Abstract
This study examined the prevalence and factors associated with inconsistent condom use among men who have sex with men (MSM) who use gay mobile geo-social networking applications (gay mobile apps) in Greater Tokyo. Among a sample of 1657 MSM recruited through advertisements on gay mobile apps, inconsistent condom use was reported by over one-third (37%) of participants with regular male partners, 18% with casual male partners, and 20% with female partners. In multiple regression analysis, inconsistent condom use with both regular and casual male partners was more commonly reported among participants without a university education, and among participants reporting lower self-efficacy for safer sex. Inconsistent condom use with casual male partners was more commonly reported among participants living in the central 23 wards of Tokyo. Inconsistent condom use with regular male partners was more commonly reported among participants who identified as a member of the gay community, and who only had male partners. These results indicate that a substantial proportion of Greater Tokyo gay mobile app users use condoms inconsistently, particularly with regular partners, and may be at risk for HIV. This paper provides useful information to help design tailored strategies to reduce inconsistent condom use.
Highlights
men who have sex with men (MSM) are estimated to make up between 2.87% of the male population [1] in Japan, but accounted for 72.7% of HIV cases between 2011–2015 among Japanese nationals [2]
Condom use is an important determinant of HIV incidence among MSM, and to our knowledge, this is the first study to examine the correlates of inconsistent condom use among gay mobile app users in Japan
Inconsistent condom use with casual male partners was more commonly reported among participants without a university education, those living in the central 23 wards of Tokyo, and among participants reporting lower self-efficacy for safer sex
Summary
MSM (men who have sex with men) are estimated to make up between 2.87% of the male population [1] in Japan, but accounted for 72.7% of HIV cases between 2011–2015 among Japanese nationals [2]. MSM likely account for a greater proportion of HIV and AIDS cases in Japan than surveillance suggests due to underreporting of homosexual transmission [3]. MSM-related HIV surveillance in Japan faces a variety of difficulties including a lack of sustainable financing and limited researchers [4], while MSM uptake of prevention services is hindered by community stigma, Japanese heteronormative cultural values expecting marriage and children, and the limited experience and knowledge of the specific prevention needs facing MSM among health workers [3]. Public Health 2018, 15, 2815; doi:10.3390/ijerph15122815 www.mdpi.com/journal/ijerph
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