increased among either group of Gulf War veterans when compared to the Germany deployed veterans. The study was limited by small numbers and the potential for differential recall.

Unwin et al. (1999) conducted a 1997-1998 survey of male Gulf War veterans (n = 2735), nondeployed veterans (n = 2422), and servicemembers deployed to Bosnia (n = 2393) (65% response rate). Participants were asked to respond to a questionnaire that inquired about the presence of 50 symptoms and 39 medical disorders during the previous month. Gulf War veterans who had been deployed had an increased prevalence of sexual problems compared with nondeployed (OR 3.2, 95% CI 2.4-4.2) and with Bosnia deployed (OR 2.2, 95% CI 1.5-3.1). Gulf War deployed veterans also had a greater prevalence of disease of the genital organs than either comparison group (deployed vs nondeployed: OR 1.5, 95% CI 1.1-2.2; deployed vs Bosnia deployed: OR 1.6, 95% CI 1.1-2.4).

In a 1998 phone survey of Kansas veterans, the 1548 deployed Gulf War veterans were more likely than 482 nondeployed veterans to report that they or their partner felt a burning sensation after sex (OR 3.75, 95%CI 1.88-7.49) (Steele, 2000). This condition was reported by 8% of Gulf War veterans and 2% of nondeployed veterans. The Iowa Persian Gulf Study Group (1997) also compared self-reported medical conditions between deployed and nondeployed Iowa veterans within the regular military and within the National Guard or reserve. Gulf War veterans in the National Guard or reserves reported a higher prevalence of symptoms of sexual discomfort for their female partner (prevalence difference 3.6, 95% CI 2.3-4.8) compared with their nondeployed counterparts. No differences in sexual discomfort were reported for the respondents themselves. Sexual discomfort was not associated with Gulf War deployment among members of the regular military.

Self-reported genitourinary and reproductive problems were also assessed among Gulf War veterans according to their potential exposure to sarin or cyclosarin at the Khamisiyah demolition (Page et al., 2005). In the National Health Survey of Gulf War Era Veterans Study, the prevalence of genitourinary conditions including frequent or painful urination (OR 0.91, 95% CI 0.70-1.19), bladder infection (OR 0.98, 95% CI 0.80-1.20), and any disease of the genital organs (OR 0.94, 95% CI 0.76-1.17) was similar among the exposed and unexposed Gulf War veterans. Sexual difficulties such as painful sexual intercourse (OR 1.16, 95% CI 0.81-1.65) or impotence/other sexual problems (OR 0.85, 95% CI 0.65-1.12) were also similar between the two groups.

Pierce (1997) assessed the effects of Gulf War service on women’s health by administering two surveys to a stratified sample of all women serving in the US Air Force during the Gulf War, including active-duty personnel, reserve, and National Guard. For the first survey, 153 Gulf War deployed veterans and 331 women deployed elsewhere (92% response) reported gynecologic, reproductive, and general medical conditions for which they had sought medical care since joining the Armed Forces. The prevalence of abnormal Pap smears and genital herpes did not differ by deployment status at this time. However, when asked 2 years later (87% response) about conditions experienced in the previous 12 months, Gulf War deployed veterans reported an increased prevalence of abnormal Pap smears (10.4% vs 4.9%, p < 0.036). Among the deployed veterans, no statistical differences in the prevalence of abnormal Pap smears were observed by duration of deployment. The results of a later survey conducted in a larger sample (n = 1164) of the same female veteran population showed that Gulf War deployed veterans were more likely to report 29 of 48 symptoms when compared to women deployed elsewhere (Pierce, 2005). Among the symptoms reported more frequently by deployed veterans “urinary urgency and frequency” was the only genitourinary condition identified in the report. This condition was



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