Journal of Preventive Medicine and Public Health

Original Article

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

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Abstract Summary 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.

Systematic Review

Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis: Suchitra Hudrudchai, Charin Suwanwong, Pitchada Prasittichok, Kanu Priya Mohan, Nopphadol Janeaim; J Prev Med Public Health. 2024;57(1):8-17. Published online December 12, 2023; DOI: https://doi.org/10.3961/jpmph.23.345

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Abstract Summary PDF Supplementary Material

Objectives
The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors.
Methods
The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale.
Results
Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM.
Conclusions
Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.

Summary

Key Message
This systematic review and meta-analysis confirmed that factors such as education, number of sexual partners, engagement in sexual activities with an HIV-positive partner, substance use, and lower levels of depression were associated with higher rates of PrEP adherence among MSM. Healthcare providers and interventions should take these aspects into consideration when developing strategies to promote optimal PrEP adherence and reduce the risk of HIV transmission.

Citations

Citations to this article as recorded by

Socio‐economic status and adherence to HIV preventive and therapeutic interventions: exploring the mediating role of food insecurity among men who have sex with men and transgender and non‐binary persons from Brazil
Paula M. Luz, Thiago S. Torres, Victor C. Matos, Giovanna G. Costa, Brenda Hoagland, Cristina Pimenta, Marcos Benedetti, Beatriz Grinsztejn, Valdilea G. Veloso
Journal of the International AIDS Society.2025;[Epub] CrossRef
Preferences for Starting Daily, On-Demand, and Long-Acting Injectable HIV Preexposure Prophylaxis Among Men Who Have Sex With Men in the United States (2021-2022): Nationwide Online Cross-Sectional Study
Duygu Islek, Travis Sanchez, Jennifer L Glick, Jeb Jones, Keith Rawlings, Supriya Sarkar, Patrick S Sullivan, Vani Vannappagari
JMIR Public Health and Surveillance.2024; 10: e62801. CrossRef

Original Article

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

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Abstract Summary 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

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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

Perspective

Gender in Climate Change: Safeguarding LGBTQ+ Mental Health in the Philippine Climate Change Response From a Minority Stress Perspective: Rowalt Alibudbud; J Prev Med Public Health. 2023;56(2):196-199. Published online March 13, 2023; DOI: https://doi.org/10.3961/jpmph.22.501

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Abstract PDF

Climate-related events unevenly affect society, worsening mental health disparities among vulnerable populations. This paper highlights that lesbians, gays, bisexuals, transgender, queers, and other individuals identifying as sexual and gender minorities (LGBTQ+) could be considered a climate-vulnerable population in the Philippines, one of the most climate-vulnerable countries. As such, this paper elucidated that LGBTQ+ Filipinos can be marginalized in climate response efforts due to their sexual orientation and gender minority identities. According to the minority stress theory, discrimination against LGBTQ+ individuals may predispose them to mental health problems. Thus, there is a need to institute an LGBTQ+ inclusive mental health response for climate-related events to address discrimination against LGBTQ+ individuals and uphold their mental health.

Summary

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Penelope M. Wong, Jasmine Eve C. Ong, Jasper S. Chua, Annika Shanice C. See, Rowalt Alibudbud
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Original Articles

Open Communication About Reproductive Health Is Associated With Comprehensive HIV Knowledge and a Non-stigmatising Attitude Among Indonesian Youth: A Cross-sectional Study: Gede Benny Setia Wirawan, Ni Luh Zallila Gustina, Pande Putu Januraga; J Prev Med Public Health. 2022;55(4):342-350. Published online June 13, 2022; DOI: https://doi.org/10.3961/jpmph.21.581

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Abstract PDF

Objectives
Human immunodeficiency virus (HIV) prevention among youth seems under-prioritised compared to other key populations. HIV knowledge and stigma are important parts of HIV prevention. To inform HIV prevention among youths, this study quantitatively analysed the associations between open communication regarding sexuality and sexual health, comprehensive HIV knowledge, and non-stigmatising attitudes in Indonesia.
Methods
This study used data from the Indonesian Demographic and Health Survey (IDHS) 2017. The analysis included unmarried men and women aged 15-25 years old. Comprehensive HIV knowledge and a stigmatising attitude were defined according to the IDHS 2017. Open communication about sexuality and sexual health was defined as the number of people with whom participants could openly discuss these topics in their direct network of friends, family, and service providers, with a scale ranging from 0 to a maximum of 7. Primary analysis used binomial logistic regression with weighting adjustments.
Results
The final analysis included 22 864 respondents. Twenty-two percent of youth had no one in their direct network with whom to openly discuss sexual matters, only 14.1% had comprehensive HIV knowledge, and 85.9% showed stigmatising attitudes. Youth mostly discussed sex with their friends (55.2%), and were less likely to discuss it with family members, showing a predominant pattern of peer-to-peer communication. Multivariate analysis showed that having a larger network for communication about sexuality and sexual health was associated with more HIV knowledge and less stigmatising attitudes.
Conclusions
Having more opportunities for open sex communication in one’s direct social network is associated with more HIV knowledge and less stigmatising attitudes.

