I think it's supposed to be an A and a T put together in to one design. Kind of like how some versions of Ayu's "A" are A + H put together.

I have two friends who did this, also. They put their initials together in to a single design. It's really cool.

As far as if this is real... who knows? Who really cares, though? It's not a big deal. The tattoos could be ink, or they could just be henna. The people in the picture could be Ayu and Tomoya, or they might not be the real deal. The book might be released, or it might not even exist.