. Finally, we extend our thanks to the reviewers who provided helpful and constructive comments on an earlier version of this manuscript. ABSTRACTIn the UK and Japan there is concern regarding rising rates of annual new HIV infections among Men who have Sex with Men (MSM). Whilst in the UK and Europe, gay businesses are increasingly recognised 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 to Japan. A series of expert workshops were conducted in Tokyo, Nagoya, and Osaka with intersectoral representatives from Japanese and UK non-governmental organisations (NGO), gay businesses, universities, and gay communities (n=46). Further discussion groups and meetings were held with NGO members and researchers from Nagoya City University who realise the Ministry of Health, Labour and Welfare's Research Group on HIV Prevention Policy, Program Implementation and Evaluation among MSM (n=34). 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 developed 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.Key words: HIV prevention; MSM; Japan; intersectoral collaboration Word count: 7,167 words (5,665 for text body, 245 for abstract, 952 for references, 121 for acknowledgements; 2 Tables; 1 Figure)

Background: In Japan, most new HIV cases are reported amongst men who have sex with men (MSM); thus, there is an urgent need for further widespread testing of MSM. The use of Digital Vending Machines (DVM) in the UK offering HIV test kits targeting MSM show promising results. Digital Vending Machines could be useful to promote and increase the uptake of testing in Japan, although no studies have yet been conducted. We aimed to assess the acceptability and feasibility of distributing HIV test kits using DVMs exploring needs and concerns as well as preferred types of test kits and locations. Methods: Fifty-four individuals participated in workshops and meetings with a further 224 MSM answering a quantitative survey assessing HIV testing and prevention needs. Results: Amongst MSM who had never been tested, 73% showed willingness to purchase tests from DVMs. Responses were broadly positive about DVMs but there were concerns regarding being seen receiving test kits from the machines and linkage to confirmatory testing and appropriate care. Conclusions: Using DVMs to distribute HIV test kits in Japan was found to be both acceptable and feasible and may have the potential to increase access to testing for MSM. Future large-scale evaluation studies are required.

The number of HIV-1-infected men who have sex with men (MSM) Mongolian patients started to increase steeply just before 2011. We started collaborative work with community-based organizations that promote safer sex and HIV testing for MSM since mid-2010. Since early 2013, the Mongolian Government has implemented the treat-all strategy for MSM. To determine the efficacy of these countermeasures, we established an MSM cohort in the capital of Mongolia, Ulaanbaatar, in December 2013. HIV antibody was examined at every visit by rapid test. Syphilis was also examined to monitor their sexual behavior. Clients positive for either rapid test were referred to the National Center for Communicable Diseases, Ulaanbaatar, to confirm the results and treatment. Since safer sex promotion is one of the purposes of this cohort, HIV-positive clients were also eligible to participate. A total of 849 MSM were registered and 2,409 HIV/syphilis tests were conducted until December 2017. During this period, 499 (58.8%) clients visited the testing sites repeatedly. Among the 849 clients, HIV-1 infection was confirmed in 83 at registration (prevalence of HIV-1: 9.8%). One HIV-1 seroconverter was identified (from negative to positive), resulting in incidence of HIV-1 of 0.10/100 person-years (PY). Syphilis was positive in 144 cases at registration (syphilis prevalence: 17.0%), and 53 new syphilis infection cases were diagnosed during the same period, with an incidence of 5.66/100 PY. Despite the high prevalence of HIV-1, the incidence was very low. The results suggest that countermeasures for HIV-1 prevention seem effective in this cohort, however, we still need further strategies for syphilis control.