男性同性間におけるセクシャルヘルス増進に関する研究

Outline of MSM Group Research Activities from 2000 to 2008

Note: Gay NGO, gay community center, and gay community are used to describe activities and research projects, but this is not a direct translation of the Japanese language used.

Location Osaka

Location Osaka
2000 - 2002	SWITCH, G-SWITCH & S-SWITCH HIV and STI Gay Community Testing event	Onitsuka Tetsuro, Seiichi Ichikawa	HIV Testing (2000) 249 (2001) 403 (May 2002) 150 (Aug 2002) 152 Survey respondents (2000) 254 (2001) 399 (2002) 301	2000-2002 HIV prevalence 2.4%-1.3%, Syphillis (TPHA) 14.6%-19.4%. Respondents lifetime experience of HIV Testing 19% (1999), 26% (2000), 24% (2001), 34% 2002. Condom use every time during anal sex with regular partners 37% (1999), 40% (2000), 35% 2001, 45% (2002).	MASH Osaka established in 1998 to conduct HIV prevention and support for gay and bisexual men. SWITCH facilitated formation of partnerships between epidemiological researchers, gay community, and medical professionals to provide gay friendly, free STI testing. NGO began HIV/STI workshops and condom outreach using volunteer staff to gay bars and club events. Due to the needs demonstrated by this research, in 2002 the Ministry of Health established an Investigation Committee to develop HIV policy for MSM.
2000	Tokyo Club Event Survey	Hirokazu Kimura, Seiichi Ichikawa	493	HIV/STI knowledge low and condom use during anal lower among younger age groups. Respondents saying they used condoms every time during receptive anal sex in previous 6 months w/ regular partner (15-19 year olds) 12%, 20-24 year olds 36%, 25 to 29 year olds 42%, 30-39 year olds 32%. Lifetime HIV testing behavior 25%.	MASH Tokyo established in 2000 to conduct HIV prevention and support for gay and bisexual men. Due to the need to focus prevention activities on younger age groups, condom and poster outreach to gay bars, shops and saunas and HIV workshops commenced by volunteer staff. Need for Drop-in Center or Community center to conduct outreach activities identified.

Location Tokyo

Location Tokyo
2000	Tokyo Club Event Survey	Hirokazu Kimura, Seiichi Ichikawa	493	HIV/STI knowledge low and condom use during anal lower among younger age groups. Respondents saying they used condoms every time during receptive anal sex in previous 6 months w/ regular partner (15-19 year olds) 12%, 20-24 year olds 36%, 25 to 29 year olds 42%, 30-39 year olds 32%. Lifetime HIV testing behavior 25%.	MASH Tokyo established in 2000 to conduct HIV prevention and support for gay and bisexual men. Due to the need to focus prevention activities on younger age groups, condom and poster outreach to gay bars, shops and saunas and HIV workshops commenced by volunteer staff. Need for Drop-in Center or Community center to conduct outreach activities identified.
2002	Survey investigating HIV prevention behaviors of HIV test partipants at Minami Shinjuku HIV Testing Site.	Seiichi Ichikawa		Among 5,184 HIV testers in 2002, 81 people were diagnosed with HIV (1.56%); 68 people (84%) were MSM. Increase in HIV infection prevalence mong MSM from 1.6% (1995) to 4.4% (2002).	Due to increasing HIV infection rates among MSM, the Ministry of Health Investigation Committee decided to increase the opening times of the Minami Shinjuku HIV testing site.

Location San Francisco and Tokyo

Location San Francisco and Tokyo
2000	HIV Risk and Testing Behavior of Japanese MSM in the US	Kyung Hee Choi, Seiichi Ichikawa	41	HIV testing life experience of US living MSM 85%, Tokyo living MSM 29%. Satisfaction with counselling experienced at HIV testing for US living MSM was 82%, and for Tokyo living MSM 50%.

Location Internet

Location Internet
2001	SPIRITS Wave 1	Yasuhara Hidaka, Seiichi Ichikawa	388	Condom use during anal sex lowest among teen age groups, with more than half reporting no use in previous year. Other age groups reported condom use every time during anal sex ranged from 11.1% to 47.8%. Lack of condom use during anal sex related to 'respecting, trusting and loving sex partner' rather than knowledge and assessment of HIV related risk.	Need for prevention among internet using MSM identified. The simple message 'Use condoms' is not effective for HIV prevention interventions.
2002	SPIRITS Wave 2	Yasuhara Hidaka, Seiichi Ichikawa	509	Condom use lowest in older (50-64) and younger (15-19) age groups. Lack of condom use in receptive anal sex associated with sexual identity acceptance issues, lower self-esteem, isolation and depression.	HIV prevention interventions should aim to increase knowledge about HIV and STIs, as well as paying attention to MSMs social and pyschological situations.