Summary

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Sources of HIV information and women’s HIV knowledge in Southwest Sumba Indonesia: a cross-sectional study with mediation analysis
Angela Kurniadi, Judith A. Levy, Timothy P. Johnson
BMC Public Health.2025;[Epub] CrossRef
A Scoping Review of Knowledge, Awareness, Perceptions, Attitudes, and Risky Behaviors of Sexually Transmitted Infections in Southeast Asia
Vimala Balakrishnan, Kok Khuen Yong, Chiong Kian Tiong, Nicholas Jian Shen Ng, Zhao Ni
Healthcare.2023; 11(8): 1093. CrossRef

Effects of Socio-demographic Factors on the Decreasing Trend in the Sex Ratio at Birth in Korea, 1997-2017: Jisuk Bae; J Prev Med Public Health. 2020;53(5):371-380. Published online August 7, 2020; DOI: https://doi.org/10.3961/jpmph.20.282

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Abstract PDF Supplementary Material: Objectives
This study investigated the effects of socio-demographic factors on the decreasing trend in the sex ratio at birth from 1997 to 2017 in Korea.
Methods
Data from 10 349 602 live births registered with Statistics Korea from 1997 to 2017 were analyzed. The secondary sex ratio (SSR), defined as the ratio of male to female live births, during the study period (1997-1999 [phase I], 2000-2002 [phase II], 2003-2005 [phase III], 2006-2008 [phase IV], 2009-2011 [phase V], 2012-2014 [phase VI], and 2015-2017 [phase VII]) was calculated according to selected socio-demographic factors, such as parental age, education, occupation, and birth order. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals for a male birth after adjusting for potential confounders.
Results
The SSR gradually decreased from 1.10 (in 1998-2000 and 2002) to 1.05 (in 2013-2016). While a decreasing trend in the SSR was not noted among first births, male-biased sex ratios were prominent among third and higher-order births, for which the highest SSR was 1.46 in 1998. Higher birth order was significantly associated with an excess of male births in phases I-VI (≥third vs. first, OR range, 1.03 to 1.35). Advanced maternal age was significantly associated with an excess of female births in phases II, III, and V (≥40 vs. 20-24 years, OR range, 0.92 to 0.95).
Conclusions
This study demonstrated that advanced maternal age and reduction of the artificially-biased SSR among third and higher-order births may partially explain the decreasing trend in the SSR from 1997 to 2017 in Korea.; Summary

Sexual Intercourse and Its Correlates Among School-aged Adolescents in Indonesia: Analysis of the 2015 Global School-based Health Survey: Anissa Rizkianti, Iram Barida Maisya, Nunik Kusumawardani, Christine Linhart, Jerico Franciscus Pardosi; J Prev Med Public Health. 2020;53(5):323-331. Published online August 7, 2020; DOI: https://doi.org/10.3961/jpmph.20.028

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Abstract PDF

Objectives
This study aimed to determine the prevalence and correlates of sexual intercourse among junior secondary and high school students in Indonesia from the 2015 Global School-based Health Survey (GSHS).
Methods
The survey was conducted among 11 110 students from 75 schools in Indonesia using a self-administered questionnaire. Univariate and multivariate analyses were conducted to explore associations between sexual intercourse and socio-demographic variables, substance use, mental distress, and protective factors.
Results
Overall, 5.3% of students reported having ever had sex (6.9% of boys and 3.8% of girls). Of students who engaged in sexual intercourse, 72.7% of boys and 90.3% of girls had an early sexual debut (before reaching the age of 15) and around 60% had multiple sex partners. Sexual intercourse was associated with gender, school grade, smoking, alcohol consumption, drug use, suicidal ideation, truancy, peer support, and parental supervision.
Conclusions
These findings indicate a pressing need to develop more comprehensive sexual health education in the national curriculum. An effective strategy should also address other risky behaviours.

