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Perceptions of Reducing HIV-Preventive Behaviors among Men Who Have Sex with Men Living with HIV in Japan

Health 2018年第12期10卷 1719-1733页

作者： Yuka Matsutaka Junko Koyano yasuharu hidaka Department of Social and Clinical Psychology Faculty of Contemporary Culture Hijiyama University Hiroshima Japan Matsuhama Hospital Niigata Japan Takarazuka University School of Nursing Osaka Japan

Sexual health and behavior among HIV-positive men who have sex with men (MSM) have attracted attention in Japan and elsewhere. It has been reported that perceptions about sex are one factor leading to a reduction in HIV-preventive behaviors. This study investigated types of perceptions, termed self-talk, which allow HIV-positive Japanese MSM to permit themselves to participate in unprotected anal intercourse (UAI). A package of internet surveys for MSM including 20 items assessing self-talk on UAI and condom usage in anal intercourse was administered in 2014. Data from 479 HIV-positive Japanese MSM were analyzed. Exploratory factor analysis was conducted to reveal the factor structure of the self-talk. In addition, using the Kruskal-Wallis test, we examined the relationship between the types of self-talk and the tendency to have UAI. Factor analysis of 20 items assessing self-talk on UAI produced four dimensions: “Diversion/Desire for Stimulation,” “Optimism/Defiant Attitude,” “Denial of Concern of Transmitting,” and “Concern about Relationships.” The score of the subscale “Diversion/Desire for Stimulation” was significantly higher than the other three subscales. It was shown that there was a tendency for the self-talk assessed to be associated with the UAI frequency. The types of perceptions permitting UAI and the psychological stress of being an HIV-positive MSM in Japan were discussed. This study was the first to reveal the factorial structure of perceptions in reducing HIV-preventive behaviors among HIV-positive MSM in Japan. We found positive associations between certain types of self-talk and risky sexual behaviors. We provided recommendations for psychosocial support and HIV risk-reduction intervention for HIV-positive MSM.

关键词： HIV Prevention Safe Sex Men Who Have Sex with Men Perceptions about Sex Psychological Stress

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Perceived Difficulties Regarding HIV/AIDS Services among Public Health Nurses in the Kinki Region of Western Japan: Implications for Public Health Nursing Education in Japan

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Open Journal of Nursing 2017年第3期7卷 419-434页

作者： Yumiko H. Nishimura Mieko Iwai Akiyo Ozaki Asuka Waki yasuharu hidaka School of Nursing Kansai University of Nursing and Health Sciences Hyogo Japan HRD Training & Consulting Office Double Eyes Hyogo Japan Ikeda-Shiritsu Shibutani Junior High School Osaka Japan School of Nursing Senri Kinran University Osaka Japan Takarazuka University School of Nursing Osaka Japan

Objective: To determine the perceived difficulties in providing HIV/AIDS services among public health nurses and to identify their correlates, we carried out a cross-sectional study in the Kinki region of western Japan. Methods: Structured self-administered questionnaires were distributed to all public health nurses in the region, and 1535 valid questionnaires were retrieved (valid response rate 78.7%). Results: More than half of the participants (52.8%) reported difficulties with HIV/AIDS services. The factors associated with perceived difficulties were having a negative attitude towards consultations on sexual matters (adjusted odds ratio [AOR] 2.2, p p = 0.002 and AOR 1.8, p p p = 0.016), and low permissiveness of the diversity of sexual behavior (AOR 2.0, p Conclusions: Overall, our results suggest that nursing and public health nursing education in Japan should cover sexual issues and HIV/AIDS in a more systematic way.

关键词： Perceived Difficulties HIV/AIDS Public Health Nursing Education Sexual Diversity

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Effectiveness of a Training Program for Improving Public Health Nurses’ Attitudes and Confidence in Dealing with Men Who Have Sex with Men

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Open Journal of Nursing 2017年第2期7卷 169-184页

作者： Asuka Waki Yumiko H. Nishimura Mieko Iwai Gaku Okamoto Mikiko Ito yasuharu hidaka Faculty of Nursing Senri Kinran University Osaka Japan School of Nursing Kansai University of Nursing and Health Sciences Hyogo Japan Double-Eyes Hyogo Japan Division of Medical Counseling National Hospital Organization Osaka National Hospital Osaka Japan Department of Public Health Nursing Shiga University of Medical Science Otsu Japan School of Nursing Takarazuka University Osaka Japan

Objective: This study examined the effect of an educational intervention on public health nurses’ attitudes and confidence in dealing with men who have sex with men (MSM). In Japan, HIV is primarily transmitted through sexual contact between men, and free HIV testing and counseling are provided by public health nurses. However, because of a lack of education, public health nurses do not often recognize the existence of MSM in daily life. Thus, improving public health nurses’ understanding of MSM is crucial. Methods: This study used a quasi-experimental design to examine public health nurses’ homophobia, confidence in dealing with MSM, and low awareness of MSM in daily life at pre-test, post-test, and 1 and 3 months follow-ups. The intervention comprised a 3-hour training session conducted between November 2012 and September 2013 in the Kinki region. Results: A total of 124 public health nurses participated in the training, 117 of which were allocated to the intervention group;182 public health nurses who did not participate in the training session were allocated to a control group. Homophobia scores had significantly decreased at post-test, and remained at that low level by the follow-up at 3 months (pre-test to post-test;p = 0.00, post-test to 1 month;p = 0.83, 1 month to 3 months;p = 0.64, pre-test to 3 months;p = 0.00). Confidence in dealing with MSM and recognition of MSM had significantly increased by post-test;these were also maintained by the follow-up at 3 months (pre-test to post-test;p = 0.0, post-test to 1month;p = 0.18, 1 to 3 months;p = 0.44, pre-test to 3 months;p = 0.0). Discussion: While the three-hour training session was short, it was effective for improving attitudes toward MSM and building confidence in dealing with them.

关键词： Men Who Have Sex with Men Public Health Nurse HIV Test Training

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