title: Prevalence of sexual victimization and correlates of forced sex in Japanese men who have sex with men.
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.
authors.affiliation: Takarazuka University School of Nursing, Osaka city, Osaka, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Hidaka
authors.affiliation: Brown University School of Public Health, Providence, Rhode Island, United States of America.
authors.forename: Don
authors.initials: D
authors.lastname: Operario
authors.affiliation: Japanese Foundation for AIDS Prevention, Osaka city, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuji
authors.affiliation: Kansai AIDS Council, Osaka city, Osaka, Japan.
authors.forename: Mie
authors.initials: M
authors.lastname: Takenaka
authors.affiliation: Health and Social Welfare Bureau, City of Yokohama, Yokohama city, Kanagawa, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kimura
authors.affiliation: Keio University Graduate School of Health Management, Fujisawa city, Kanagawa, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kamakura
authors.affiliation: Nagoya City University School of Nursing, Nagoya city, Aichi, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Ichikawa
mesh_terms: D000293:Adolescent; D000328:Adult; D019548:Crime Victims / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012742:Sex Offenses / Q000523:psychology*