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Location Osaka

Location Osaka
2003	Osaka Club event Survey	Hirokazu Kimura	626	Condom outreach has increased the accessibiity of HIV related information, but this has not translated directly into safe sex behavioural change. HIV testing in past year 31.4%. Previous 6 months condom use every time during receptive anal sex with regular partner 39%., casual partner 54%.	Gay community center 'dista' established in Doyama in April, 2003, providing a drop in center, exhibition and event space, and base to conduct project and outreach activities. Production of Gay Community paper Sal+ commenced, distributing to gay bars, shops, and saunas. The paper increased the strength of networks with gay commercial venues.
2004	Osaka Club event survey	Hirokazu Kimura	607	Results indicate increasing levels of HIV knowledge, condom use and HIV testing among club clients. However, there is a need to expand research base in order to more effectively evaluate program activities. Lifetime HIV testing experience 35.7%. Condom use during anal sex every time with regular partner (receptive) 46.4%.	Results indicate increasing levels of HIV knowledge, condom use and HIV testing among club clients. However, there is a need to expand research base in order to more effectively evaluate program activities. Lifetime HIV testing experience 35.7%. Condom use during anal sex every time with regular partner (receptive) 46.4%.

Location Tokyo

Location Tokyo
2002	Tokyo Club Event Survey	Hirokazu Kimura	539	Previous 6 months condom use everytime during receptive anal sex with regular partners was 40.1%, casual partners 46.5%. Lifetime HIV testing experience 43.3%. Sauna users have higher levels of HIV prevention knowledge, condom use duing anal sex, and HIV testing experience.	New NGO 'Rainbow Ring' established to conduct HIV prevention among gay and bisexual men. Gay community center 'akta' was established in Shinjuku 2 chome in August, 2003, providing a drop in center, exhibition and event space, and a base to conduct project and outreach activities. In 2003, deli-hel boys starts with young MSM volunteers conducting outreach activities to gay bars, shops, and saunas.. Club event/ Sauna program also commenced which aimed to increase the visibility of HIV among MSM by distributing condom packaging designed by various graphic designers and gay artists.
2003	Tokyo Club Event Survey	Hirokazu Kimura	532	HIV Testing behaviour increasing, as as well as increase in knowledge of NGO distributed HIV materials. Previous 6 months condom use everytime with regular partners 59.1%, casual partners 65.9%. Lifetime HIV testing experience 25.4%.

Location Nagoya

Location Nagoya
2001	NLGR HIV/STI Testing Event	Makoto Utsumi	148	HIV prevalence 2.7% (N=4)	Angel Life Nagoya NGO established in 2000, to provide HIV prevention and support for gay and bisexual men. Community center established in 2004.
2002	NLGR HIV/STI Testing Event	Makoto Utsumi	304	HIV prevalence 2.3% (N=7)
2003	NLGR HIV/STI Testing Event	Makoto Utsumi	346	HIV prevalence 1.2% (N=4)
2004	NLGR HIV/STI Testing Event	Makoto Utsumi	439	HIV prevalence 2.7% (N=12)

Location Fukuoka

Location Fukuoka
2003	Fukuoka Gay Event Survey	Masahiro Yamamoto	60	HIV testing experience low indicating lack of accessible gay friendly testing services. HIV testing in previous 6 months 26%, Condom use everytime during anal sex (receptive) 31%.	Gay NGO Love Act Fukuoka established in 2002, facilitating the formation of a network with community health center and HIV treatment medical staff.
2004	Fukuoka Gay Event Survey	Masahiro Yamamoto	63	HIV testing in previous year 30%, condom use everytime during receptive anal sex with regular partner 49%, casual partner 55%.

Location National general population Survey

Location National general population Survey
2002	Survey evaluating knowledge of HIV campaign materials.	Seiichi Ichikawa	Men over the age of 16 (Nationally N=4,239)	General awareness of HIV campaigns conducted in movie theatres, buses, internet and mobile phones was low among general population, and very low among MSM.	Need to define the target of HIV prevention materials and develop specific interventions for target groups in order to increase HIV prevention awareness.

