This is the English translation of brochure describing
outcomes of the study involving people living with HIV in Japan.

When a close friend
wants to talkabout drugs
This pamphlet provides guidance about what to dowhen a special person in your life asks about drugs.
It introduces background information for drug use situations
and explores drug use for mental health,physical health, and stressful conditions in life.

Catalyst for starting to use drugs
The main catalysts (Survey C results) are listed below.
Anyone could experience these situations.
Out of curiosity...

aave,
gs h
Dru y image readtren friends .
ymthemandingsu
also

I'm noas m t as coolyand
I jus friends,twalon
g wit ant to goh them.

“I started using drugs because I wanted
to get along with everyone, and before
long, I used up my disposable income
and living expenses. And before I knew
it, my friends had disappeared.”

To lift one's mood...

Invited by someone...
kee I li toeone
Som aged m ausecourd be ,nenca,sted .
drug interes
usethems
I wa d using
rteatsI,rugs ffose dn I u y mindehWmgs.
keep nt thinnaaIcleasunp

A deprescanbe b sed moo
in a rushed dn instan offt.

You
feel will
good.

“The intention was to enjoy
sex, but before I knew it, drugs
became the main course.”“Before I started using drugs,
I worked hard, but in the end
I lost my job due to drugs.”

Usage status of drugs
A survey (Survey A) of HIV-positive personsrevealed that 55.0% of the respondents had
experienced using some form of drug (used in thepast year, plus have used in the past).
For those who used drugs in the past year andprior years, 51.2% used Rush, 32.3% used erectile
dysfunction drugs, 25.6% used 5MeO-DIPT, 17.3%
used quasi-legal drugs, and 11.1% usedstimulants.
For those who used drugs in the past year only,
14.5% used erectile dysfunction drugs, 10% used
Rush, and 4.8% used stimulants and 4.8% usedquasi-legal drugs.

According to the survey, the number of
respondents who started drug before an HIV
diagnosis is greater than those who started afteran HIV diagnosis.
Also, the survey shows clear evidence that drugs
are often use in conjunction with sex. So, we cansay that drug use is a health issue, as well as it is
an issue that people often encounter in theprocess of developing relationship, such as dating
and romantic relationship.
*Among the drugs mentioned here, 5MeO-DIPT, Rush, and somequasi-legal drugs (dangerous drugs) were unregulated until 2005, 2006 and2014 respectively.

HIV-positive persons and drug usage

What proportion of persons are using drugs?
Rush

10.0

HIV-positive persons as a whole

Erectile
dysfunction drugs

41.2

14.5

5MeO-DIPT

0.5

Quasi-legal drugs

4.8

Stimulants

17.8

20.9%

12.5

2.3

8.8

Gas

0.8

9.1

Cannabis

0.4

9.0

MDMA

0.4 5.3

Thinner

0.1 2.5

Cocaine0.1 2.0

HeroinUsed in thepast year

25.1
Have never used

45.0%

34.1%

Used in the past year
Used in the past

0.2 0.60.0(n=1,084)

Multiple responses（n=1,083）

0.0 0.6

Other

Used in the past

10.0

20.0

30.0

40.0

50.0

60.0（%）*The responses for erectile dysfunction drugs are thought to include drugs obtained online or from other persons,in addition to drugs prescribed by doctors.

At what kind of times are drugs used?
HIV-positive persons
who have experienced using drugs

When having sex

18.2（n=451)

When wanting to liftoneʼs mood

65.7

8.0

（Survey B n=163)

0.0

43.6
10.0

20.0

83.9
Used in the past year

51.6

30.0

40.0

50.0

60.0

Used in the past70.0

80.0

90.0（%）

Timing of using drugs for the ﬁrst time
5MeO-DIPT/cannabis/stimulants/
MDMA/heroin/cocaine

81.9

13.1 5.0

85.9

6.2 7.8（n=337)

quasi-legal drugs/Rush/gas/thinner（n=562)

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0（%）

Before HIV diagnosis
After HIV diagnosis
Unsure of timingImpact of drug usage
Drug usage and mental healthHas experienced
using drugs（n=585）

48.7

No experience inusing drugs（n=469）

36.4

62.3

0.0

10.0

K6 score:

20.0

30.00 to 4

14.9

27.9
40.0

50.0

5 to 1260.0

Drug usage and HIV infection

70.0

80.0

9.8
90.0

100.0（%）

13 or more

According to the K6 scale which measures the level of mental health, those
who had used drugs tended to have poorer levels of mental health comparedto those who have not used drugs.
*On this scale, the higher the score, the poorer the mental health. A score of 5 or moreindicates that the person has some kind of mental burden, while a score of 13 or moreindicates a high possibility of a serious problem. Cut-oﬀ value: 5/13

When using drugs during sex, condom use
tends to become more diﬃcult. This makes
the users more susceptible to infection byHIV, as well as HCV (Hepatitis C virus) andother sexually-transmitted infections. It wasalso reported that the use of drugs is linked
to interruption of outpatient treatment forHIV. Furthermore, care is required as anumber of drugs may cause severe
side-eﬀects when they interact with themedicine used to treat HIV.

