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9 YInoue et al :Medical Sta# s Support for Sexual Health of People with HIV in Japan +, -. / / HIV : +/ HIV : + WHOQOL Group : The World Organization Quality of Life Assessment (WHOQOL) : development and general psychometric properties. Social Science & Medicine.0, +/03 +/2/, +332., Schiltz MA : HIV-positive people, risk and sexual behavior. Social Science & Medicine /*, +/1+ +/22,,***. - Inoue Y, Seki Y, Wakabayashi C, Yamazaki Y, Kihara M:Sexual activities and social relationships of people with HIV in Japan. AIDS Care +0, -.3-0,,,**... World Health Organization : Education and Treatment in Human Sexuality : the Training of Health Professionals Report of a WHO Meeting. Technical Report Series /1,, / --, +31/. / Robinson BE, Bockting WO, Rosser BRS, Miner M, Coleman E : The sexual health model : application of a sexological approach to HIV prevention. Health Education Research +1,.- /1,,**,. 0 Margolis AD, Wolitski RJ, Parsons JT, Gomez CA : Are healthcare providers talking to HIV-seropositive patients about safer sex? AIDS +/,,--/,--1,,**+. 1 Marks G, Richardson JL, Crepaz N, Stoyano# S, Milam J, Kemper C, Larsen RA, Bolan R, Weismuller P, Hollander H, McCutchan A : Are HIV care providers talking with patients about safer sex and disclosure? : A multi-clinic assessment. AIDS +0, +3/- +3/1,,**,. 2 Lofland J, Lofland LH : Analizing Social Settings : A Guide to Qualitative Observation and Analysis. Belmont, Wadsworth Publication, +33/. 3 :,**-. +* Cresswell JW : Qualitative Inquiry and Research Design : Choosing among Five Traditions. London, Sage Publications, HIV Prevention in Clinical Care Working Group : Incorporating HIV prevention into the medical care of persons living with HIV. Morbidity and Mortality Weekly Report /,(RR-+,), +,-,,**-. +, Pakenham KI : Specification of social support behaviours and network dimensions along the HIV continuum for gay men. Patient Education and Counselling -., +.1 +/1, : -3 /12 / : /3 / /. +/ : : -3 /3, / American Cancer Society : Sexuality and cancer : for the man/women who has cancer, and his/her partner. Atlanta, American Cancer Society, , 10

10 The Journal of AIDS Research Vol. 0 No. -,**. Medical Sta# s Support for Sexual Health of People with HIV in Japan Yoji INOUE +, Michiko MURAKAMI,, Mina ARIMA -, Keiko ICHIHASHI., Toshiko OHNO /,Yasuyuki YAMAMOTO +, Aikichi IWAMOTO / and Masahiro KIHARA + + Department of Community Health Nursing, School of Nursing, Chiba University, Chiba, Research Hospital, Institute of Medical Science, University of Tokyo, Tokyo - Tokyo Metropolitan Komagome Hospital, Tokyo. Doyama Home-visit Nursing Station, Osaka / Department of Nursing, Hokkaido University Hospital, Sapporo 0 Department of Laboratory Medicine, Tokyo Medical University, Tokyo 1 Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo 2 Department of Global Health and Socio-epidemiology, School of Public Health, University of Kyoto, Kyoto Objective :To clarify the state of support provided by medical sta# for the sexual health of people with HIV (PWH), and related factors. Methods : Four focus-group discussion sessions and two semi-structured interviews involving members of the medical sta# directly involved in the support for sexual health of PWH, were carried out in September and October,**-, and the data obtained were analyzed. Results :The data suggests that the sta# members recognized the importance of supporting for sexual health of PWH, but that they also considered the actual support to be insu$cient. As factors related to this state, the following / points were categorized : +) Lack of confidence and hesitation in providing support for sexual health,,) shifting between the position of a medical professional and that of an unbiased person, -) diversity of the contents for consultation regarding sexual health,.) patients selecting suitable consultants from among the medical sta# members, and /) inadequacy of the team care system for providing support for sexual health. Conclusion :These factors are considered to be based on the facts that there is no consensus among those involved in giving care, either in- or outside of the hospitals that medical sta# should provide support for the sexual health of PWH, and that few medical facilities have announced to patients that they can provide consultation concerning their sexual health. Such a situation urgently requires correction. Key words : people with HIV, quality of life, sexual health, medical sta#, support +2-11