Location National Internet Survey

Location National Internet Survey
2003	SPIRITS 2	Yasuharu Hidaka	2062	MSM have mental health needs not being met but current services. Poor mental health inhibits HIV preventive sexual behaviour. HIV testing in previous year 23.7%, previous 6 months condom use every time during receptive anal sex with regular partner 24.5%, casual partner 33.5%.	Demonstrated the need for internet based HIV intervention (conducted in 2006).

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Location Osaka

Location Osaka
2005	Osaka Gay Bar Survey	Seiichi Ichikawa	546	Respondents who had picked up NGO condom 63.6%, picked up gay community paper 64.8%, knew gay community center 27.3%, HIV testing in previous year 28.2%, previous 6 months condom every time during receptive anal sex with regular partner 36.1%, casual partner 50%. Analysis of condom use in relation to behaviour change stage indicates low levels of condom use associated with low intention to use condoms consistently. Life time experience of Popper use was 61.4%.	The results of this research indicated a different group of MSM was reached by this survey, showing different HIV prevention and support needs. Gay bar survey respondents have lower condom use and drug use than club event survey respondents.
2007	Osaka Gay Bar Survey	Seiichi Ichikawa	966	Experience of life time HIV testing 53.6%, previous 6 months condom use every time during receptive anal sex with regular partner 32.9%, casual partner 40.8%. Due to increased outreach to bars frequented by older MSM, data comparing older MSM and younger age groups was obtained. Older MSM had lower knowledge of gay NGO prevention projects, lower HIV testing rates. While the level of sexual activity is comparable among all age groups, condom use among 50+ year olds is considerably lower.	Further qualitative interview research was conducted to investigate the needs of older MSM. Results indicate different prevention materials need to be developed for older age groups of MSM.
2006	Osaka Club Event Survey	Hirokazu Kimura	687	Life-time HIV testing 38%, previous 6 months condom use everytime during receptive anal sex with regular partner 59.6%, casual partner 65.7%.
2004	Osaka Saturday HIV Testing Site Client Survey	Mie Takanaka	333	MSM respondents lifetime experience of HIV testing 58.6%, HIV testing in previous year 36.3%. Condom use in previous 6 months every time during anal sex 39.6%.
2005	Osaka Saturday HIV Testing Site Client Survey	Mie Takanaka	430	MSM respondents lifetime experience of HIV testing 59.3%, HIV testing in the previous year 37.2%. Condom use in previous 6 months every time during anal sex 36.4%.
2006	Osaka Saturday HIV Testing Site Client Survey	Mie Takanaka	373	MSM respondents lifetime experience of HIV testing 72.4%, HIV testing in previous year 46.4%. Condom use in previous 6 months every time during anal sex 50.8%.
2006	Social Geographical Survey: Doyama	Sohei Yamada		This research aimed to estimate the MSM population accessing an area with a concentration of gay businesses. Using social geographical survey methods, the proportion of building space in the Doyama area was estimated to be 6.2%. Applying this proportion to results of a population movement survey, the numbers of MSM estimated to come to Doyama on weekdays was 1,932 people, and 2,392 on weekends.	Using this methodology, MSM population estimates were subsequently made for Shin-Sakae, Minamai, and Kobe gay commercial areas.
2007	Qualitative Evaluation of MASH Osaka's 'Chat' HIV/STI education workshops	Sachiko Omori	7 W'shop staff 18 participants 10 non-participants	Changing the STI prevention workshops to a more informal format has made participation more 'fun' and increased the motivation of volunteer staff.

Location Tokyo

Location Tokyo
2005	MSM Club Event Survey	Hirokazu Kimura	934	Increase in No. of MSM going to gay saunas (45.1%) and using gay internet meeting sites (52.8%), previous 6 months condom use every time during receptive anal sex with regular partner 55.9%, casual partner 62%. Picked up NGO condom 43%, Knowledge of and visit to gay community center associated with increased condom use. Condom use with casual partner everytime 65%. Lifetime experience of HIV testing 36%. Seen Living Together project pamphlet 13.4%	Living Together Joint project with PLACE Tokyo (HIV and Gay Support NGO) to increase the awareness of gay and bisexual men with HIV within gay communities. Project materials were developed using real life stories on day to day issues of sex and relationships faced by HIV positive and negative MSM. Living Together Events were also conducted consisting of reading set to live music by DJs. At the end of 2007, 110 Living Together Readings have been conducted including on Radio FM Tokyo, gay bars and other venues in Tokyo and other regional areas.
2006	Drug use among 2005 Club Event Survey participants	Hirokazu Kimura	934	In the previous 6 months during sex, 45% of participants had use poppers, 8.2% 5 Meo, and another type of illicit substance 4.9%. Drug use during sex was associated with lower levels of condom use, but did not affect HIV testing behavior.	Identified need for drug related information materials to be developed, and for outreach to club events.
2007	Tokyo Club Event Survey	Hirokazu Kimura	1039	In comparison with 2005 suvery results, HIV knowledge increased but condom use slightly decreased. Knowledge of HIV prevention projects linked with HIV preventive behaviors. HIV testing in previous year 37%, condom use every time during anal sex with regular partner 54%, casual partner 62.4% . Lifetime experience of HIV testing 37%.