Consultation status and information sought
HIV-positive persons who are using drugs actually consult more with close friends,partners and HIV-positive acquaintances more than counsellors.
Also, they responded that they need the following kinds of information.

Who do users consult with?

FriendInformation needed about drugs
Basic information
about drugs

43.5

HIV-positive persons who have experienced using drugs

Partner/lover/husband/wife

The relationshipbetween
HIV and drugs

19.3

HIV-positive
acquaintance

13.7

Medical staﬀ providing
HIV treatment

3.5

Psychiatrist/neurologist

3.5

Online acquaintance

3.0Group of drug users(NA, DARC, etc.)

2.1

Volunteer/
patient support group

1.7

Medical institution
specializing in drugs

1.4

Mental health andwelfare center

0.3

Health care center

0.2

24.1

Consultation with a friend,
partner, family, etc.,
regarding drug use

9.6

No information/counsellingneeded in particular

30.4
0.0

10.0

20.0

30.0

40.0

50.0（%）

Multiple responses（n=572）

Have never discussed or
consulted with anyone

45.2
0.0

39.5

Methods andsupport services
for quitting drugs

8.3

Parent/sibling/relative

45.6

10.0

20.0

30.0

40.050.0（%）

Multiple responses（n=575）

Will use/not use in the future?
Intention of persons who used drugs in the past year (20.9%) to continue use in the future
I want to use more

2.0%

I quit alreadyI wantcontinue
using as is

37.0%

24.0%

I want to quit

24.0%

I want to use less

13.0%

Survey B (n=54)

As someone close to a user,
what can you do to help?
One thing you can do is help direct him/her toseveral places where he/she can talk about it.
These places include specialist clinic and self-helpgroups, such as NA where groups of users canprovide mutual support for their recovery. In addition,
users can consult with Mental Health and Welfare
Center or Health Care Center in each municipality.
The friends of many users can see there is an issue,
yet the user thinks he/she is OK. It is still importantto give information about the places where help isavailable. The information can be used when theusers ﬁnally acknowledged the need for help.
If you are confused or anxious about what to do,telephone counselling can be useful for sorting out
your feelings. There are various counsellingorganizations available. A good way is to try a few
of the services to ﬁnd out what suits you.

Organisations, groups and counselling services that are available in your area
“Drug OK talk” http://www.ok-talk.com/

Telephone counselling for drug addiction (☎06-6320-1196/ Sat 3 p.m. to 7 p.m.)“For persons who are concerned
about drug issues in the family”
http://www.ncnp.go.jp/nimh/yakubutsu/drug-top/data/family/H25.family̲all̲date.pdf“Narcotics Anonymous Japan（NA Japan）” http://najapan.org/“HIV map” http://www.hiv-map.net/

Hotline for discussing anything about drugs (☎090-4599-6444/ Wed, Fri 12 p.m. to 6 p.m.)“Freedom” http://www.freedom-osaka.jp/

Self-help group where users can provide mutual support for their recovery“Nar-Anon” http://www4.ocn.ne.jp/~nar633/

Self-help group for family or friends of persons who have drug issues“Japan DARC headquarters” http://www.darc-dmc.info/
Inpatient admission/outpatient-type drug rehabilitation facility

See the website below for more detailed information.

“Futures Japan” http://futures-japan.jp/“PLACE TOKYO” http://www.ptokyo.org/
Counselling services for HIV-positive persons

These services are available in Japanese.

“Website for supporting people living with HIV in regional communities”
Contact: #403 Sanko Heights, 4-11-5, Takadanobaba, Shinjuku-ku, Tokyo, Japan 169-0075

http://www.chiiki-shien.jp/

Research division of the non-proﬁt organisation PLACE TOKYO

Survey summary:
Aids research programme supported by a grant-in-aid for scientiﬁc research from the Ministry of Health, Labour and Welfare
Research on supporting the mental health of PLHIV in regional communities (Representative: Masayoshi Tarui)“Factual survey on the health and lives of HIV-positive persons”
Survey A…An anonymous survey was distributed to 1,786 HIV-positive persons who are outpatients of ACC and the AIDS care core hospitals of 8 regional blocks(a total of 9 hospitals),with 1,100 surveys returned (response rate of 61.6%). Conducted from July to December 2013.
Survey B…An anonymous survey was distributed to 687 HIV-positive persons who are outpatients of 22 AIDS core base hospitals, with 369 surveys returned (response rate of 53.7%).
Conducted from August 2013 to April 2014.
"Interview survey targeting users of drugs"
Survey C…Paper survey and semi-structured interview conducted individually for 19 HIV-positive persons who have experienced using drugs and are gay/bisexual/other MSM,from September to November 2013.
*The data in the graphs was created based entirely on the results of Survey A, unless otherwise stated.
Thank you to all who participated in or cooperated with the surveys.

Editing: The research group that supports the mental health of PLHIV in regional communities Design: Takeshi Shindo Illustrations: Shiro Shirai Date of issue: March 2015