • 1
  • Rachel Hallum-Montes
    • 2
  • Elfryn Reyes
    • 3
  • Russell Manzanero
    • 3
  • Helen Chun
    • 4
  1. 1.New York UniversityNew YorkUSA
  2. 2.Cicatelli Associates Inc.New YorkUSA
  3. 3.The Belize Defense ForceLadyvilleBelize
  4. 4.The Department of Defense HIV/AIDS Prevention ProgramSan DiegoUSA

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