AIDS and Japanese teens

Beautiful, single and sexually active, Emi is the sort of person who causes nightmares among Japan’s health ministry bureaucrats. At 20, she says she has had more than a dozen sexual partners in relationships that sometimes lasted just a few days. She admits that condoms are not always high on her list of priorities. “Japan is pretty safe that way,” she says.

Beautiful, single and sexually active, Emi is the sort of person who causes nightmares among Japan’s health ministry bureaucrats. At 20, she says she has had more than a dozen sexual partners in relationships that sometimes lasted just a few days. She admits that condoms are not always high on her list of priorities. “Japan is pretty safe that way,” she says.

Such complacency is part of a potentially lethal cocktail of freewheeling sexual habits and slow-moving government that is pushing this traditionally safe, healthy society towards an Aids crisis, claim medical experts.

“I think we’re looking at an Aids explosion in the very near future,” says Dr Kunio Kitamura, the head of Japan’s Family Planning Association. “This is the only G7 country where the disease has continually expanded since 1993.”

Japan has just over 10,000 official cases of Aids, well below rates in most other countries. But in contrast to the UK, where the epidemic peaked in the mid-1990s and the disease remains largely confined to well-defined categories, the epidemic is growing sharply in Japan – a record 1,165 new cases in 2004. And the rate is doubling every four years.

More worrying still is the profile of the victims. Many Aids sufferers in Japan are heterosexual and drug-free and they are getting younger – the Welfare Ministry says 40 per cent of all Japanese newly infected with Aids are in their teens or twenties. Other sexually transmitted diseases are rising even faster. A conference in December last year heard that one in 10 Japanese teenagers had chlamydia. “We know from studies in the US that where chlamydia goes, Aids often follows,” said Dr Kitamura. “It shows a lot of youngsters are engaging in unprotected sex.”

The key to tacking the looming crisis is changing Japan’s sexual habits, say experts, especially among teenagers: a recent poll found that nearly 40 per cent of senior high school students have had sex, rising to nearly 50 per cent for girls, and condom use is falling. “The figures might not seem especially high compared to other countries, but it is an enormous leap compared to what it was 20 or even 10 years ago,” said Masako Kihara, a government researcher at Kyoto University.

“What worries me most is the complacency and very high number of sexual partners. There is a lot more awareness of Aids now, but teenagers don’t think it has anything to do with them. The children don’t know they’re engaging in risky behaviour so they don’t wear condoms.”

The situation is worsened by some of the highest rates of prostitution in the advanced world; Dr Kihara claims more than 10 per cent of Japanese men pay for sex, and thousands of high school girls looking for extra pocket money are contacted by by middle-aged men who use internet dating sites. Critics say the government must do more to crack down on this activity, and spend more on combating Aids. But they say testing centres are in short supply, anti-Aids budgets in many cities are falling, and sex education in schools is inadequate.

BBC NEWS | Asia-Pacific | Japan’s Aids time bomb

By Jonathan Head

The focus of most of the delegates to the International Aids Conference in Bangkok is on the enormous problems posed by the disease to developing countries.

Kuki Uchikawa
 It’s always been somewhere in the back of my mind, HIV, but I’m afraid I’ve never done much to protect myself in the past 
Kuki Uchikawa, university student

But it is not just the poor who are unprepared to deal with Aids.

In Japan, one of the world’s wealthiest societies, awareness of the risks posed by the disease is almost non-existent among many young people, and yet their sexual behaviour is increasingly risky.

While HIV infection rates in Japan remain officially low at around 6,000, experts fear the real total could be higher, and will get a lot worse unless attitudes begin to change to a disease many Japanese believe only foreigners can catch.

One Friday a month, gynaecologist Dr Tsuneo Akaeda visits Club Jamaica, one of dozens of places in Tokyo where young Japanese party till sunrise. He gives free blood tests for HIV – with almost immediate results.

University student Kuki Uchikawa, who has taken the test, said: “It’s always been somewhere in the back of my mind, HIV, but I’m afraid I’ve never done much to protect myself in the past. This is the first time I’ve decided to come and find out more about the disease.”

Among the volunteers helping Dr Akaeda is Mariko – she is 18, and has only just become aware of the risk HIV poses to her generation.

Poor education

“We never had much sex education at school. We were taught little about contraception, or how you catch HIV or other diseases. Teachers just don’t feel comfortable talking about sex,” she said.

Kuki Uchikawa getting tested

HIV tests are being offered in Japan’s clubs

Her friend, Madoka Izumi, also a high school student, agreed.

“I go to a girl’s school, and we’ve never been able to learn what boys think about sex. They’ve taught us some of the physical sides of sex, but none of the emotional aspects, so we’re not really prepared to deal with it,” she said.

