Abstract
Studies of men who have sex with men (MSM) in diverse geographic and cultural contexts have identified health challenges affecting this population. MSM might be particularly vulnerable to sexual victimization and forced sex. The aim of this research study was to examine prevalence of sexual victimization and correlates of forced sex among Japanese MSM. We recruited a sample of 5,731 Japanese MSM who completed an internet-administered survey. Participants reported on history of different types of sexual victimization, unprotected anal sex, other health risk behaviors, exposure to gay-related teasing and bullying, depression, and suicidality. Over one-fifth of the sample (21.4%) reported experiencing at least one form of sexual victimization, and 8.7% reported a history of forced sex. MSM who had ever experienced forced sex were significantly more likely to report experiencing psychological risks (depression OR = 1.55, 95% CI = 1.28–1.89; attempted suicide OR = 2.25, 95% CI = 1.81–2.81; other forms of bullying OR = 1.38, 95% CI = 1.13–1.68) and other behavioral risks (unprotected anal sex OR = 1.56, 95% CI = 1.29–1.90; sex venue attendance OR = 1.27, 95% CI = 1.04–1.54; methamphetamine use OR = 1.57, 95% CI = 1.05–1.36), compared to MSM who had not experienced forced sex. Efforts to develop holistic and integrated health services for Japanese MSM are warranted, particularly related to psychosocial determinants of HIV prevention. However, due to cultural factors that emphasize familial and social relations and that stigmatize same-sex behavior, Japanese MSM might experience challenges to seeking social support and health services. Interventions must be provided in safe and non-judgmental settings where Japanese MSM feel comfortable disclosing their health and social support needs.
Highlights
There have been an increasing number of studies examining health and psychosocial risk factors affecting men who have sex with men (MSM) [1]
5.3% identified as HIV-positive, 48.7% reported having unprotected anal sex in the past six months, 52.6% had visited a sex venue in the past six months, and 3.7% had ever used methamphetamines
MSM who had ever experienced forced sex were significantly more likely to report experiencing psychological risks and other behavioral risks compared with their peers who did not experience forced sex. These cross-sectional findings suggest that assessing for sexual victimization and addressing the consequences of forced sex might be an important component of clinical screenings or public health interventions related to HIV prevention and mental health services for MSM in Japan
Summary
There have been an increasing number of studies examining health and psychosocial risk factors affecting men who have sex with men (MSM) [1]. Much of this attention has focused on disproportionate HIV prevalence among MSM across international settings [2,3,4]. Some of the documented health challenges among Japanese MSM include HIV risk [10], drug use [11], and suicidal ideation and attempted suicide [12].
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