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Mode of Human Immunodeficiency Virus Transmission in Korea: The Korea HIV/AIDS Cohort Study

국내 Human Immunodeficiency Virus 감염의 감염 경로: 한국 HIV/AIDS 코호트 연구

  • Kim, June Myung (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Choi, Jun Yong (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Jeong, Woo Yong (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Seong, Hye (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Shin Woo (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Woo Joo (Department of Internal Medicine, Korea University College of Medicine) ;
  • Choi, Hee Jung (Department of Internal Medicine, Ewha Womans University College of Medicine) ;
  • Kim, Min Ja (Department of Internal Medicine, Korea University College of Medicine) ;
  • Woo, Jun Hee (Department of Internal Medicine, University of Ulsan College of Medicin) ;
  • Kim, Youn Jeong (Department of Internal Medicine, The Catholic University College of Medicine) ;
  • Choi, Bo Youl (Department of Preventive Medicine, Hanyang University College of Medicine) ;
  • Choi, Yun Su (Department of Preventive Medicine, Hanyang University College of Medicine) ;
  • Kee, Mee Kyung (Division of Virus Disease Research, Korea Centers for Disease Control and Prevention) ;
  • Kim, Ki Soon (Division of Virus Disease Research, Korea Centers for Disease Control and Prevention) ;
  • The Korea HIV/AIDS Cohort Study (The Korea HIV/AIDS Cohort Study)
  • 김준명 (연세대학교 의과대학 내과학교실) ;
  • 최준용 (연세대학교 의과대학 내과학교실) ;
  • 정우용 (연세대학교 의과대학 내과학교실) ;
  • 성혜 (연세대학교 의과대학 내과학교실) ;
  • 김신우 (경북대학교 의학전문대학원 내과학교실) ;
  • 김우주 (고려대학교 의과대학 내과학교실) ;
  • 최희정 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 김민자 (고려대학교 의과대학 내과학교실) ;
  • 우준희 (울산대학교 의과대학 내과학교실) ;
  • 김윤정 (가톨릭대학교 의과대학 내과학교실) ;
  • 최보율 (한양대학교 의과대학 예방의학교실) ;
  • 최윤수 (한양대학교 의과대학 예방의학교실) ;
  • 기미경 (국립보건연구원 바이러스질환연구과) ;
  • 김기순 (국립보건연구원 바이러스질환연구과) ;
  • 한국 HIV/AIDS 코호트 연구 (한국 HIV/AIDS 코호트 연구)
  • Received : 2018.05.09
  • Accepted : 2018.05.23
  • Published : 2018.08.01

Abstract

Background/Aims: Global efforts to prevent human immunodeficiency virus (HIV) infection and strengthen treatment programs have reduced the annual incidence of HIV infection. However, the incidence recently increased unexpectedly in Korea. Therefore, to understand the cause of the increase in HIV infection incidence in Korea, it is important to identify the mode of HIV transmission. Methods: We included HIV-infected individuals enrolled in the Korea HIV/AIDS (acquired immune deficiency syndrome) Cohort from December 2006 to January 2018. The subjects were older than 18 years and were receiving care at 21 participating hospitals. They were interviewed by their physician at enrollment, and an epidemiological survey was conducted using a standardized questionnaire provided by a professional counseling nurse. Results: There were 1,474 subjects: 1,377 men and 97 women. Their mean age was $41.4{\pm}12.6$ years, and the male-to-female ratio was 14.2. The transmission modes were as follows: homosexual and bisexual contacts in 885 (60.1%), heterosexual contacts in 508 (34.6%), blood transfusion and blood products in 5 (0.3%), and injected drug use in 1 (0.0%). Regarding age, the proportion infected by homosexual and bisexual contacts was higher in the younger age groups: 71.5% in subjects aged 18-29 years. When this age group was further subdivided, 92.9% of those aged 18-19 years were determined to be infected via homosexual and bisexual contacts. Conclusions: In Korea, HIV is transmitted predominantly via homosexual and bisexual contacts, which is more common among younger age groups and the cause of infections in most teenagers.

목적: 전 세계적으로 매년 신규 HIV 감염의 발생은 서서히 감소하는 추세를 보이고 있다. 그러나 국내 신규 HIV 감염의 발생은 도리어 급격히 증가하는 양상을 보이고 있으며, 젊은 층에서의 급격한 증가가 원인으로 알려졌다. 이에 국내에서 HIV 감염의 감염 경로를 분석하고 규명함은 국내에서 급격한 증가 원인을 밝히고, 그에 대한 예방 및 관리 대책을 수립함에 있어서 중요한 근거가 되겠다. 방법: 2006년 12월부터 2018년 1월 까지 '한국 HIV/AIDS 코호트'에 등록된 HIV 감염인을 조사하여 분석하였다. 전국 21개 참여 병원에서 진료를 받고 있는 18세 이상의 HIV 감염인으로서 등록 시에 주치의의 역학 관련 문진에 이어 훈련된 전문 상담 간호사가 제시하는 표준화된 설문지를 통해서 역학 조사를 실시하였다. 수집된 자료를 분석하여 전체 대상 및 연령군에 따른 감염 경로를 규명하였고, 특히 젊은 층에서는 좀 더 세부적으로 연령을 구분하여 감염 경로를 조사하고 비교하였다. 결과: 조사 대상은 1,474명이었으며, 남자는 1,377명, 여자는 97명이었다. 조사 대상의 평균 연령값은 $41.4{\pm}12.6$세였으며, 남녀 성비는 14.2:1이었다. 전체 대상 HIV 감염인의 감염 경로를 분석해 보면 동성 및 양성 간 성접촉이 886명(60.1%), 이성 간 성접촉이 508명(34.6%), 수혈 및 혈액제제에 의한 감염이 5명(0.3%), 마약주사 공동사용에 의한 감염이 1명(0.0%)이었다. 연령군에 따른 감염 경로를 비교해 보면 젊은 연령군으로 갈수록 동성 및 양성 간 성접촉에 의한 비율이 증가하였다. 다시 말해서, 18-29세의 젊은 연령군에 있어서는 동성 및 양성 간 성접촉이 71.5%로 크게 증가하였다. 또한, 18-29세의 젊은 연령군을 좀 더 세분화해서 조사해 보면 젊을수록 동성 및 양성 간 성접촉에 의한 감염이 크게 증가하여 18-19세의 10대에서는 92.9%가 동성 및 양성 간 성접촉에 의해서 감염되었다. 결론: 국내 HIV 감염의 가장 주된 감염 경로는 동성 및 양성 간 성접촉이며, 이러한 경향은 연령이 젊어질수록 더욱 뚜렷이 나타났다. 특히, 10대의 경우에는 대부분이 동성 및 양성 간 성접촉에 의하여 감염되었다. 따라서 그에 따른 합리적인 예방 및 관리 정책을 수립하는 것이 절실히 요구된다 하겠다.