Yusuke Izumi, a university student, said: “I don’t remember getting any sex education at school – we just talked about it among ourselves, about the things we did with girls.”

Adults are probably oblivious about teenagers’ sexual activity, Mariko said.

“Parents always think their children are different. They can’t imagine them having sex or having abortions. They can only think of them studying hard at school.”

By the age of 17, more than a third of teenagers in Japan have already had sex at least once.

There are other statistics which Dr Akaeda finds even more alarming. Sexually-transmitted diseases are rising rapidly among young women – a sure sign of having sex with multiple partners but without using condoms.

“Teenagers these days are very casual about sex. They’re happy to have sex with anyone they meet – they use phrases like ‘let’s play together?’

“I gave away vouchers for free STD tests to girls, and found that 82% them were infected.

“It’s incredible. I suspect a lot of them may have HIV as well.”

In Japan, sex has become a freely-traded commodity, seemingly unconstrained by moral concerns.

Dozens of pornographic cable TV channels on sale here, and yet sales of condoms have been falling for several years.

Condom dearth

“We’re very concerned about the negative image of condoms among young people, because it’s not just HIV, but other sexually-transmitted diseases which are spreading,” said Toshiaki Ishii, of the Okamoto Condom Co Ltd.

“We’re trying to find ways to make them more appealing, but so far without success. I think the lack of sex education is partly to blame for this,” he said.

The absolute number of people infected with HIV in Japan is still quite small – but unlike other developed countries, every year that number keeps rising.

Young people in Tokyo

There could be a price to pay for young people’s blissful ignorance

And yet there is still a marked reluctance here to discuss the problem openly, or to run the kind of hard-hitting awareness campaigns that would wake this country up to the danger it faces.

That reluctance prevails even in the corridors of Tokyo’s city government. Ida Mami, of the Medical Service’s Division, is sounding the alarm over Aids awareness, but said getting more explicit sex education in schools is not easy.

“It is a sensitive issue. We have to start with what’s possible, and avoid provoking a reaction from conservatives. If we push too hard on discussing condoms and safe sex in classrooms, some people may demand we stop all HIV education,” she explained.

A start of sorts has been made in one of Tokyo’s most elite girls’ schools. They invited Dr Akaeda to educate, not the pupils, but their mothers – though only a handful turned up.

His use of graphic illustrations and even more graphic statistics had its intended effect – to shake any illusions they may have that their daughters are somehow immune to the wave of adolescent promiscuity sweeping Japan.

Social taboo

Actually talking about sex to their children, though, is another matter.

“Well it’s rather difficult to bring this subject up in a casual way. If I can find the right opportunity, I hope I will feel able to discuss it,” said one mother.

“I think this is a subject our children are already interested in, so I guess they’ll understand if we raise it with them,” another said.

Young people often seem like Japan’s golden generation, unburdened by the work ethic of their parents, enjoying more leisure, more affluence, more security.

In such a cosseted environment it is hard to imagine the spectre of Aids. But it is here, and they don’t seem to realise.

Survey of attitudes toward sex, abortion and HIV/AIDS among the first grade of Japanese high school students. 


HIV/AIDS continues steep increase in Japan (Japan Today) Oct 15, 2009


Many foreigners who live in Japan are surprised to know that HIV and AIDS is increasing rapidly in Japan. While HIV/AIDS infections in North America, Western Europe and Australia peaked in the late 1980s, Japan’s HIV infections have continued to increase. The Ministry of Health, Labor and Welfare’s Annual Report on HIV/AIDS Surveillance in Japan reports that in 2008 there were 1,126 HIV and 431 AIDS reports, the largest number of yearly reports to date.

Despite much media attention to the point of what is now known as the “AIDS panic” when the first AIDS patients were diagnosed in 1992, in recent years there has been a lack of media attention given to HIV/AIDS. The lack of English information, in particular, might lead foreigners in Japan to assume that they do not need to think about HIV when having sex in Japan.

“The majority of HIV and AIDS reports in Japan are among gay and bisexual men, who have little targeted HIV information and support, and there is a particular lack of resources in English. In recent years, the data indicates a slight increase in HIV reports among foreign gay and bisexual men, so we decided there was a need to investigate the health and information needs of foreigners in Japan,” said Prof Seiichi Ichikawa who is head of the Study Group on the Development and Evaluation of Community-based HIV Prevention Interventions for Men who have sex with Men at Nagoya City University.

