Objective: This paper aims to qualitatively analyze social interactions leading to consistent non-use of condoms among sexually active Japanese high school girls.
Methods: Between 2001 and 2003, we conducted 8 focus groups with 41 high school girls (median age 17, 35/41 had sexual experience) from 2 provincial cities in southwestern Japan. The data was analyzed by grounded theory approach.
Results: We found 3 social interactive processes regarding their non-use of condoms: 1 core process and 2 sub-processes (A and B).
The core process revealsthat, as the high school girls become sexually experienced, they come to view their body as pregnant-free and withdrawal as an effective contraceptive method. Their major concern is unwanted pregnancy and not STD infection. Although they know condom is the most available contraceptive, the decision of its use is left to their partners who are mostly unwilling to use it. After practicing withdrawalor the rhythm method for several months, they empirically learn that they do notget pregnant so easily. These experiences allow them to reason that their body is pregnant-free; and, withdrawal is a reliable enough contraceptive method.
The sub-process A reveals the perception of some minorities who do not regard pregnancy as a risk, and some factors associated with condom-acquisition impediments and condom repulsion. The sub-process B shows how some participants develop their unique pseudo-safesex perceptions. All of these contribute to their non-useof condom.
Conclusions: Since the social interactive processes regarding non-use of condoms by high school girls unfold in and beyond sexual encounters, they must be dealt holistically. Moreover, we cannot simply expect them to act always rationally regardless of social interactive processes in which they are engaged. To devise truly effective HIV/STD prevention measures for Japanese youth, further investigation of their social interactive processes regarding (non-) use ofcondoms is indispensable.

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Objective: Mother to child transmission (MTCT) accounts for the majority of HIV infections among children. As it is necessary to know the HIV status of pregnantwomen to implement the preventive measures against MTCT, Voluntary Counseling and Testing (VCT) is promoted as the entry point to the prevention of MTCT (PMTCT). Since VCT coverage among pregnant women in Thailand is high compared with thatin other countries, it could be a model of an effective VCT service.
Materials and Methods: A cross-sectional study was conducted to illustrate characteristics of VCT at an antenatal clinic in Lerdsin Hospital in Bangkok. The data was collected from 311 pregnant women in January 2003, using a self-administered questionnaire.
Results: Factor analysis covered 4 aspects of VCT: 1) Accessibility and quality of services, 2) Social circumstances, 3) Personal concern and 4) Decision making process. Fourteen components were then extracted: 1) Availability of services, 2) Low-cost accessibility, 3) High-cost accessibility, 4) Local support, 5) Support from the government, 6) People's negative reaction, 7) Maturity of epidemic, 8) Concern about health, 9) Fear of HIV testing result, 10) Recognition of HIV/AIDS as an unavoidable and problematic disease, 11) Expectation for being saved from problems, 12) Influence from other people, 13) Role of counseling and 14) Time required to make a decision.
Conclusion: Significant policy implications were: 1) Integrating VCT into antenatal service is recommended for PMTCT for its convenience and low cost, 2) Continuity of prevention, care andtreatment services for sero-positive mothers and their babies is important to increase VCT acceptance, 3) As the reaction of people close is an important factorfor accepting VCT, pre- and post-test counseling should concentrate on increasing women's confidence in making an informed choice about the test result and 4) Allowing VCT clients enough time to make a voluntary decision is important, together with the quality of counseling.

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Objective: Our hospital has carried out a screening test for HIV infection in preoperative patients and pregnant women since 1994. In 1999, when the first HIV-positive case was found, no manual was available to guide administrative management of such cases; great confusion occurred among the hospital staff. We restored an orderly approach to the problem and prepared a manual. Our measures were very effective, so we felt that reporting our experience could be helpful.
Materials and Methods: From April 1994 to March 2003, seven putative positive cases were discovered. We examined problems in assessment of results, reporting of results to physicians and nurses and notification of affected patients.
Results: Screening was done in 16, 739 patients, of whom 7 (0.04%) were positive by enzyme immunoassay; EIA. On definitive testing, 2 EIA-positive results were found to be false, leaving 5 confirming positive cases (0.03%). After analysis of the problems, procedures were formulated and implemented. When a HIV-positive case is confirmed, the result is reported directly to the physician in charge of HIV infection management, who contacts the patient's physician and the nurses in charge of HIV infection control. These staff members notify and advise the patient together. Since the manual has been distributed, major confusion never has occurred.
Conclusion: Implementing procedures specified in our manual was very helpful in managing positive cases. A special problem at our institution is large numbers of foreign patients, so effective use of social resources and interdisciplinary coordination are very important for reliable follow-up in the outpatient clinic.

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