Summary

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Exploring Sociodemographic Determinants: An Investigation into Sexual Behavior among Adolescents in Indonesia
Ayu Ashari, Bagoes Widjanarko, Zahroh Shaluhiyah, Ani Margawati
Asian Journal of Social Health and Behavior.2025; 8(1): 36. CrossRef
The Development and Initial Validation of the Youth Sexual Intention Scale: Indonesian Version
Rahmi Lubis, Zahrotur R. Hinduan, Ratna Jatnika, Baydhowi Baydhowi, Hendriati Agustiani
INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2022;[Epub] CrossRef
Factors Related to Sexual Intercourse Among Korean Middle and High School Students
Joohee Shim, Jihyun Baek, Seungwoo Han
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Investigation of the Relationship Between Sociodemographic Characteristics and Sexual Health Behaviours of University Students
Şahika ŞİMŞEK ÇETİNKAYA, Esra DEMİRARSLAN
Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi.2022; 11(2): 425. CrossRef
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JM Seno Adjie, Andrew Pratama Kurniawan, Raymond Surya
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Ariane Utomo, Aris Ananta, Diahhadi Setyonaluri, Calvin Aryaputra
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Sex-specific Associations Between Serum Hemoglobin Levels and the Risk of Cause-specific Death in Korea Using the National Health Insurance Service-National Health Screening Cohort (NHIS HEALS): Yoonsuk An, Jieun Jang, Sangjun Lee, Sungji Moon, Sue K. Park; J Prev Med Public Health. 2019;52(6):393-404. Published online November 1, 2019; DOI: https://doi.org/10.3961/jpmph.19.146

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Abstract Summary PDF Supplementary Material

Objectives
The purpose of this study was to determine the associations between blood hemoglobin (Hgb) levels and the risk of death by specific causes.
Methods
Using the National Health Insurance Services-National Health Screening Cohort (n=487 643), we classified serum Hgb levels into 6 sex-specific groups. Cox regression analysis was used to analyze the associations between Hgb levels and the risk of cause-specific death.
Results
Hgb levels in male population showed a U-shaped, J-shaped, or inverse J-shaped association with the risk of death from ischemic heart disease, acute myocardial infarction, liver cancer, cirrhosis and chronic obstructive pulmonary disease (COPD) (all non-linear p<0.05; hazard ratio [HR]; 95% confidence interval [CI]) for the lowest and the highest Hgb levels for the risk of each cause of death in male population: HR, 1.14; 95% CI, 0.98 to 1.34; HR, 2.87; 95% CI, 1.48 to 5.57; HR, 1.16; 95% CI, 0.96 to 1.40; HR, 3.05; 95% CI, 1.44 to 6.48; HR, 1.36; 95% CI, 1.18 to 1.56; HR, 2.11; 95% CI, 1.05 to 4.26; HR, 3.64; 95% CI, 2.49 to 5.33; HR, 5.97; 95% CI, 1.44 to 24.82; HR, 1.62; 95% CI, 1.14 to 2.30; HR, 3.84; 95% CI, 1.22 to 12.13, respectively), while in female population, high Hgb levels were associated with a lower risk of death from hypertension and a higher risk of death from COPD (overall p<0.05; HR, 1.86; 95% CI, 1.29 to 2.67 for the lowest Hgb levels for hypertension; overall p<0.01, HR, 6.60; 95% CI, 2.37 to 18.14 for the highest Hgb levels for COPD). For the risk of lung cancer death by Hgb levels, a linear negative association was found in male population (overall p<0.01; the lowest Hgb levels, HR, 1.17; 95% CI, 1.05 to 1.33) but an inverse J-shaped association was found in female population (non-linear p=0.01; HR, 1.25; 95% CI, 0.96 to 1.63; HR, 2.58; 95% CI, 1.21 to 5.50).
Conclusions
Both low and high Hgb levels were associated with an increased risk of death from various causes, and some diseases showed different patterns according to sex.

