Objective: This study examined the effect of an educational intervention on public health nurses' attitudes and confidence in dealing with men who have sex with men (MSM). In Japan, HIV is primarily transmitted through sexual contact between men, and free HIV testing and counseling are provided by public health nurses. However, because of a lack of education, public health nurses do not often recognize the existence of MSM in daily life. Thus, improving public health nurses' understanding of MSM is crucial. Methods: This study used a quasi-experimental design to examine public health nurses' homophobia, confidence in dealing with MSM, and low awareness of MSM in daily life at pre-test, post-test, and 1 and 3 months follow-ups. The intervention comprised a 3-hour training session conducted between November 2012 and September 2013 in the Kinki region. Results: A total of 124 public health nurses participated in the training, 117 of which were allocated to the intervention group; 182 public health nurses who did not participate in the training session were allocated to a control group. Homophobia scores had significantly decreased at post-test, and remained at that low level by the follow-up at 3 months (pre-test to post-test; p = 0.00, post-test to 1 month; p = 0.83, 1 month to 3 months; p = 0.64, pre-test to 3 months; p = 0.00). Confidence in dealing with MSM and recognition of MSM had significantly increased by post-test; these were also maintained by the follow-up at 3 months (pre-test to 170post-test; p = 0.0, post-test to 1month; p = 0.18, 1 to 3 months; p = 0.44, pre-test to 3 months; p = 0.0). Discussion: While the three-hour training session was short, it was effective for improving attitudes toward MSM and building confidence in dealing with them.

Objective: To determine the perceived difficulties in providing HIV/AIDS services among public health nurses and to identify their correlates, we carried out a cross-sectional study in the Kinki region of western Japan. Methods: Structured self-administered questionnaires were distributed to all public health nurses in the region, and 1535 valid questionnaires were retrieved (valid response rate 78.7%). Results: More than half of the participants (52.8%) reported difficulties with HIV/AIDS services. The factors associated with perceived difficulties were having a negative attitude towards consultations on sexual matters (adjusted odds ratio [AOR] 2.2, p < 0.001), a perceived lack of encounters with homosexual people and people with HIV/AIDS during practice (AOR 1.6, p = 0.002 and AOR 1.8, p < 0.001), poor knowledge of sexual diversity (AOR 2.0, p < 0.001), lack of training in sexual diversity in public health nursing education (AOR 1.4, p = 0.016), and low permissiveness of the diversity of sexual behavior (AOR 2.0, p < 0.001). Conclusions: Overall, our results suggest that nursing and public health nursing education in Japan should cover sexual issues and HIV/AIDS in a more systematic way.