Utilisation and barriers to health check-ups among people living with human immunodeficiency virus in South Korea: a cross-sectional survey of clinic-attending patients

Abstract

People living with human immunodeficiency virus (PLWH) continue to experience higher mortality rates than that in the general population. As this increased mortality is largely attributed to chronic comorbidities, regular health check-ups are required. This cross-sectional survey, conducted in five HIV clinics in South Korea from July 2024 to March 2025, examined the status of health check-ups among PLWH and factors associated with their utilisation. Patients with HIV completed the survey during routine visits. The questionnaire included participants’ demographic data, comorbidities, health check-up experiences, health status, and lifestyle habits. The total number of patients approached was not recorded, precluding calculation of a response rate. Among 234 respondents, 182 (77.8%) had received a health check-up at least once, of whom 111 (61.0%) reported receiving them regularly, though regularity was measured based on self-reported periodicity without standardised criteria and should be interpreted with caution. Multivariable logistic regression analysis showed that health check-up participation was significantly associated with a monthly income of ≥ 3 million won, alcohol consumption two to four times/month (reference: ≤ 1 time/month), age ≥ 40 years, and more frequent consumption of balanced, regular meals (reference: never/rarely, but a marginally significant association that was not robust in bootstrap validation). Due to the cross-sectional design, all associations are correlational and should not be interpreted as causal; unmeasured confounding, selection bias, and reverse causation remain possible. Our study demonstrated the need to further increase the regular health check-up rate among PLWH. Our findings highlight the need for multilevel interventions, including financial assistance for low-income PLWH and measures to address psychological, structural, and system-level barriers, to improve health check-up participation in this population. Findings may not generalise to women, PLWH not engaged in care, or non-universal healthcare settings.