Summary

Korean summary
본 연구는 2002년 및 2003년 한국 국민건강보험공단 건강검진 수검자 코호트(NHIS-HEALS)를 이용하여 총 487,643명을 대상으로 2013년 말일까지의 통계청 사망자료 추적관찰 기반 혈중 헤모글로빈과 전체, 심뇌혈관, 암, 기타 질환의 (만성 폐쇄성 폐질환, 간경화증) 사망위험 간 상관관계를 성별 층화하여 콕스회귀모형으로 분석하였음. 연구 결과 남성에서는 낮은 헤모글로빈 및 높은 헤모글로빈 농도와 허혈성 심질환, 심근경색, 간암, 간경화증, 그리고 만성 폐쇄성 폐질환 사망위험이 통계적으로 유의하게 증가함을 보인 반면, 여성에서는 낮은 헤모글로빈 농도에서는 고혈압, 높은 헤모글로빈 농도에서는 만성 폐쇄성 폐질환 사망위험도가 통계적으로 유의하게 증가하였음.결과적으로 낮은 그리고 높은 헤모글로빈 농도가 기존에 알려져 있던 심혈관질환의 사망위험에 영향을 주었을 뿐만 아니라 암 질환 및 기타 다른 질환들의 사망위험에도 영향을 주는 것으로 나타났기에 혈중 헤모글로빈 농도가 사망위험도의 잠재적인 예측인자로써의 가능성을 보였음. 주요 단어: 헤모글로빈, 빈혈, 사망, 성별, 한국인

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Barriers to Health Service Utilization Among Iranian Female Sex Workers: A Qualitative Study: Mehran Asadi-Aliabadi, Jamileh Abolghasemi, Shahnaz Rimaz, Reza Majdzadeh, Fereshteh Rostami-Maskopaee, Effat Merghati-Khoei; J Prev Med Public Health. 2018;51(2):64-70. Published online February 6, 2018; DOI: https://doi.org/10.3961/jpmph.17.174

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Abstract PDF

Objectives
In most countries around the world, sex work is an illegal activity. Female sex workers (FSWs) in Iran hide their identities, and they are known to be a hard-to-reach population. Despite free access to HIV testing, fewer than half of FSWs receive HIV testing. The purpose of this study was to characterize the reasons for which FSWs do not seek testing at drop-in centers (DICs) and voluntary counseling and testing (VCT) centers in Iran. Methods: A qualitative study was conducted in 2016. The participants were 24 FSWs who received services at VCT centers and DICs for vulnerable females in the north of Iran and 9 males who were the clients of FSWs. In this study, we made use of purposive sampling and carried out a thematic analysis. Results: We found 4 major and 6 minor themes. The major themes were: fear of being infected (with HIV), stigma, indifference, and knowledge. Conclusions: Despite the significant efforts made by the government of Iran to establish and expand DICs for vulnerable females, the number of FSWs receiving services at these centers has not been very considerable. Consequently, by introducing and implementing training programs for peer groups, it may be possible to take steps toward establishing strategic programs for the control and prevention of HIV/AIDS.

Summary

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Differential Association of Vitamin D Deficiency With Albuminuria by Sex in the Korean General Population: A Cross-sectional Study of the Korea National Health and Nutrition Examination Survey 2011-2012: Yongwoo Jeon, Jaeyong Shin, Jong Hyun Jhee, Youngdae Cho, Eun-Cheol Park; J Prev Med Public Health. 2018;51(2):92-99. Published online February 6, 2018; DOI: https://doi.org/10.3961/jpmph.17.005

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Abstract PDF Supplementary Material

Objectives
Albuminuria has emerged as a biomarker for several medical conditions, and vitamin D has received attention due to its associations with various disorders. We evaluated the association between low serum vitamin D levels and prevalent albuminuria by sex in the Korean general population. Methods: We analyzed 9823 participants (4401 males, 5422 females) from the Korea National Health and Nutrition Examination Survey 2011-2012 (KNHANES V-2), and categorized them as having a normal range of vitamin D levels, vitamin D insufficiency, or vitamin D deficiency. A multivariable logistic regression model was used to compare the risk of albuminuria across these groups. Stratified analyses were conducted by smoking status, obesity, and renal function. Results: Albuminuria was found in 325 of the 4401 male participants (7.4%) and in 455 of the 5422 female participants (8.4%). Among the males, vitamin D deficiency was associated with an odds ratio (OR) for albuminuria of 1.78 (95% confidence interval [CI], 1.07 to 2.97, p<0.05). However, such an association was not found in females. The association was stronger in male current smokers (OR, 3.54; 95% CI, 1.47 to 8.50; p=0.005). Conclusions: The findings of this study suggest that sex differences exist in the association between serum vitamin D deficiency and albuminuria. Additionally, we observed that the association was stronger in current smokers than in the overall male population, but was not seen in non-smokers. Therefore, different approaches by sex and smoking status might be needed when considering using vitamin D as a biomarker for renal function.

