Contents:
Whilst in the UK and Europe, gay businesses are increasingly recognized as being important settings through which to deliver HIV prevention and health promotion interventions to target vulnerable populations; in Japan such settings-based approaches are relatively underdeveloped. This article draws on qualitative data from a recently completed study conducted to explore whether it is feasible, acceptable and desirable to build on the recent European Everywhere project for adaptation and implementation in Japan.
The results showed that it is desirable, feasible and acceptable to adapt and implement a Japanese version of Everywhere. Such a practical, policy-relevant, settings-based HIV prevention framework for gay businesses may help to facilitate the necessary scale up of prevention responses among MSM in Japan.
Given the high degree of sexual mobility between countries in Asia, there is considerable potential for the Everywhere Project or its Japanese variant to be expanded and adapted to other countries within the Asia-Pacific region. HIV infection globally continues to be a public health burden with 35 million These subpopulations are more at risk of acquiring and transmitting HIV infection than others. The most recent data available for indicates that the total number of Japanese new male HIV diagnoses in was , In Central Europe, although the HIV epidemic is relatively low and stable, increasing transmission through male-to-male contact is evident.
Mirandola et al.
In this article, we focus on a recent collaboration between the UK and Japan to explore HIV prevention frameworks for MSM, and specifically on developments related to the European Everywhere project; which was a 2 year multi-partner pilot project co-funded by the European Commission between and The present collaboration involved conducting a qualitative feasibility study in order to scope the potential for adapting the Everywhere HIV prevention framework to Japanese contexts.
Comprising 17 partners from eight European countries, the overarching objective of the Everywhere project was to develop and pre-test a culturally adaptable settings-based European framework of HIV prevention targeting MSM through 'gay' businesses that would be common amongst partner countries.
We thus focus on sexual practices rather than identities. MSM, heterosexual, lesbian, transgender etc. Three central tenets underpinned the project and its working practices: firstly, and theoretically, Everywhere embraced the settings approach to health promotion which recognizes that health is created and lived by people within the settings of their everyday life such as where they work, learn, play, love, and age WHO, In other words, strategies and interventions addressing global health threats that have a cross-border impact, such as HIV, need to include an international dimension cooperation of multiple countries to maximize potential efficacy.
In Everywhere, the project was designed specifically to operate at local, national, and European levels. In Everywhere, the partner consortium comprised representatives from each of these key sectors. Detailed findings as well as descriptions of how the project functions are reported elsewhere e. Hernandez et al. Business types included sex venues e. The Everywhere prevention standards were developed via a comprehensive consensus-building process over 30 months. In practice, representatives from local gay NGOs experienced in conducting outreach with gay businesses were trained to use social mediation techniques to initiate dialogues, build relationships and if possible facilitate agreements concerning HIV prevention activities with gay businesses in each partner country.
In doing so, branded condoms and lubricants as well as other prevention and marketing materials were distributed to businesses and their customers. Evidence from the project's internal evaluation process and immediate outcome evaluation including the pilot action; see Pottinger et al. Evaluation data suggested that for European businesses, the project was acceptable because there were potential benefits in being certified with the ESA which were economic e. For European NGOs, data indicated that one of the key benefits in terms of feasibility was that Everywhere provided an overarching framework for existing HIV prevention and health promotion activities targeting MSM.
In other words for NGOs, a core condition that made the project feasible was that implementation of the Everywhere framework did not considerably increase the work already being done as most were already conducting outreach to gay businesses in some capacity. Everywhere activities provided a coherent structure for achieving existing outreach commitments, as well as extending and deepening relationships with businesses e.
Moreover, both in the UK and Japan, community development approaches have been a dominant feature of HIV prevention efforts and strategies, as well as collaborations between gay communities and commercial gay venues in addition to other stakeholders. In Japan, however, the mobilization of a response to HIV has been somewhat slower and followed a different trajectory compared with the UK and other Western European countries.
