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Assessing COVID-19 Vulnerability Among HIV-positive Men Who Have Sex With Men in Korea: The Role of Vaccination and Sexual Behaviors
Minsoo Jung
J Prev Med Public Health. 2024;57(4):370-378.   Published online June 24, 2024
DOI: https://doi.org/10.3961/jpmph.24.196
  • 1,778 View
  • 184 Download
AbstractAbstract AbstractSummary PDF
Objectives
Comorbidities increase susceptibility to severe coronavirus disease 2019 (COVID-19) infections, but limited information has been published regarding human immunodeficiency virus (HIV) and COVID-19 co-infections. This study explored the relationships among socioeconomic characteristics, sexual behaviors, and COVID-19 infection rates among Korean men who have sex with men (MSM) who are also living with HIV.
Methods
Data were collected through a web survey aimed at members of the largest gay portal site in Korea, supported by the National Research Foundation of Korea (n=1005). The primary independent variables included COVID-19-related vaccinations and sexual behaviors. The dependent variable was the incidence of COVID-19 infection among respondents during the pandemic. For statistical analysis, hierarchical multiple logistic regression was performed, controlling for potential confounding variables.
Results
Model I indicated that older MSM were less likely to contract COVID-19 (adjusted odds ratio [aOR], 0.98; 95% confidence interval [CI], 0.96 to 0.99). Model II demonstrated that HIV-positive MSM were nearly twice as likely to be infected with COVID-19 compared to their HIV-negative counterparts (aOR, 1.97; 95% CI, 1.14 to 3.41). Furthermore, even after accounting for COVID-19 vaccination status in model III, HIV-positive MSM continued to show a higher risk of infection (aOR, 1.93; 95% CI, 1.12 to 3.35).
Conclusions
The findings of this study indicate that HIV-positive MSM are at an increased risk of contracting COVID-19, even when their vaccination status is considered. Therefore, it is essential to prioritize the prevention of COVID-19 infections in HIV-positive individuals by administering appropriate antiretroviral therapy and ensuring adherence to public health guidelines.
Summary
Korean summary
이 연구는 한국의 HIV 양성인 남성 동성애자(MSM)가 코로나-19 백신접종을 했어도 HIV 음성인 MSM에 비하여 COVID-19에 감염될 위험이 더 높다는 것을 보여주었다. 이러한 결과는 항레트로바이러스 요법의 준수나 촉진과 더불어 이들 취약 계층을 위한 COVID-19 예방조치 강화와 맞춤형 공중보건 전략의 필요성을 강조한다.
Key Message
This study found that HIV-positive men who have sex with men (MSM) in Korea are at a heightened risk of contracting COVID-19 compared to HIV-negative individuals, even when vaccination status is accounted for. This finding underscore the necessity of targeted public health strategies, including the promotion of adherence to antiretroviral therapy and the reinforcement of COVID-19 prevention measures for this vulnerable population.
Behavioral Predictors Associated With COVID-19 Vaccination and Infection Among Men Who Have Sex With Men in Korea
Minsoo Jung
J Prev Med Public Health. 2024;57(1):28-36.   Published online November 27, 2023
DOI: https://doi.org/10.3961/jpmph.23.381
  • 2,097 View
  • 268 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
This study investigated the impact of socioeconomic factors and sexual orientation-related attributes on the rates of coronavirus disease 2019 (COVID-19) vaccination and infection among men who have sex with men (MSM).
Methods
A web-based survey, supported by the National Research Foundation of Korea, was conducted among paying members of the leading online portal for the lesbian, gay, bisexual, transgender, or queer and questioning (LGBTQ+) community in Korea. The study participants were MSM living in Korea (n=942). COVID-19 vaccination and infection were considered dependent variables, while sexual orientation-related characteristics and adherence to non-pharmacological intervention (NPI) practices served as primary independent variables. To ensure analytical precision, nested logistic regression analyses were employed. These were further refined by dividing respondents into 4 categories based on sexual orientation and disclosure (or “coming-out”) status.
Results
Among MSM, no definitive association was found between COVID-19 vaccination status and factors such as socioeconomic or sexual orientation-related attributes (with the latter including human immunodeficiency virus [HIV] status, sexual orientation, and disclosure experience). However, key determinants influencing COVID-19 infection were identified. Notably, people living with HIV (PLWH) exhibited a statistically significant predisposition towards COVID-19 infection. Furthermore, greater adherence to NPI practices among MSM corresponded to a lower likelihood of COVID-19 infection.
Conclusions
This study underscores the high susceptibility to COVID-19 among PLWH within the LGBTQ+ community relative to their healthy MSM counterparts. Consequently, it is crucial to advocate for tailored preventive strategies, including robust NPIs, to protect these at-risk groups. Such measures are essential in reducing the disparities that may emerge in a post–COVID-19 environment.
Summary
Korean summary
한국에서 남성 동성애자의 코로나-19 예방접종과 그들의 사회경제적 지위 또는 성적 지향과 관련된 요인 사이에는 명확한 연관성이 없었지만, HIV에 감염된 남성 동성애자는 코로나-19의 감염 위험이 유의미하게 높았다. 또한, 남성 동성애자의 비약물적 중재 실천율이 높을수록 그들의 코로나-19 감염 가능성은 감소하는 경향이 있었다. 이 연구는 LGBTQ+ 커뮤니티 내의 HIV 양성 동성애자와 같은 취약한 집단을 보호하고 포스트 코로나-19 환경에서 성 소수자 간의 건강 격차를 줄이기 위한 강력한 맞춤형 예방 전략의 필요성을 강조한다.
Key Message
While there were no clear associations between COVID-19 vaccination and socioeconomic or sexual orientation-related factors among men who have sex with men (MSM) in Korea, individuals living with HIV (PLWH) had a significantly higher risk of COVID-19 infection. Additionally, greater adherence to non-pharmacological intervention (NPI) practices was linked to a reduced likelihood of COVID-19 infection among MSM. This study emphasizes the need for tailored preventive strategies, including robust NPIs, to protect at-risk groups like PLWH within the LGBTQ+ community and reduce health disparities in a post-COVID-19 environment.