Location Nagoya

Location Nagoya
2005	NLGR HIV/STI Testing Event and Survey	Makoto Utsumi, Noriyo Kaneko	HIV Testing 425 Survey 374	First time behavioral surveys conducted along with testing. HIV incidence 2.1%, syphillis 14.3%, Hep B 2.2%. 59.3% of respondents say HIV testing at Community Health Centers is inaccessable, of these 43% say it is because of inconvenient availability of testing times. Previous 6 months condom use everytime during receptive anal sex with regular partners 40.5% casual partners 60.3%. Lifetime HIV testing experience 40.5%.	Community health center HIV testing has not become more accessible (regarding times of availablity, and 'gay friendliness'). The Nagoya testing events, because they are combined with a community festival, attract MSM from all over the country, and in 2007, half those diagnosed with HIV were from outside the Tokai area. This highlights the difficulty in meeting the needs of people from outside the local area diagnosed at the testing event in terms of post diagnosis support, and referral on to appropriate services. Community center moves to new space named 'Rise'.
2006	NLGR HIV/STI Testing Event and Survey	Makoto Utsumi, Noriyo Kaneko	HIV Testing 471 Survey 374	HIV prevention interventions are not reaching younger age groups. HIV prevalence 4.5%, Syphillis 14.9%. Hep B 1.8%. 31.9% of participants say health center HIV testing is inacessible, with 35.2% saying this is because of testing times are inconvenient. Lifetime HIV experience of HIV testing 74.9%. Participants visiting gay bars decreased. 37% have friend or acquaintance with HIV. Previous 6 months condom use everytime during receptive anal sex with casual partners 63.3%, regular partners 46.9%.
2007	NLGR HIV/STI Testing Event and Survey	Makoto Utsumi, Noriyo Kaneko	HIV Testing 538 Survey 374	HIV prevalence 2.2%. 36.1% of respondents say health center HIV testing is inaccessable, with 32.5% saying this is because of inconvenient availability of testing times. Lifetime experience of HIV testing 76.1%. Condom use every time during anal sex (receptive) with regular partner 40.7%. Participants state they prefer combined STI & HIV testing, rapid HIV testing and testing clinics that are accessed by gay men.
2007	HIV positive Medical record survey investigating late diagnosis and delayed medical care after diagnosis.	Yumi Fukuyama	Diagnosis from 1997 in Tokai area N=425	Late diagnosis in 35.8% of cases; related with unemployment, past or present marriage, HIV testing as a part of separate diagnosis, existence of symptoms, concurrent illness. Delayed medical care associated with being a woman, and being diagnosed during blood donation or at a testing event.	In order to reduce late diagnosis in the Tokai area, interventions are needed targetting married heterosexual and homosexual men. In order to reduce delays in medical care, non English speaking foreigners, and those diagnosed at HIV testing events and through blood donation, need to be targetted.

Location Fukuoka

Location Fukuoka
2005	Gay Event Survey	Masahiro Yamamoto	63	Increase in younger aged and rural participants. Increase in condom use & HIV testing.
2006	Gay Event Survey	Masahiro Yamamoto	91	Increase in participants from out of prefecture. HIV testing and condom use increased.	Community center HACO established in Hakata.
2007	Gay Event Survey	Masahiro Yamamoto	41	HIV testing same as previous year, but condom use increased slightly.
2006	Mobile phone RDS Survey	Noriyo Kaneko	1st Survey 68 2nd Survey 62	1st Survey Cell phone survey using Respondent Driven Sampling Method. As the survey is referred on, gay CBO knowledge and condom use decreases while number of anal sex partners in previous 6 months increases. Respondents referred 5 chains of referral. Condom use everytime in last 6 mo with casual partner 64.7%. Knowing someone with HIV 23.5%. 2nd survey: Lifetime experience of HIV testing 66.1%, using condoms everytime during anal sex (receptive) with regular partner 24.2%.