Historically, the gay community in Japan has comprised small sporting and cultural groups. Whilst gay community organizing and involvement in HIV prevention is increasing, the numbers remain small. There are various likely reasons for this such as high social stigma and the negative consequences of identifying openly as gay, as well lower levels of community organizing more broadly Hidaka, ; Pekkanen, ; see also McLelland, However, the impetus and gay community response since in Japan has nevertheless been impressive.
Relatively small and isolated outreach activities with commercial gay venues conducted in Osaka in and Tokyo in now extend to seven prefectures across Japan Miyagi, Tokyo, Aichi, Osaka, Ehime, Fukuoka, and Okinawa. In each region, an NGO has been established to work with gay communities using a community development model that encourages gay individuals and groups to carry out education and support programmes developed by and for them, but with input from public health and other professionals.
Additional centres were subsequently opened in Nagoya , Fukuoka and Sendai and Naha Each NGO through its respective community centre, provides free and anonymous information about HIV, HIV testing and support services including materials on safer sex, as well as conducting art and cultural events e. Specifically, the establishment of community centres has been critical in creating cultural and social spaces for MSM to meet and engage, and access testing, materials, and information.
Therefore, securing appropriate resourcing remains an urgent problem to be solved to ensure that prevention activities are sustained.
Only Lads is a great place to meet hot gay and bi guys in Nagoya. If you're looking for free gay dating or gay chat in Nagoya, then you've come to the right place! Join today and join the worlds biggest gay and lesbian scene! If you want friends, chat or free dating in Nagoya, then One Scene is the community for you!
Despite the very different pace of mobilization internationally, there remain a number of conditions in Japan which make the Everywhere concept appealing and favourable to implementation: i Japanese surveillance data, like the UK and Europe, indicate rising HIV among MSM in regional areas as well as large cities indicating local, intra-regional and international approaches to HIV prevention are needed; ii operationalization of the Everywhere framework requires intersectoral collaboration among the relevant sectors, but particularly between NGOs, gay businesses, and PHAs. In Europe and in Japan, the need for such intersectoral working for effective HIV is recognized and established; iii from a systems perspective, low resourcing for community-based HIV prevention activities means that it is important to consider opportunities to maximize processes, outputs and outcomes whilst minimizing inputs.
Thus, embracing approaches that are able to help different sectors to achieve their different goals despite very different agendas, is invaluable. These provided invaluable contextualization, clarification and detail where required. Summary of workshops and discussion groups held in Japan during January—June Moreover, the workshops meant it was possible to explore in detail the complexities of implementing the Everywhere project in Japan including likely facilitating and inhibiting factors e.
The design of the workshops followed focus group interviewing methods as outlined by Liamputtong Liamputtong, , Workshops were facilitated to generate ideas and opinions from participants, and given that the facilitators were known to participants, rapport and trust had already been established. Although ethical approval to conduct the workshop series was not required, ethical consideration for the project upon which the work was based was received from the chair of the ethics and governance committee at the UoB.
Across all workshops and meetings, the Chatham House rule was discussed, agreed and applied; that is, anonymity was assured and participants were free to speak knowing comments made would not be attributed to them either by name or in any way that could be traced back to them. In consultation with workshop participations, it was decided that discussions would not be audio recorded as it was felt strongly that dialogue would be freer and more honest if they were not recorded.
Consequently, for each workshop, discussions were transcribed by hand by a combination of three authors NK, MT, SS who then compared notes to produce a single agreed transcript of each workshop with the assistance of NK, SI, and NS. To enhance credibility of the analytical process, the data were also analysed by the third author NK and all themes discussed with the other authors to achieve consensus. Findings were sent to all participating Japanese NGOs; two of these organizations subsequently provided feedback which was incorporated into the final analysis.
The results presented in this article thus represent a summary of findings from the series of workshop discussions and where necessary, outcomes from the additional discussion groups and meetings held prior to, and following, the workshops , including a description of the major themes that emerged based on a detailed analysis of the transcripts. Analysis revealed the emergence of three broad themes as follows including: facilitating and prohibiting factors to implementing Everywhere in Japan e.
Data revealed a number of facilitating factors regarding the acceptability and feasibility of implementing Everywhere in Japan.