Citations

Citations to this article as recorded by  
  • Health of Korean sexual and gender minorities: a narrative review of quantitative studies
    Heesung So, Ssirai Kim, Sun Young Lee
    The Ewha Medical Journal.2024;[Epub]     CrossRef
  • Assessing COVID-19 Vulnerability Among HIV-positive Men Who Have Sex With Men in Korea: The Role of Vaccination and Sexual Behaviors
    Minsoo Jung
    Journal of Preventive Medicine and Public Health.2024; 57(4): 370.     CrossRef
Associations Between Conventional Healthy Behaviors and Social Distancing During the COVID-19 Pandemic: Evidence From the 2020 Community Health Survey in Korea
Rang Hee Kwon, Minsoo Jung
J Prev Med Public Health. 2022;55(6):568-577.   Published online October 14, 2022
DOI: https://doi.org/10.3961/jpmph.22.351
  • 3,728 View
  • 129 Download
  • 5 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
Many studies have shown that social distancing, as a non-pharmaceutical intervention (NPI) that is one of the various measures against coronavirus disease 2019 (COVID-19), is an effective preventive measure to suppress the spread of infectious diseases. This study explored the relationships between traditional health-related behaviors in Korea and social distancing practices during the COVID-19 pandemic.
Methods
Data were obtained from the 2020 Community Health Survey conducted by the Korea Disease Control and Prevention Agency (n=98 149). The dependent variable was the degree of social distancing practice to cope with the COVID-19 epidemic. Independent variables included health-risk behaviors and health-promoting behaviors. The moderators were vaccination and unmet medical needs. Predictors affecting the practice of social distancing were identified through hierarchical multiple logistic regression analysis.
Results
Smokers (adjusted odds ratio [aOR], 0.924) and frequent drinkers (aOR, 0.933) were more likely not to practice social distancing. A greater degree of physical activity was associated with a higher likelihood of practicing social distancing (aOR, 1.029). People who were vaccinated against influenza were more likely to practice social distancing than those who were not (aOR, 1.150). However, people with unmet medical needs were less likely to practice social distancing than those who did not experience unmet medical needs (aOR, 0.757).
Conclusions
Social distancing practices were related to traditional health behaviors such as smoking, drinking, and physical activity. Their patterns showed a clustering effect of health inequality. Therefore, when establishing a strategy to strengthen social distancing, a strategy to protect the vulnerable should be considered concomitantly.
Summary
Korean summary
본 연구는 코로나-19 판데믹 기간 동안 한국사회에서 전통적인 건강 행태와 의료이용 행태가 사회적 거리두기 실천과 어떻게 연관되는지 탐구하였다. 연구 결과에 따르면 흡연과 음주 같은 건강위험 행태는 사회적 거리두기의 실천 가능성을 낮추었고 운동과 같은 건강증진 행태는 사회적 거리두기의 실천 가능성을 높였다. 아울러 인플루엔자 백신 접종을 받은 집단은 미접종 집단에 비하여 사회적 거리두기의 실천 가능성이 높았다. 따라서 사회적 거리두기와 같은 방역정책을 수립할 때 인구집단의 건강행태 특성을 고려할 필요가 있다.