Location Tohoku

Location Tohoku
2005	Northern Honshu Hospital and Gay Community Event Survey	Isao Sato	40 hospitals send data regarding 190 HIV patients Volleyball event survey 110	HIV infection increasing among MSM, with the number of HIV positive people infected through homosexual sex doubling in previous 4 years. Prevention activities are hampered by few links between gay businesses, MSM and the gay NGO. HIV testing in previous year 13.6%. Know someone with HIV 15%. Condom use every time during receptive anal sex with regular partner 38.8%, casual partner 65.8%.	Tohoku HIV Community Gay Volunteers joins Research Group in 2005. In 2006, the group is re-named 'Yarokko'.
2006	Gay Community Event Survey	Isao Sato	Spring 76 Autumn 93	Self reported history of Syphillis 28%, HIV testing in previous year 14%, condom use every time during receptive anal sex with regular partner 38.8%, casual partner 65.8%.
2007	Gay Community Event Survey	Isao Sato	69	Decreased knowledge of where to go for HIV testing, but condom use behavior increased. HIV testing in previous year 13%. Condom use everytime during receptive anal sex with regular partner 40%, casual partner 50%. Know someone with HIV 17.6%.
2007	Sendai RDS Mobile Phone Survey	Noriyo Kaneko	60	Life-time experience of HIV testing 39%, previous 6 months condom use every time during receptive anal sex with regular partner 40%, casual partner 50% Know someone with HIV 18.3%.

Location National Internet Survey

Location National Internet Survey
2005	Researching Epidemiological Agenda for Community Health (REACH Online 2005)	Yasuharu Hidaka	5731	Lifetime experience of HIV testing 41.7%, history of syphillis diagnosis 10.6%, used illicit drugs in previous 6 months 44.2%, poppers 33.1%, 5Meo 8.8%. Previous 6 months condom use every time during anal sex 26%.
2006	REACH Online 2006 Cyber Intervention	Yasuharu Hidaka	651	Random controlled Testing of an internet based HIV prevention intervention. Increases in HIV prevention knowledge and risk were observed, but this did not translate into increased condom use at one month post intervention. Lifetime experience of HIV testing 50.7%.
2007	REACH Online 2007	Yasuharu Hidaka	6282	90% of respondents had been given no or negative information regarding homosexuality at school. Recognition of gay NGO activites was dependant on regional area, indicating effectiveness of outreach in respective regional areas. Lifetime experience of HIV testing 43.3%, previous 6 months condom use during anal sex 33.8%.

Location National Cell phone RDS Survey

Location National Cell phone RDS Survey
2007	Social Network Survey RDS method to investigate 'hidden populations' and gay community social networks in Tokyo, Osaka, Fukuoka, Sendai, Nagoya	Noriyo Kaneko	1st survey Fukuoka 68 Tokyo 78 Osaka 87 2nd Survey Sendai 60 Fukuoka 62	Analysis conducted according to chain of referral. Respondents in 2nd and 3rd chains less likely to have come out to family, have lower knowledge of CBO activities, have smaller social network size, lower number of people to talk about regarding sex, and less likely to know someone with HIV.

Location HIV positive support

Location HIV positive support
2005	HIV prevention from the perspective of HIV+ MSM.	Hiroshi Hasegawa		Stigma and environmental factors need to be addressed in order to impact on sexual behavioural change The stigmatization of homosexuality and sexuality related issues results in extreme isolation for MSM with HIV who are exhibit reluctance to come out about their HIV status for fear of losing housing and jobs. The HIV testing and HIV treatment environment is not open to discusing sexuality related issues, leaving MSM with HIV with few support options.	Training conducted with HIV testing Community Health Center staff and HIV treatment medical professionals regarding sexuality issues and HIV.
2006-2007	HIV Positive MSM Needs Survey	Hiroshi Hasegawa		Focus Group Interviews with HIV+ MSM to investigate sexual health information and support needs. Peer Support Group set up to support HIV+ MSM, however resistence to discussing sexual health related issues exist.

Location International MSM

Location International MSM
2006	Evaluation of Australian and Japanese MSM related HIV policy	Jane Koerner		High levels of government commitment combined with gay community driven prevention efforts are effectively in promoting HIV prevention among MSM. Japanese gay NGOs receive very low levels of funding in comparison to the Australian response among MSM.
2007	Comparison of HIV epidemic among Japanese and Asian MSM	Jane Koerner		Japan shares a number of features with the Asian HIV epidemic including late appearance of the epidemic, previous assumptions of a heterosexual epidemic due to lack of adequate surveys in MSM populations, diverse homosexual identities, high levels of social and structural stigma resulting in low levels of government funding and commitment for MSM.

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