Perhaps most importantly was the strong expression of interest from the communities represented in the workshops, namely, MSM, business owners gay saunas and gay NGOs. There was broad agreement across the three workshops that many NGOs across Japan already have a firm foundation for conducting outreach activities with businesses e.
Everywhere partner countries in Europe. Furthermore, and linking closely with the following theme, the transferability of the project e. However, there were considerable cultural differences identified in the workshops that indicate some adaptability is required in transferring Everywhere to the Japanese context. During the Osaka workshop, important discussions occurred regarding the availability and provision of lubricants.
In Europe, condom wallets are given out by the NGOs implementing Everywhere which contain both a condom and sachet of lubricant. There is strong feeling amongst European NGOs that to not give out lubricants with condoms is irresponsible; partly because if it is not available, MSM may use other unsafe means such as oil based lubricants e.
In practice, therefore, condoms and lubricants are generally not available or distributed together as they are in the UK and Europe. To circumvent this, some Japanese MSM carry their own water-based lubricants with them to venues but some still use other inappropriate substances such as oil-based lubricants.
In terms of inhibiting factors regarding the acceptability and feasibility of implementing Everywhere in Japan, an issue raised by participants across all three workshops was the issue of strong cultural values and related stigma and discrimination. This manifests itself more broadly, to a lack of community capacity locally and nationally across Japan. Stigmatization of sexual minorities historically resulted in a slow response to the epidemic compared to many Western European cultures, and continues currently to result in very low levels of financial support from Japanese local and national governments for HIV prevention activities conducted by gay NGOs.
It is therefore likely that significant political lobbying for financial support as well as capacity building work with local Japanese NGOs and community centres will be required prior to any attempt to implement the Everywhere framework. Workshop discussions revealed that participants felt the international dimension of the Everywhere project was important not just in Japan itself e. For example, participants reported that in Okinawa MSM tourists are often from Shanghai and Beijing China , in Osaka there are many Korean-Japanese but only a handful of bars targeting foreign nationals, whilst in Kyoto there are a greater number of foreign targeted bars which is relatively unusual in Japan.
In other words, an Everywhere certified business and its customers in Tohoku would still potentially benefit because the standards upheld by the business would be compatible with other certified businesses both locally and across Japan. With appropriate marketing, this would allow MSM from the region to know which businesses have prevention materials and information available both in Tohoku and other cities.
A key issue discussed across all three workshops concerned the practicalities of how, where, and when Everywhere or its Japanese variant could be implemented and sustainably managed. For example, consistent across the workshops, discussions centred on the different types of gay businesses in Japan and Europe such as bars, discos, shops, cinemas, cafes, saunas and so on and the potential implications for NGOs commencing Everywhere activities.
In Japan, workshop participants reported that although most venues with saunas as the exception did not have dedicated sex spaces such as dark rooms mostly due to size , they were nonetheless places for MSM to meet and go elsewhere for sex. In the Osaka workshop, participants felt that given there were many gay bars and shops where sex on site is not possible but relatively fewer sex venues such as gay saunas where sex on site is possible , the former might be the best place to start Everywhere activities and then move on to the latter once the scheme becomes more established.
However, this view was not unanimous; in Sendai Miyagi prefecture , for example, the NGO representative felt that given their existing positive relationship with the two gay saunas, these venues would be the best place for them to begin Everywhere. There was broad agreement across the three workshops that the benefits of adopting the Everywhere framework would be maximized if all major cities in Japan participated and collaborated nationally at the same time.
It turns the most casual riffler into a reader with its knowing commentary on various gay issues and evocative descriptions of various gay scenes and areas. Utopia's mission for the last 12 years has been to promote positive alternatives to the sex industry.
We do not advertise gogo bars, prostitutes or porno. We do hope you will explore the wonderful variety of gay places available in The Land of Smiles. The Utopia Guide to Thailand is stuffed with information about Thai venues where you can meet local gays and lesbians on a friendship basis. Click here to join our mailing list. Expanded Second Edition of the first ever travel guide to gay and lesbian life in Malaysia. Expanded Second Edition of the first ever travel guide to gay and lesbian life in Singapore.