Citations

Citations to this article as recorded by  
  • Behavioral Predictors Associated With COVID-19 Vaccination and Infection Among Men Who Have Sex With Men in Korea
    Minsoo Jung
    Journal of Preventive Medicine and Public Health.2024; 57(1): 28.     CrossRef
  • Physical Distancing for Gay Men from People Living with HIV During the COVID-19 Pandemic
    Minsoo Jung
    Journal of Homosexuality.2024; : 1.     CrossRef
  • Factors Affecting Adherence to Social Distancing among Adults Aged 19–44 Years: Insights from a Nationwide Survey during COVID-19 Pandemic
    Eun Jung Kim, Mikyong Byun
    Medicina.2024; 60(5): 827.     CrossRef
  • Assessing COVID-19 Vulnerability Among HIV-positive Men Who Have Sex With Men in Korea: The Role of Vaccination and Sexual Behaviors
    Minsoo Jung
    Journal of Preventive Medicine and Public Health.2024; 57(4): 370.     CrossRef
  • Change in prevalence of smoking during the first year of the COVID-19 pandemic among middle-aged and older adults in Canada: a cohort study of the Canadian Longitudinal Study on Aging
    Jayati Khattar, Urun Erbas Oz, Vanessa De Rubeis, Margaret de Groh, Ying Jiang, Lauren Griffith, Laura N Anderson
    BMJ Public Health.2024; 2(2): e001175.     CrossRef
  • Non-rigorous versus rigorous home confinement differently impacts mental health, quality of life and behaviors. Which one was better? A cross-sectional study with older Brazilian adults during covid-19 first wave
    Lucimere Bohn, Pedro Pugliesi Abdalla, Euripedes Barsanulfo Gonçalves Gomide, Leonardo Santos Lopes da Silva, André Pereira dos Santos
    Archives of Public Health.2023;[Epub]     CrossRef
Comparison of Sexual Risky Factors of Men Who Have Sex With Men and Sex-buying Men as Groups Vulnerable to Sexually Transmitted Diseases
Minsoo Jung, Joongyub Lee, Dong Seok Kwon, Byung-Joo Park
J Prev Med Public Health. 2012;45(3):156-163.   Published online May 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.3.156
  • 9,411 View
  • 92 Download
  • 9 Crossref
AbstractAbstract PDF
Objectives

It is necessary to examine groups carrying out sexually risky behavior because the prevalence of sexually transmitted diseases (STDs) is high among them. In this study, the prevalence of STDs among homosexuals and sex-buying men in South Korea was investigated, along with their sexual risk factors.

Methods

Men who have sex with men (MSMs, n=108) were recruited in Seoul and Busan by applying the time location sampling method, while sex-buying men (n=118) were recruited from a john school in Gyeonggi province, the suburbs of Seoul. Dependent variables included past or present infection with syphilis, Chlamydia, gonorrhea, and human immunodeficiency virus. Independent variables included health behavior, social support, sexual behavior, and safe sex.

Results

It was found that when the MSMs were non-drunk while having sexual intercourse (odds ratio [OR], 0.132), they showed a higher STD infection rate when they had a higher number of anal sex partners (OR, 5.872), rarely used condoms (OR, 1.980), had lower self-efficacy (OR, 0.229), and were more anxious about becoming infected with an STD (OR, 3.723). However, the men who paid for sex showed high STD infections when they had more sex partners (OR, 2.286) and lower education levels (OR, 3.028).

Conclusions

STD infections among the two groups were high when they were engaged with many sex partners and not having protected sex. In other words, there was a gap in risky sex behavior within such groups, which was significantly related to the possibility of developing an STD. Therefore, the preventive intervention against STDs for these groups needs to be expanded to include management of sex behaviors.

