Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea; Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea.
Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea; Department of Agricultural Economics and Rural Development, Seoul National University, Seoul, Republic of Korea.
J Infect Public Health. 2024 Dec;17(12):102567. doi: 10.1016/j.jiph.2024.102567. Epub 2024 Oct 22.
We identified the uptake of people living with HIV (PLWH) using health-screening services and compared the screening rate with the general population, to identify factors associated with the use of screening services by PLWH.
This population-based study used data from the Korean National Health Insurance, a single mandatory health insurance system covering all residents. The uptake rates for screening for general health, gastric cancer, and colorectal cancer, which were provided by a national health screening program with free of charge or minimal cost in Korea from 2010-2020. Factors associated with general health, gastric cancer, and colorectal cancer screening were also explored.
Screening uptake rates for general health, gastric cancer, and colorectal cancer in PLWH increased from 2010-2019 but decreased in 2020. The standardized screening ratio showed lower screening rates for general health, gastric cancer, and colorectal cancer in PLWH with 0.80 (95 % confidence interval (CI) = 0.77-0.83), 0.64 (95 % CI = 0.61-0.67), and 0.67 (95 % CI = 0.64-0.71) in 2019. Increased age, Charlson Comorbidity Index, and years since HIV diagnosis were associated with increased screening uptake in PLWH. Otherwise, PLWH recipients of medical aid programs received less for each screening compared to PLWH who paid insurance premiums higher than 50 %. An increased medication possession ratio of highly active antiretroviral therapy was associated with decreased general health and gastric cancer screening uptake but increased colorectal cancer screening uptake.
Significant disparities in health-screening uptake were observed in PLWH compared to the general population in a nationwide organized screening setting without cost barriers.
我们确定了艾滋病毒感染者（PLWH）使用健康筛查服务的情况，并将筛查率与一般人群进行比较，以确定与 PLWH 使用筛查服务相关的因素。
本项基于人群的研究使用了韩国国家健康保险的数据，该保险是一种覆盖所有居民的单一强制性健康保险制度。从 2010 年至 2020 年，在韩国通过国家健康筛查计划提供了免费或低费用的一般健康、胃癌和结直肠癌筛查服务，本研究利用了这些数据。还探讨了与一般健康、胃癌和结直肠癌筛查相关的因素。
PLWH 的一般健康、胃癌和结直肠癌筛查率从 2010 年至 2019 年增加，但在 2020 年下降。标准化筛查比显示，PLWH 的一般健康、胃癌和结直肠癌筛查率较低，分别为 0.80（95%置信区间（CI）=0.77-0.83）、0.64（95%CI=0.61-0.67）和 0.67（95%CI=0.64-0.71），在 2019 年。年龄增加、Charlson 合并症指数和 HIV 诊断后年数与 PLWH 筛查率增加相关。否则，与支付保险费高于 50%的 PLWH 相比，接受医疗补助计划的 PLWH 每次筛查的费用较低。高效抗逆转录病毒疗法的药物持有率增加与一般健康和胃癌筛查率降低相关，但与结直肠癌筛查率增加相关。
在全国性的有组织筛查环境中，没有费用障碍，与一般人群相比，PLWH 的健康筛查利用率存在显著差异。
