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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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