Summary

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    S. Pilar Suguimoto, Teeranee Techasrivichien, Patou Masika Musumari, Christina El-saaidi, Bhekumusa Wellington Lukhele, Masako Ono-Kihara, Masahiro Kihara
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    Minsoo Jung, Deepak Shukla
    PLoS ONE.2013; 8(6): e66867.     CrossRef
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    T. Zink, C. Singe, M. Bohrer, D. Schilling
    Der Gastroenterologe.2012; 7(6): 522.     CrossRef
Factors Related to Perceived Life Satisfaction Among the Elderly in South Korea.
Minsoo Jung, Carles Muntaner, Mankyu Choi
J Prev Med Public Health. 2010;43(4):292-300.
DOI: https://doi.org/10.3961/jpmph.2010.43.4.292
  • 6,078 View
  • 91 Download
  • 23 Crossref
AbstractAbstract PDF
OBJECTIVES
This study attempted to explore the aging phenomena that now characterize much of Korean society, and assessed issues associated with the life satisfaction experienced during the process of aging. METHODS: By employing the National Survey on the State of Life and the Desire for Welfare of the Elderly, 2004 in South Korea this study attempted to identify the factors that determine subjective life satisfaction among the elderly. The data utilized herein consisted of 3278 elderly people aged 65 years or older, from 9308 households. RESULTS: The results of analysis from the final model after the introduction of 19 variables in 8 factors showed statistically similar explanatory power in men (adj. R2=0.320) and in women (adj. R2=0.346). We found that economic condition was the most influential factor in both men (B=0.278) and women (B=0.336) except perceived health condition variables. The second most influential variable in life satisfaction was health checkups in men (B=0.128) and degree of nutritional diet in women (B=0.145). Those who had experience with chronic diseases also reported significantly lower perceived life satisfaction and this was particularly true of women. CONCLUSIONS: The aging society requires an understanding of the lives of elderly individuals. This study explored factors associated with life satisfaction in old age by using a life satisfaction model. The success of an aging society begins with an accurate understanding of the elderly, and thus political attention will need to be focused on this matter.
Summary

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Research Support, Non-U.S. Gov't
Associations of Income and Wealth with Health Status in the Korean Elderly.
Bo Hyun Park, Minsoo Jung, Tae Jin Lee
J Prev Med Public Health. 2009;42(5):275-282.
DOI: https://doi.org/10.3961/jpmph.2009.42.5.275
  • 5,867 View
  • 79 Download
  • 21 Crossref
AbstractAbstract PDF
OBJECTIVES
This study aimed to verify the association between wealth or income level and health status after adjusting for other socio-economic position (SEP) indicators among Korean adults aged 45 and over. METHODS: Data were obtained from the 1st wave of Korean Longitudinal Study of Ageing (households: 6,171, persons: 10,254). We used self-rated health status and activities of daily living (ADLs) as dependent variables. Explanatory variables included both net wealth measured by savings, immovables, the other valuated assets and total income including pay, transfer, property and so on. Binary logistic regression was conducted to examine the relationships. Also, in order to determine the relative health inequality across economic groups, we estimated the relative index of inequality (RII). RESULTS: The inequality of health status was evident among various wealth and income groups. The wealthiest group (5th quintile) was much healthier than the poorest group, and this differential increased with age. Likewise, higher income was associated with better health status among the elderly. However, these effects, as measured by the odds ratio and RII, showed that wealth was more important in determining health status of elderly people. CONCLUSIONS: This study suggests that economic capability plays a significant role in determining the health status and other health-related problems among the elderly. Particularly, our results show that health status of the aged is related more closely to the individual's wealth than income.
Summary

