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Rise in AIDS, other sexual illnesses threaten Japan
By Natalie Obiko Pearson
June 13, 2005
Tokyo - A rapid spread of AIDS over the past decade has confounded and alarmed
the health establishment in Japan, a country that has long felt protected by a
first-rate health system and widespread condom use.
Infections that had stayed at infinitesimal levels are surging at rates similar
to developing countries, and some experts say the real number of Japanese with
HIV or AIDS is two to four times the official toll.
Many also fear a silent AIDS epidemic is brewing among the nation's sexually
active middle- and high-schoolers. Other sexually transmitted diseases --
chlamydia, genital herpes, gonorrhea and the human papillomavirus, or HPV --
also are on the rise.
"Japan is on the brink of going under," said Dr. Tsuneo Akaeda, a gynecologist
who raises AIDS awareness by offering free blood tests in Tokyo's nightclubs
and streets. "They're ignoring that they have diseases; they're ignoring that
they are sick."
The official toll of 10,070 HIV/AIDS sufferers in a nation of 127 million
people pales next to some countries. Even if the actual figure is closer to
40,000, that would mean roughly one in 3,000 are infected, compared to about
one in 100 in Thailand or one in 1,500 in China, according to estimates by
UNAIDS, the U.N. body waging the global war on AIDS.
But many in Japan are alarmed at the dangerous mixture of chronic
underreporting of cases, a sexually freewheeling youth culture that's less
inclined to use condoms and the powerful social stigma of a sexually
transmitted disease.
Satoshi Kimura, head of the AIDS Clinical Center at the Tokyo-based
International Medical Center, estimates that 20,000 and 30,000 people in Japan
don't know they have the virus.
In 2004, a record 1,165 people were reported newly infected, up 14 percent from
the previous year -- the same percentage growth rate as in AIDS-hit areas such
as Sub-Saharan Africa, UNAIDS figures show.
The total number of cases is thought to be doubling at a rate of every four
years and could reach at least 50,000 by 2010, the Japan Center for
International Exchange said in a 2004 report.
The virus appears to be spreading the fastest among males under 35.
Transmission between gay men accounts for the majority of cases, but the health
ministry's 2004 annual AIDS report notes that infections among heterosexual and
homosexual men are increasing at roughly the same rate.
Unprotected
Among women, Sato is one of the careful ones. The 23-year-old Tokyoite has
unprotected sex with multiple partners, but at least she occasionally gets
herself tested for HIV.
"I know about the risks of disease, but usually the guys I'm with refuse to use
a condom -- so we just end up having sex without one," said Sato, who would
give only her last name as she waited for her blood to be drawn at a health
center.
The risky behavior also extends far beyond youth: Older men often consort with
part-time prostitutes of high-school age, businessmen go abroad on "sex tours"
and the country's enormous sex industry offers services condom-free for higher
prices.
After Japan's official toll of HIV/AIDS cases broke the 10,000 mark in April,
Health Minister Hidehisa Otsuji said, "This is worrisome, and I realize the
gravity of the situation."
The history of AIDS in Japan has played a role in worsening the problem.
Japanese became seriously aware of the AIDS threat in the 1990s over a
tainted-blood scandal in which about 2,000 patients, mostly hemophiliacs,
contracted HIV.
The tragedy brought a basic understanding of AIDS and established world-class
medical treatment. But many say it also sowed complacency and misconceptions --
chiefly that ordinary Japanese don't get AIDS through sex.
"The average person just doesn't seem to be able to grasp the immediacy of the
threat," said Tokyo city health official Shizuko Tominaga. "AIDS is perceived
as someone else's problem" --hemophiliacs, gays, foreigners.
Inadequate AIDS education leaves many Japanese unaware of multi-drug cocktails
effective against the disease, so those who fear they are infected suffer in
silence rather than seek help.
In Tokyo, even as new infections are being reported at a rate of more than one
per day, the AIDS budget has gradually fallen by two-thirds, to 213 million yen
($2 million) in fiscal 2005. The capital also suffers from problems common
across the country: a shortage of testing centers and sex education in schools
that critics say tiptoes around the specifics.
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New
figures prompt fears of AIDS explosion in Japan
2-10-2005
New
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