Keywords

Acknowledgement

Grant : Korea HIV/AIDS Cohort Study

Supported by : Korea Centers for Disease Control and Prevention

References

  1. UNAIDS. UNAIDS data 2017. Geneva: UNAIDS, 2017.
  2. Joint United Nations Programme on HIV/AIDS (UNAIDS). 90-90-90: an ambitious treatment target to help end the AIDS epidemic. Geneva: UNAIDS, 2017.
  3. UNAIDS. Fast-track cities: ending the AIDS epidemic. Geneva: UNAIDS, 2014.
  4. UNAIDS. Global AIDS update 2016. Geneva: UNAIDS, 2016.
  5. Korea centers for disease control and prevention (KCDC). Annual report on the notified HIV/AIDS in Korea 2016. Cheongju: KCDC, 2017.
  6. Kim YG, Hahn SJ. Homosexuality in ancient and modern Korea. Cult Health Sex 2006;8:59-65. https://doi.org/10.1080/13691050500159720
  7. Suguimoto SP, Techasrivichien T, Musumari PM, et al. Changing patterns of HIV epidemic in 30 years in East Asia. Curr HIV/AIDS Rep 2014;11:134-145. https://doi.org/10.1007/s11904-014-0201-4
  8. Ministry of Health, Labour and Welfare (MHLW). Annual report of the national AIDS surveillance committee for year 2012. Tokyo: MHLW, 2013.
  9. Ministry of Health, Labour and Welfare (MHLW). AIDS surveillance committee report: public health center statistical data 2016. Tokyo: MHLW, 2017.
  10. Centers for disease control R.O.C. (Taiwan). Statistics of HIV/AIDS 2016. Taiwan: Centers for disease control R.O.C. (Taiwan), 2017.
  11. National health and family planning commission of the People's Republic of China. 2015 China AIDS response progress report. Beijing: National health and family planning commission of the People's Republic of China, 2015.
  12. European centre for disease prevention and control (ECDC). HIV/AIDS surveillance in Europe 2015. ECDC surveillance report. Solna kommun: ECDC, 2016.
  13. Beyrer C, Baral SD, van Griensven F, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet 2012;380:367-377. https://doi.org/10.1016/S0140-6736(12)60821-6
  14. Centers for disease control and prevention. Diagnoses of HIV infection in the United States and dependent areas, 2015. HIV surveillance report. Atlanta: Centers for disease control and prevention, 2016;27.
  15. Centers for disease control and prevention. HIV among gay and bisexual men. CDC report 2017. Atlanta: Centers for disease control and prevention, 2017.
  16. World Health Organization (WHO). HIV and young men who have sex with men. WHO technical brief 2015. Geneva: WHO, 2015.
  17. Dong Z, Xu J, Zhang H, et al. HIV incidence and risk factors in Chinese young men who have sex with men--a prospective cohort study. PLoS One 2014;9:e97527. https://doi.org/10.1371/journal.pone.0097527
  18. Li Y, Xu J, Reilly KH, et al. Prevalence of HIV and syphilis infection among high school and college student MSM in China: a systematic review and meta-analysis. PLoS One 2013;8:e69137. https://doi.org/10.1371/journal.pone.0069137
  19. Patel P, Borkowf CB, Brooks JT, Lasry A, Lansky A, Mermin J. Estimating per-act HIV transmission risk: a systematic review. AIDS 2014;28:1509-1519. https://doi.org/10.1097/QAD.0000000000000298
  20. Moon DG. National survey on the sexual consciousness 2014. Korea centers for disease control and prevention survey report 2015. Cheongju: Korea centers for disease control and prevention, 2015.
  21. Concerted action on seroconversion to AIDS and death in Europe. HIV reference information [Internet]. Concerted action on seroconversion to AIDS and death in Europe, c2018 [cited 2018 May 4]. Available from: http://www.ctu.mrc.ac.uk/cascade/default.asp.
  22. Multicenter AIDS cohort study. HIV reference information [Internet]. Multicenter AIDS cohort study, c2018 [cited 2018 May 4]. Available from: http://aidscohortstudy.org/.

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