Awareness of sexually transmitted infections: Results from a survey on 10,000 people

Tokyo Sexual Health interview

Dr. Junko Tanuma
AIDS Clinical Cener
National Center for Global Health and Medicine (NCGM), Tokyo, Japan

Where do you usually get your information on sexually transmitted diseases? Who do you talk to about your sexual problems and questions?
Tokyo Sexual Health, a website providing information on sexual health, conducted a survey on awareness of knowledge about sexually transmitted diseases from 28 September to 11 October 2020 via LINE, Japan's largest communication application. We asked Dr Junko Tanuma of the National Centre for AIDS Treatment and Research (ACC), National Center for Global Health and Medicine, who led the survey, about what the survey found and the issues it revealed.

Less than half of respondents know that syphilis is increasing in Japan

-How was this survey on sexually transmitted diseases conducted?

Dr. Tanuma : Among registered LINE Research monitors, those aged 18-49 were invited to cooperate in a questionnaire. The responses of the 9,604 people who cooperated in the questionnaire were compiled and reported in the 'FY2020 Basic Project on AIDS Control Policy 'Summary of Research Results'' (Ministry of Health, Labour and Welfare).

-What did the survey reveal?

Dr. Tanuma : 81.6% of respondents had had sexual intercourse. This means that more than 80% of the respondents have had sexual intercourse, but less than half (45.1%) are aware that syphilis is increasing in Japan. Syphilis is diagnosed under the Infectious Disease Prevention Act, and the doctor who diagnoses the disease is required to report it to the public health centre. The number of syphilis cases in post-war Japan has been on the decline, with less than 1,000 cases reported annually since the early 1990s, but the number began to increase around 2011 and exceeded 7,000 in 2017. Some of these cases were very advanced by the time they reached the hospital, and some infants were infected from mother to child.
Research has shown that many people are still unaware that syphilis is increasing in Japan today.

What are your sources of information on sexually transmitted diseases and your awareness of condom use?

-There seems to be a lack of an environment for obtaining correct knowledge about sexually transmitted diseases.

Dr. Tanuma : Yes. In the survey, 42.3% of respondents said they had problem finding someone to talk to about their sexual problems and concerns.
When asked where they get their knowledge of sexually transmitted infections, the most common source was the internet (62.7%), followed by school lectures (34.7%). By age group, 'school lessons' (Male (66.0%), Female (67.7%)) was more popular than 'internet' (Male (49.4%), Females (52.7%)) among 18-24 year olds. This shows the importance of imparting correct information through sex education in schools and enabling people to be open to concerns about their sexuality.

-What about against the prevention of sexually transmitted diseases?

Dr. Tanuma : Condom use is important not only for contraception but also for preventing sexually transmitted diseases, but 33.6% of respondents to the survey said that they always use condoms during intercourse. Furthermore, only 7% of men and 10.9% of women said that condoms should always be used. However, by age group, the highest proportion of both men and women aged 18-24 years said that condoms should always be used, with men (11.4%)and women (17.2%) saying that condoms should always be used. Younger people seem to have a higher awareness of the need to use condoms properly.

On the other hand, there was a large difference by gender, with 17.4% of men and 2.8% of women agreeing that they would not have to use a condom if their sexual partner did not wish to. The tendency for men to think that there is no need to use a condom if their partner does not wish to. It was a common answer across all ages covered by the survey.

Condoms are an excellent contraceptive and have a low failure rate (2%) if used correctly. We urge people to use condoms during intercourse as it can also prevent sexually transmitted diseases.

Sexual health in Japan

-Please tell us about the mission of this website, Tokyo Sexual Health, and the importance of sexual health.

Dr. Tanuma : 'Tokyo Sexual Health' is a programme designed to prevent the increase of sexually transmitted diseases in the run-up to the Tokyo 2020 Olympic and Paralympic Games. Although the Games were closed to spectators due to the COVID-19, this programme was started to address the increased risk of the spread of various infectious diseases at mass gatherings over a certain period of time.

Therefore, we looked at what happened during previous Olympic and Paralympic Games: (1) there was no evidence of an increase in sexually transmitted infections during the Olympic and Paralympic Games, but (2) the Olympic and Paralympic Games have led to increased HIV prevention campaigns by initiatives related to sexually transmitted disease control and sexual health.

To combat HIV infection, the United Nations launched the Joint United Nations Programme on AIDS (UNAIDS) in 1996, which also works with the International Olympic Committee (IOC). The Olympic Charter's concept of 'Diversity and Inclusion' (meaning accepting and making the most of diversity) fights against all forms of discrimination and disparity. This is in line with UNAIDS' philosophy of developing a society where people can live together with LGBTQ community and other sexual minorities, HIV-positive people and other groups. The distribution of condoms in the Olympic and Paralympic athletes' villages is not just about contraception and preventing sexually transmitted infections in the athletes' villages, but also about raising awareness about the prevention of HIV infection and combating discrimination and prejudice against HIV positive people worldwide.

Data also showed that, although the number of sexually transmitted infections did not increase during the past Olympic and Paralympic Games, there was a temporary increase in the number of consultations on sexual problems. Some of the consultations include victims related to sexual violence.

In light of these, Tokyo Sexual Health was given the mission of strengthening sexual health in Japan and pursuing, from the user's perspective, the ideal system for consultation whenever they want to regarding sexual health problems.

We would like to create a system whereby people who have suffered sexual violence can receive total care at hospital emergency departments, not only treatment for injuries but also emergency contraceptives (after-pills), HIV prophylaxis, psychological care and support for police contacts and others. We also aim to deliver a portal site providing a range of information on sexual health.