ArticleBMC public health2025
Trends in HIV testing and Seroprevalence among key populations at public health centers in South Korea, 2011-2023: a nationwide analysis.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPublic health centers (PHCs) in South Korea provide free anonymous and named HIV testing and serve as an essential component of the national testing infrastructure, particularly for populations underserved by conventional healthcare settings. Identifying temporal shifts in testing behavior and positivity is vital for targeted prevention and diagnostic strategies.
methodsWe analyzed HIV testing data from 260 PHCs nationwide between 2011 and 2023. Temporal trends in the number of tests, testing purposes, and HIV seroprevalence were assessed. Multivariable logistic regression analysis was used to identify independent predictors of HIV positivity, and temporal changes were evaluated using the Mann-Kendall trend test.
resultsOver the 13-year study period, approximately 4.7 million HIV screening tests were completed at PHCs. Annual testing volume sharply declined during the COVID-19 pandemic, reaching 104,621 tests in 2021 (about 24% of the pre-COVID annual average of 443,609), but rebounded to 255,051 tests by 2023. In that year, the overall HIV seroprevalence at PHCs was 0.17%, with elevated positivity among foreign nationals (0.68%), men (0.43%), individuals in their 20s (0.25%), and those undergoing voluntary anonymous (1.15%) or named (0.71%) testing. Multivariable logistic regression revealed that male sex (adjusted odds ratio [aOR] = 9.48, 95% CI: 6.52-13.80), foreign nationality (aOR = 6.22, 95% CI: 4.27-9.07), voluntary testing (aOR = 7.67, 95% CI: 5.67-10.40), and residence in metropolitan areas (aOR = 2.50, 95% CI: 1.93-3.24) were significant independent predictors of HIV positivity (p < 0.001 for all). Trend analysis demonstrated significant increases in testing among individuals aged 30-39 years (Kendall's tau = 0.821, p < 0.001) and in antenatal care screening (Kendall's tau = 0.897, p < 0.001), reflecting expanded maternal health services and changing demographic patterns in test uptake.
conclusionsThroughout the study period, PHCs performed fewer than 5% of national HIV tests but consistently contributed a disproportionately large share of new diagnoses-28.3% in 2023-particularly among vulnerable groups such as men, foreign nationals, young adults, urban residents, and individuals undergoing voluntary anonymous testing. Strengthening PHC-based services and expanding outreach tailored to these populations will be essential for enhancing early diagnosis and achieving national HIV prevention goals.
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