The Sociodemographic Characteristics of Concurrent Sexual Partnerships and their Risky Sexual Behaviors: Results of a Nationally Representative Sample of South Korean Adults

Unveiling the dynamics of HIV transmission among young homosexual and bisexual men in Korea

BACKGROUND

Despite the relatively low prevalence of HIV/AIDS in Korea, the incidence of HIV is steadily increasing, centering on same-sex sexual contact among men in their 20s and 30s. However, in Korean society, where acceptance of homosexuality is low, LGBTQ + research is lacking and there is little empirical data on HIV transmission. This study explored the context in which anal intercourse occurs among male sexual minorities in Korea.

METHODS

Data were collected by conducting a web survey targeting paid members of Korea's largest homosexuality portal site (n = 941). The dependent variable was whether anal intercourse was preferred, and the major independent variables were health behavior, health status, and sexual behavioral characteristics.

RESULTS

Those who reported that their gender identity was homosexual tended to prefer anal sex more than those who reported that they were bisexual (Chi-square = 5.165, p <.05). For homosexuals that had more unprotected sex (OR = 1.538, 95% CI = 1.281-1.847), had a primary sex partner (OR = 1.943, 95% CI = 1.345-2.809), and had been diagnosed with an STD (OR = 2.978, 95% CI = 1.592-5.568), there was a high possibility of preferring anal intercourse. Bisexuals were more likely to prefer anal intercourse if they had unprotected sex (OR = 1.715, 95% CI = 1.322-2.225) or had a primary sex partner (OR = 1.927, 95% CI = 1.141-3.257).

CONCLUSIONS

This study found that young non-heterosexual men in South Korea are more likely to engage in condomless anal sex while living with HIV/STDs. As a result, primary partners are at higher risk of infection, and bisexual individuals are more likely to transmit HIV/STDs due to similar sexual contexts.

Trend Analysis of the Profiles of 12 Sexually Transmitted Disease Pathogens in the Republic of Korea in 2019

Background: Sexually transmitted diseases (STDs) are common infectious diseases in humans transmitted through unprotected sexual activities. In South Korea, despite the high annual incidence of STDs, detailed examinations of pathogen-specific factors and causes for delays in diagnosis and treatment are still lacking. Furthermore, STD prevalence patterns and important pathogen-specific factors remain unclear. Herein, we retrospectively analyzed the epidemiology of STDs in South Korea in 2019 by analyzing the association of pathogen-specific infection patterns with factors such as sex, age, region, and month. Methods: We obtained the STD test results of 172,973 individuals from the Seoul Clinic Laboratory in 2019, most of whom had multiple infections; hence, 275,296 STD-positive cases were included in this analysis. Through deoxyribonucleic acid (DNA) amplification, they were categorized by pathogen type. Subsequently, they were further classified by month, region, and age while concurrently being stratified according to sex. Results: Among the 12 pathogens detected in this study, Gardnerella vaginalis had the highest prevalence, with 92,490 cases in both sex groups; moreover, many of them were concurrently infected by two or more pathogens. The prevalence of STDs did not differ according to month or region. Conversely, the pathogen-specific prevalence rates significantly differed according to age. Older adults had higher prevalence rates of Chlamydia trachomatis, Trichomonas vaginalis, Candida albicans, and herpes simplex virus type 1 infections than younger adults. Conclusion: These pathogen-specific prevalence patterns provide information that helps to understand population vulnerability according to region and age and helps develop STD prevention and treatment strategies in South Korea.

Risk factors of sexually transmitted infections among female sex workers in Republic of Korea

Background

Female sex workers (FSW) who live in urban areas in Republic of Korea have a particularly high risk of sexually transmitted diseases (STD). We investigated the prevalence of s STDs in FSWs in order to determine the factors associated with sexually transmitted infections in Korea.

Methods

Study data were collected from 832 FSWs through a 2014 survey on the prevalence of STDs in high risk populations in Republic of Korea. We assessed the associations between sexually transmitted infections and demographic and risk behaviour variables through logistic regression analysis.

Results

The risk probability of sexually transmitted infection was higher for those who drank alcohol often as well as those who had their first sexual experience at an early age. However, the effects of these factors were attenuated by working conditions. The risk probability of sexually transmitted infections was higher for those who engaged in sex with several customers per day as well as for those who did not practice regular condom use.

Conclusions

The risk factors for sexually transmitted infections among FSWs in Republic of Korea are related to and affected by working conditions. Thus, multifaceted health interventions to protect FSWs and their sexual health are deemed necessary.

Electronic supplementary material

The online version of this article (10.1186/s40249-019-0516-x) contains supplementary material, which is available to authorized users.

