Abstract
BackgroundIn Korea, approximately 70% of HIV-positive individuals are currently diagnosed in hospitals, while most HIV-positive patients were diagnosed at public health centers in 1980 s and 1990 s. However, there are no reporting systems to identify how many HIV tests are performed in the Korean hospitals different from public health centers and Blood centers. We estimated how many HIV tests were performed in hospitals and analyzed the nationwide hospital-based HIV seroprevalence in the present study.MethodsBetween 2002 and 2008, data included HIV tests on insurance claims in hospitals and the proportion of computerized insurance claims from the Health Insurance Review and Assessment Services. The number of HIV tests from the survey in the External Quality Assurance Scheme for hospital laboratories was collected to calculate the insurance claim proportion. HIV seroprevalence was estimated using data of tested individuals, including infected individuals. Statistical analysis was confirmed with the 95% confidence interval. Statistical significance was defined at p-values < 0.05.ResultsThe number of HIV tests in hospitals increased from 2.7 million in 2002 to 5.0 million in 2008. The trend of HIV seroprevalence was decrease (1.5-1.3 per 10,000 individuals, P < 0.0028), except in 2002. The number of women tested was greater than men, and the proportion increased in older individuals and in small towns. Men had a higher annual HIV seroprevalence than women (P < 0.0001). The annual seroprevalence decreased in men (P = 0.0037), but was stable in women. The seroprevalence in the 30-39 year age group demonstrated higher than other age groups except 2008.ConclusionsThe nationwide hospital-based number of HIV tests and seroprevalence were estimated using a new method and seroprevalence trends were identified. This information will facilitate improvement in national HIV prevention strategies.
Highlights
In Korea, approximately 70% of HIV-positive individuals are currently diagnosed in hospitals, while most HIV-positive patients were diagnosed at public health centers in 1980 s and 1990 s
We developed a method to estimate the number of HIV tests performed in hospitals, calculated HIV seroprevalence in the hospital setting, and analyzed the trends in HIV seroprevalence
Medical costs are usually subsidized by the government when HIV tests are performed for specific indications [15], and insurance claim data for HIV tests are collected from Health Insurance Review and Assessment Services (HIRA) to estimate the number of HIV tests performed in hospitals
Summary
In Korea, approximately 70% of HIV-positive individuals are currently diagnosed in hospitals, while most HIV-positive patients were diagnosed at public health centers in 1980 s and 1990 s. There are no reporting systems to identify how many HIV tests are performed in the Korean hospitals different from public health centers and Blood centers. The number of newly diagnosed individuals is increasing annually [8] It is unclear whether the increase is secondary to increased transmission rates or to increased testing and identification. We hoped to estimate the annual number of HIV tests nationwide and compare this to the annual HIV prevalence. The nationwide seroprevalence and total number of HIV tests has not been estimated because the number of HIV tests in the hospitals was lacking
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