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Long-term vitamin D deficiency promotes renal fibrosis and functional impairment in middle-aged male mice
Zhi-Hui Zhang, Biao Luo, Shen Xu, Zhi-Cheng Zhang, Wei-Yang Xing, Yuan-Hua Chen, Cheng Zhang, Hua Wang, Dong-Dong Xie, De-Xiang Xu
British Journal of Nutrition.2021; 125(8): 841. CrossRef

Socioeconomic Inequality in Malnutrition in Under-5 Children in Iran: Evidence From the Multiple Indicator Demographic and Health Survey, 2010: Abdollah Almasian Kia, Aziz Rezapour, Ardeshir Khosravi, Vajiheh Afzali Abarghouei; J Prev Med Public Health. 2017;50(3):201-209. Published online May 10, 2017; DOI: https://doi.org/10.3961/jpmph.17.028

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Abstract PDF

Objectives
The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality.
Methods
Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children.
Results
Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children’s sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant.
Conclusions
This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.

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Causes of Child Mortality (1 to 4 Years of Age) From 1983 to 2012 in the Republic of Korea: National Vital Data: Seung Ah Choe, Sung-Il Cho; J Prev Med Public Health. 2014;47(6):336-342. Published online November 7, 2014; DOI: https://doi.org/10.3961/jpmph.14.024

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Abstract PDF

Objectives
Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea.
Methods
Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012.
Results
The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012).
Conclusions
In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

Summary

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Child mortality of twins and singletons among late preterm and term birth: a study of national linked birth and under-five mortality data of Korea
Young Shin Kim, Minku Kang, Young June Choe, Joohon Sung, Ji Yeon Lee, Seung-Ah Choe
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Association Between Socioeconomic Status and Obesity in Adults: Evidence From the 2001 to 2009 Korea National Health and Nutrition Examination Survey: Jihye Kim, Shreela V. Sharma, Sung Kyun Park; J Prev Med Public Health. 2014;47(2):94-103. Published online March 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.2.94

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Abstract PDF

Objectives

The present study examined relationships between socioeconomic status (SES) and obesity and body mass index (BMI) as well as the effects of health-related behavioral and psychological factors on the relationships.

Methods

A cross-sectional population-based study was conducted on Korean adults aged 20 to 79 years using data from the 2001, 2005, and 2007 to 2009 Korea National Health and Nutrition Examination Survey. Multivariate logistic and linear regression models were used to estimate odds ratios of obesity and mean differences in BMI, respectively, across SES levels after controlling for health-related behavioral and psychological factors.

Results

We observed significant gender-specific relationships of SES with obesity and BMI after adjusting for all covariates. In men, income, but not education, showed a slightly positive association with BMI (p<0.05 in 2001 and 2005). In women, education, but not income, was inversely associated with both obesity and BMI (p<0.0001 in all datasets). These relationships were attenuated with adjusting for health-related behavioral factors, not for psychological factors.

Conclusions

Results confirmed gender-specific disparities in the associations of SES with obesity and BMI among adult Korean population. Focusing on intervention for health-related behaviors may be effective to reduce social inequalities in obesity.

Summary

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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

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Abstract 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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English Abstract

Trends in Sex Ratio at Birth according to Parental Social Positions: Results from Vital Statistics Birth, 1981-2004 in Korea.: Heeran Chun, Il Ho Kim, Young Ho Khang; J Prev Med Public Health. 2009;42(2):143-150.; DOI: https://doi.org/10.3961/jpmph.2009.42.2.143

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OBJECTIVES
South Korea has experienced unprecedented ups and downs in the sex ratio at birth (SRB), which has been a unique phenomenon in the last two decades. However, little is known about socioeconomic factors that influence the SRB. Employing the diffusion theory by Rogers, this study was undertaken to examine the trends in social variations in the SRB from 1981 to 2004 in Korea. METHODS: The data was taken from Vital Birth Statistics for the period from 1981-2004. We computed the annual male proportion of live births according to the parental education (university, middle/high school, primary) and occupation (non-manual, manual, others). Logistic regression analysis was employed to estimate the odds ratios of male birth according to social position for the equidistant three time periods (1981-1984, 1991-1994, and 2001-2004). RESULTS: An increased SRB was detected among parents with higher social position before the mid 1980s. Since then, however, a greater SRB was found for the less educated and manual jobholders. The inverse social gradient for the SRB was most prominent in early 1990s, but the gap has narrowed since the late 1990s. The mother's socioeconomic position could be a sensitive indicator of the social variations in the sex ratio at birth. CONCLUSIONS: Changes in the relationship of parental social position with the SRB were detected during the 1980-2004 in Korea. This Korean experience may well be explained by diffusion theory, suggesting there have been socioeconomic differences in the adoption and spread of sex-detection technology.

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