Associated with Differences in Sexual Risk-Taking Behaviors Among Migrants in South Korea

We investigated influential factors on differences in sexual risk-taking among homosexual migrants. The data used in this paper are based on the survey and medical examination for migrants' sexual behaviors that was carried out by the Korea Federation for HIV/AIDS Prevention in 2011-2013 on participants living in South Korea. Among 1141 migrants, homosexuals were 0.54 times less likely to use condom than heterosexuals. Homosexuals were 2.93 times more likely to be infected with sexually transmitted diseases (STDs) than heterosexuals. Among 250 homosexual migrants, those who preferred risky sexual intercourse were 0.19 times less likely to use a condom than heterosexual migrants. Those who have a fixed sexual partner were 0.35 times less likely to be infected with HIV than their counterparts. Administrative programs for STDs prevention of migrants should be focused on their sexual risk-taking, which were limited to casual partnership, unprotected sex, and previous contraction of sexual diseases.

Partnering Patterns and Sexual Behavior Among Korean Men Who Have Sex With Men

This qualitative study investigates the different methods for selecting sex partners by Korean homosexuals considering factors related to homosexual identity and sexual behavior. We take the approach of the grounded theory to examine the issue of sexual partnering of men who have sex with men (MSM). In-depth interviews of urban MSM and bisexual men were conducted. The snowball sampled through a MSM portal web site. Three key informants from the several areas were collected through a MSM portal website, and then, participants were gradually recruited with the snowball samplings in South Korea, 2011 (n=32). The results of coding the interviews based on the grounded theory approach identified three types of partnering: 1) MSM who do not prefer anal intercourse, but pursue safe sex in long-term relationships with fixed partners; 2) those who have fixed partners and perform anal sex, a category into which both MSM and bisexuals fall; and 3) those engaged in anal sex, but enjoy a concurrent sexual relationship without having fixed partners, which was common among bisexuals. The findings from this study elucidate several MSM and bisexual partnering types practice safe sex. This diversity in MSM partnering may increase the vulnerability of some MSM to HIV infection as safe-sex practices remain a matter of individual choice. Changes in Korean societal policies are necessary to enhance capacity building and encourage the practice of safe sex at the community level.

Sexual behavior and condom use among gay men, female sex workers, and their customers: evidence from South Korea

Background

Despite the significance for sexually transmitted diseases (STD) control in East Asia, few studies have examined the relationship between high-risk sexual behavior and condom use. We investigated how three sexually vulnerable groups for STDs show differences in condom use behaviors (CUBs) depending on their STD infection.

Methods

The source of data came from the National Survey for STD Prevalence Rate and Sexual Behavior of the High-Risk Sexual Community. The effects of behavioral determinants on CUBs were estimated by using path analysis models. An 11-item questionnaire assessing subjects’ health risk behaviors, sexual beliefs, sexual risk behaviors, and condom use.

Results

Condom use was higher for men who have sex with men (MSM; n = 108) when they were bisexuals and had high self-efficacy, for Johns (Johns; n = 118) when they had experience of STD infection, and for female sex workers (FSWs; n = 1,083) when they had high self-efficacy, did not engage in drunken sex, and were anxious about infection. Regardless of whether they were infected with STDs, FSWs always used condom when they had high sexual beliefs. On the contrary, Johns exhibited a negative relationship between sexual risk behavior and condom use when they had experience of STD infection. The variable commonly significant to all three groups was the number of sex partners; but it exhibited a positive relationship with MSMs and Johns, and a negative one with FSWs.

Conclusions

CUBs were related to sexual beliefs as well as sexual risk behavior. At the same time, the experience of STD infection mediated the relationship between the two. Therefore, we need to draw social attention to promote safer sex among STD-vulnerable groups.

Anal sex practices in heterosexual and male homosexual populations: a review of population-based data

Anal sex is known to be an important risk factor for anal cancer. Yet compared with vaginal intercourse, little is known about anal sex practices in either heterosexual or male homosexual populations. Of the data that are available, it appears a significant and increasing minority of heterosexuals have ever practised anal intercourse. Among homosexual men, most, but not all, report anal sex, with large proportions of men engaging in both insertive and receptive anal intercourse. The most significant finding of the review was the dearth of population-based data, particularly relating to homosexual men.

The psychosocial determinants of the intention to reduce the number of sexual partners among recent traditionally initiated and circumcized men in the Eastern Cape Province, South Africa

This study focuses on the factors associated with the intention to reduce the number of sexual partners. An individual face-to-face interview was used to collect data amongst 2337 traditionally initiated and circumcized men in the rural areas of Eastern Cape Province, South Africa. About 55.5% reported having a main sexual partner and of those 41.4% indicated having other sexual partners. The strongest association with intention was found for self-efficacy towards having one sexual partner, which accounted for almost 49% of the variance. These findings provide specific information for the development of a focused cultural sensitive STI/HIV prevention programme in sexually active young men, which can be integrated into the initiation and health education practices.