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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
  • 1,779 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
  • 2,098 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
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

Citations

Citations to this article as recorded by  
  • Gonorrhoea: a systematic review of prevalence reporting globally
    Jane Whelan, Victoria Abbing-Karahagopian, Laura Serino, Magnus Unemo
    BMC Infectious Diseases.2021;[Epub]     CrossRef
  • Cost-effectiveness analysis of pre-exposure prophylaxis for the prevention of HIV in men who have sex with men in South Korea: a mathematical modelling study
    Heun Choi, Jiyeon Suh, Woonji Lee, Jun Hyoung Kim, Jung Ho Kim, Hye Seong, Jin Young Ahn, Su Jin Jeong, Nam Su Ku, Yoon Soo Park, Joon Sup Yeom, Changsoo Kim, Hee-Dae Kwon, Davey M. Smith, Jeehyun Lee, Jun Yong Choi
    Scientific Reports.2020;[Epub]     CrossRef
  • Differences in Risky Sexual Behavior According to Sexual Orientation in Korean Adolescents
    Ji-Su Kim, Kyunghee Kim, Yeunhee Kwak
    Journal of Homosexuality.2019; 66(1): 17.     CrossRef
  • Associated with Differences in Sexual Risk-Taking Behaviors Among Migrants in South Korea
    Minsoo Jung, Dongseok Kwon, Ji-young Oh
    Journal of Immigrant and Minority Health.2017; 19(1): 24.     CrossRef
  • PACIENTŲ, KURIEMS NUSTATYTAS SUKĖLĖJAS, ATLIKUS 7 LYTIŠKAI PLINTANČIŲ INFEKCIJŲ MOLEKULINĮ TYRIMĄ, REZULTATŲ ANALIZĖ
    Neringa Guobytė, Andrius Jurėnas, Tadas Raudonis, Rita Buivydaitė, Jūratė Grigaitienė
    Sveikatos mokslai.2017; 27(1): 63.     CrossRef
  • Health disparities between lesbian, gay, and bisexual adults and the general population in South Korea: Rainbow Connection Project I
    Horim Yi, Hyemin Lee, Jooyoung Park, Bokyoung Choi, Seung-Sup Kim
    Epidemiology and Health.2017; 39: e2017046.     CrossRef
  • Changing Patterns of HIV Epidemic in 30 Years in East Asia
    S. Pilar Suguimoto, Teeranee Techasrivichien, Patou Masika Musumari, Christina El-saaidi, Bhekumusa Wellington Lukhele, Masako Ono-Kihara, Masahiro Kihara
    Current HIV/AIDS Reports.2014; 11(2): 134.     CrossRef
  • Sexual Behavior and Condom Use among Gay Men, Female Sex Workers, and Their Customers: Evidence from South Korea
    Minsoo Jung, Deepak Shukla
    PLoS ONE.2013; 8(6): e66867.     CrossRef
  • Seltene Ursache einer unteren gastrointestinalen Blutung
    T. Zink, C. Singe, M. Bohrer, D. Schilling
    Der Gastroenterologe.2012; 7(6): 522.     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health
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