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Original Article
Perceived Service Quality among Outpatients Visiting Hospitals and Clinics and Their Willingness to Re-utilize the Same Medical Institutions.
Minsoo Jung, Keon Hyung Lee, Mankyu Choi
J Prev Med Public Health. 2009;42(3):151-159.
DOI: https://doi.org/10.3961/jpmph.2009.42.3.151
  • 5,348 View
  • 85 Download
  • 11 Crossref
AbstractAbstract PDF
OBJECTIVES
This study was to determine how the perception and the satisfaction of outpatients who utilized clinics and hospitals are structurally related with their willingness to utilize the same institution in the future. METHODS: Three hundred and ten responses (via convenient sampling) were collected from 5 hospitals and 20 clinics located in Seoul listed in the "Korea National Hospital Directory 2005". Service quality was utilized as the satisfaction measurement tool. For analysis, we used a structural equation modeling method. RESULTS: The determining factors for general satisfaction with medical services are as follows: medical staff, reasonability of payment, comfort and accessibility. Such results may involve increased competition in the medical market and increased demands for quality medical services, which drive the patients to visit hospitals on their own on the basis of changed determining factors for satisfaction. CONCLUSIONS: The structural equation model showed that the satisfaction of outpatients with the quality of medical services is influenced by a few sub-dimensional satisfaction factors. Among these sub-dimensional satisfaction factors, the satisfaction with medical staff and payment were determined to exert a significant effect on overall satisfaction with the quality of medical services. The structural relationship in which overall satisfaction perceived by patients significantly influences their willingness to use the same institution in the future was also verified.
Summary

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English Abstracts
Keywords Network Analysis of Articles in the North Korean Journal of Preventive Medicine 1997~2006.
Minsoo Jung, Dongjun Chung, Mankyu Choi
J Prev Med Public Health. 2008;41(6):365-372.
DOI: https://doi.org/10.3961/jpmph.2008.41.6.365
  • 5,431 View
  • 105 Download
  • 6 Crossref
AbstractAbstract PDF
OBJECTIVES
There are very few researches on North Korea's academic activities. Furthermore, it is doubtful that the available data are reliable. This study investigated research activities and knowledge structure in the field of Preventive Medicine in North Korea with a network analysis using co-authors and keywords. METHODS: The data was composed of the North Korean Journal of preventive medicine ranged from Vol. 1 of 1997 to Vol. 4 of 2006. It was the matrix of 1,172 articles by 1,567 co-authors. We applied R procedure for keywords abstraction, and then sought for the outcome of network forms by spring-KK and shrinking network. RESULTS: To comprehend the whole networks explicitly demonstrated that the academic activities in North Korea's preventive medicine were predisposed to centralization as similar as South Korea's, but on the other aspect they were prone to one-off intermittent segmentation. The principal co-author networks were formulated around some outstanding medical universities seemingly in addition to possible intervention by major researchers. The knowledge structure of network was based on experimentation judging from keywords such as drug, immunity, virus detection, infection, bacteria, anti-inflammation, etc. CONCLUSIONS: Though North Korea is a socialist regime, there were network of academic activities, which were deemed the existence of inducive mechanism affordable for free research. Article keywords has laid greater emphasis on experiment-based bacterial detection, sustainable immune system and prevention of infection. The kind of trend was a consistent characteristic in preventive medicine of North Korea having close correlation with Koryo medical science.
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Co-author and Keyword Networks and their Clustering Appearance in Preventive Medicine Fields in Korea: Analysis of Papers in the Journal of Preventive Medicine and Public Health, 1991~2006.
Minsoo Jung, Dongjun Chung
J Prev Med Public Health. 2008;41(1):1-9.
DOI: https://doi.org/10.3961/jpmph.2008.41.1.1
  • 5,740 View
  • 76 Download
  • 16 Crossref
AbstractAbstract PDF
OBJECTIVES
This study evaluated knowledge structure and its effect factor by analysis of co-author and keyword networks in Korea's preventive medicine sector. METHODS: The data was extracted from 873 papers listed in the Journal of Preventive Medicine and Public Health, and was transformed into a co-author and keyword matrix where the existence of a 'link' was judged by impact factors calculated by the weight value of the role and rate of author participation. Research achievement was dependent upon the author's status and networking index, as analyzed by neighborhood degree, multidimensional scaling, correspondence analysis, and multiple regression. RESULTS: Co-author networks developed as randomness network in the center of a few high-productivity researchers. In particular, closeness centrality was more developed than degree centrality. Also, power law distribution was discovered in impact factor and research productivity by college affiliation. In multiple regression, the effect of the author's role was significant in both the impact factor calculated by the participatory rate and the number of listed articles. However, the number of listed articles varied by sex. CONCLSIONS: This study shows that the small world phenomenon exists in co-author and keyword networks in a journal, as in citation networks. However, the differentiation of knowledge structure in the field of preventive medicine was relatively restricted by specialization.
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JPMPH : Journal of Preventive Medicine and Public Health
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