Japan’s AIDS stigma hampers treatment

A strong stigma against AIDS in Japan is hampering access to treatment in the world’s second-largest economy, activists said on Wednesday, even as experts warn an explosion of the disease may be looming.

AIDS is spreading fast in Asia, home to 60 percent of the world’s population, and experts warn that the fight must be intensified or the region risks having the epidemic spin out of control, much as it did in Africa.

The issue will be taken up at an Asia-Pacific AIDS Conference in the western city of Kobe from July 1 to 5.

Affluent, well-educated Japan may be one of the world’s most advanced nations, yet it is also the only such nation where AIDS cases have not dropped dramatically, a situation that AIDS activist Hiroshi Hasegawa blames at least partly on prejudice against both the disease and its sufferers.

“In Asia, many people cannot gain access to AIDS treatment due to poverty, but in Japan many people cannot access treatment because of the strong stigma,” Hasegawa told a news conference.

Hasegawa, who is in his early 50s, is openly gay, rare itself in conservative Japan, and in 1996 became one of the first Japanese to announce publicly that he was HIV positive.

“The way the problem presents itself in different countries varies due to social and political factors, but the situation is the same,” he added.

In 2004, there were 1,165 new HIV/AIDS cases reported in Japan, the highest annual figure yet and more than a tenth of all reported cases since 1985.

Some experts warn that cumulative numbers could jump to 50,000 by 2010 due to such factors as less condom use and increased sexual activity among teenagers.

Nearly half of all 17-year-old girls have had sex, up from around 17 percent in 1990. For boys, the figure is 40 percent, nearly double the 1990 figure, Health Ministry data shows.

Official indifference is also seen as a factor.

“In Japan, AIDS policy is handled by one bureau in the Health Ministry,” Hasegawa said. “But in many other places, it becomes a national campaign, taken up by the nation’s top leaders.”

STRONG STIGMA

Hasegawa is among a handful of Japanese who admit to being HIV positive. Others fear being forced out of their jobs or losing friends should their infection become known.

These fears prevent many from even going to be tested, much less treated. Hospitals require people to give their names, and while public health centres offer anonymous testing, their hours are extremely limited and results can take a week.

As a result, experts say, there may be thousands who do not realise they carry HIV until they actually fall ill. Hasegawa said the stigma against AIDS in Japan is partly due to squeamishness about frankly discussing sex in either homes or schools - a reluctance many see as ironic in a nation where pornography abounds.

Minimal coordination between government ministries has hampered AIDS teaching in schools, where sex education itself is the focus of debate between those who want more detailed education and others who say schools are already too explicit.

There is also a widespread view that the only people in danger are special groups such as homosexuals or haemophiliacs, some 2,000 of whom became infected due to tainted blood products.

The majority of new cases are homosexuals.

Hasegawa said it was imperative that Japan’s AIDS policies become much more realistic.

“When we teach children about the danger of car accidents, we don’t do it without actually showing them cars,” he said. “With AIDS, we also have to think of policies that are quite concrete.”

Provided by ArmMed Media
Revision date: June 11, 2011
Last revised: by Andrew G. Epstein, M.D.