Recreational drug use and related social factors among HIV-positive men in Japan.

This study aims to determine the relationship between recreational drug use in HIV-positive males in the past year and socio-economic factors and/or social support networks in Japan. A national online survey in a cross-sectional study was conducted by HIV Futures Japan project from July 2013 to February 2014. Of the 1095 HIV-positive individuals who responded, 913 responses were determined to be valid; responses from the 875 males were analysed. A total of 282 participants used addictive drugs (32.2%) in past year. New psychoactive substances were used by 121 participants (13.8%), methamphetamine or amphetamine by 47 (5.4%), air dusters/sprays/gas by 31 (3.5%), 5-methoxy-N,N-diisopropyltryptamine (5MeO-DIPT) by 16 (1.8%) and cannabis (1.0%) by 9. Multiple logistic regression analysis was performed with the use of alkyl nitrites, addictive drugs, air dusters and thinners, which are low illegality, as dependent variables. We found that the odds ratio (95% confidence interval) for use among participants with full-time and temp/contracted/part-time employees compared to management/administration professions were 2.59 (0.99-6.77) and 2.61 (0.91-7.51). Also, a correlation was observed between alkyl nitrites and new psychoactive substances and usage rates in people engaged in few HIV-positive networks. It is necessary to develop targeted policies for drug use prevention and user support among HIV-positive men and to support and provide care for drug users who are isolated or have a narrow HIV/AIDS support network.

[A survey comparing the route of HIV transmission reported by patients to their physicians and the self-reported "actual route"].

OBJECTIVES: To clarify the proportion of HIV patients who inform their physicians of the actual route of transmission and the factors related to non-disclosure in order to improve conditions to support open disclosure in healthcare settings. METHODS: We conducted an anonymous self-completed online questionnaire between September and December 2010 of people with HIV. The data from 237 subjects living in Japan were analyzed. To identify factors causing patients to not be truthful to their physicians, odds ratios and confidence intervals (CIs) were calculated, with "discrepancy between the actual route of HIV transmission and the route reported to the physician' as a dependent variable, and sex, age, residential area, route of transmission, presence or absence of consent to undergo HIV testing, time since being diagnosed as infected with HIV, and favorability of physician responses as independent variables. RESULTS: The proportions of patients who had informed their physicians of actual and false routes of HIV transmission were 75.1% and 17.7%, respectively. Among subjects reporting homosexual contact, 97.5% reported the actual route. On the other hand, among subjects reporting heterosexual contact, only 64.3% reported the actual route while 28.6% actually had homosexual contact. Furthermore, 47.4% of the subjects who reported their routes of HIV transmission as sexual contact, but did not disclose whether the contact had been homosexual or heterosexual, actually had homosexual contact. On comparing subjects who had evaluated responses from their physicians favorably and unfavorably, the proportion of those reporting a false route of transmission was significantly higher in the latter group, with the odds ratio being 2.51 (95% CI: 1.26-5.01). CONCLUSION: AIDS Surveillance Committee reports of HIV and AIDS cases attributed to a homosexual route of infection may be lower than actual numbers. The most common factor related to non-disclosure was the perception of unfavorable responses from physicians; improvements to support open disclosure are thus needed.

Socioeconomic Status and the Sense of Coherence among Japanese People Living with HIV.

People living with HIV (PLWH) are forced to live with multiple and severe stressors. Focusing on sense of coherence (SOC), which is a concept of salutogenic and stress coping capacity, is useful in PLWH support. This study aimed to examine the association between SOC and socioeconomic status (SES) for Japanese PLWH. Methods: This study used data from the HIV Futures Japan national survey, which is an online survey with a cross-sectional design. This survey of PLWH in Japan was conducted from July 2013 to February 2014 and December 2016 to July 2017, resulting in 1422 valid responses. The mean age (SD) was 38.6 years (8.3). The 13-item SOC scale score was divided into two groups, based on Japanese standard score in a previous study, and logistic regression analysis was performed. Results: Education levels were indirectly associated with SOC through occupation. Compared to freelance-profession/self-employed, "unemployed job seekers" (OR [95%CI] = 2.16 [1.16, 4.04]) and "homemaker/recuperating/student" (2.09 [1.09, 4.02]) were directly related to poor SOC, regardless of income. Also, there is a clear SOC disparity in income (compared to ">8 million yen/year", "<1 million yen/year" was 2.94 [1.46, 5.92], and "1−2.99 million yen/year" was 2.49 [1.33, 4.68]). Conclusion: It became clear that there is a relationship between SOC and SES. The results of this research provide important evidence for health promotion measures for PLWH.