The study group is looking for gays, lesbians and bisexuals living in Japan who are interested in doing the English language Internet survey which is being conducted until Jan 31 2010. The survey is anonymous and confidential. The Gay Travel Internet Survey can be found on a secure SSL site at


Japan Alarmed By Increase in Teenage Sex 

Japan, which has an estimated 10,000 people living with HIV/Aids, is the only G7 country in which new cases of the virus have increased since 1993. A record 1,165 new cases were diagnosed last year, the health and welfare ministry said, with about 40% of all newly infected people in their teens or 20s.

JAPAN: Sex-Disease Chlamydia Rife Among Japanese Teens

Reuters (12.02.04) – Monday, December 06, 2004

A screening of 3,190 male and female high school students from 13 schools in Japan’s main northern island of Hokkaido found an average 11.4 percent testing positive for chlamydia, the Yomiuri Shimbun recently reported. The results are considered nationally reflective of teen sexual activity, the Yomiuri said, adding to concerns of increasing sexual activity among Japanese youths. Asahikawa Medical University’s Dr. Hirohisa Imai led the survey.

The percentage of students testing positive did not greatly surprise AIDS expert and Kyoto University professor Masako Kihara – who was not involved in the study – because chlamydia is the most prevalent STD among teenagers. “If it really is spreading this fast, it shows that there’s a lot of unprotected sex going on, and that other sexual diseases could also be spread,” she said.

That prospect also concerns officials, particularly the potential of spreading HIV. Japan reported 976 new HIV cases in 2003, the highest annual figure yet and one-tenth of the nation’s total cases reported since 1985. At least 33 percent of new HIV cases involved Japanese under age 29.

Japan struggles to educate teenagers on AIDS Go to this page

HIV Among Japan’s Youth At Record High – (Nov 30, 2005)

(IPS) TOKYO — In Japan, the only major industrialized nation in which new HIV/AIDS infections have been increasing since 1993, new infections hit a record high in 2004.

Equally troubling, about 40 percent of new HIV/AIDS cases in Japan are people in their teens and 20s — up 20 percent from 2003.

Eri Iwase, 19, a first-year university student, says she is not worried about the HIV virus, even though she is sexually active.

“I just feel AIDS is a disease that has nothing to do with me,” she said, explaining that her studies, part-time work, hobbies and meeting her boyfriend keep her too busy to learn more about the virus.

Such complacency among sexually active young people represents the uphill struggle that Japan faces in trying to control AIDS.

“Despite various programs, we are finding it really hard to penetrate the younger generation, and already the statistics show nearly half of 17-year-olds have experienced sex,” says Hideko Fujimori, who heads Action Against AIDS, a small grass-roots organization promoting protection against AIDS.

Fujimori cited poor sex education programs in schools, the lack of frank discussion of sex, especially between parents and children, and minimal financial support from the government.

“When I visit schools to talk about HIV/AIDS, there is a renewed interest among the students, but that dies down a week later. New measures to make it ‘cool’ to talk about AIDS protection is the best way to empower children to help themselves,” he said.

Fujimori is planning to launch a new project next April where high-school students will be trained to develop programs geared to raise awareness.

Takuya Togawa, director of the AIDS program at the Health and Welfare Ministry, acknowledges the lack of progress in combating HIV in Japan.

“There are barriers in our current projects aimed at reaching youth. We are requesting a larger budget from 2006 to strengthen AIDS awareness projects that will, from now on, involve more activists rather than rely too heavily on doctors and health centers manned by local municipalities,” he said.

Japan’s AIDS/HIV budget is around $80 million per year. Activists say a large part of the money is spent on research and treatment, leaving insufficient money to finance protection programs geared specially to youth.

For instance, HIV testing centers manned by municipalities also cover various other diseases and are based on appointments restricted to once or twice a week. Activists say that even though the testing is conducted on an anonymous basis, the formal atmosphere turns young people away.

Dr, Masaki Kihara, a well-known AIDS expert, has developed sex education classes that incorporate social issues affecting children such as lack of peer support, problems with parents, and the importance of being able to develop close and equal intimate relationships with the opposite gender.

“My research has shown that freewheeling sexual habits among youth usually stems from their poor personal relationships. By being able to talk about these social issues in class, we aim to help children develop self-confidence that will protect them from risky sexual behavior,” Kihari said.

Kihara’s methods have found support among teachers and parents who oppose explicit education in schools such as condom usage, a major problem for advocates who see the gap between attitude towards sex between the older and younger generations.

Kihara also hopes to tackle the lucrative sex industry in Japan that employees young women, some in high school, which he says is linked to the Japanese AIDS problem.

Police reports this year indicate that the sex-delivery business — where customers are offered services over their mobile phones — has now reached more than 2,700 businesses employing around 500,000 people each.

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