HIV/AIDS Prevention: Back to the Basics for Japan?

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Since HIV/AIDS hit the surface of public consciousness in the 1980s, it has been frequently discussed and impressed upon the psyche of more than a generation’s worth of young people worldwide. As a member of this 1980s generation, I knew it was a problem that lurked about us, but I was at a loss for how to define or describe it. The disease never seemed real to me when I was young—nobody I knew had it, after all, and who really wanted to talk if you didn’t have to.

We’re older now, and (hopefully) better informed on the matter, but I was thrown for an ecstatic loop when I heard there was a drug to prevent the inception of HIV. On July 16, the FDA approved Truvada to help reduce the possibility of sexually acquired HIV-infection in high-risk teens and adults.

As Americans, cozy in our belief that bad things only happen to people we don’t like, we might not have thought about how this drug might be beneficial to some of our allies, like Japan. Japan’s total number of reported HIV cases is relatively low, but the number of reported cases keeps rising each year.

In a country so advanced in medical technology, and so informed on current events, how could growing cases of HIV even have become a blip on the radar? In Japan, this type of culture-specific issue frequently stems from a love of red tape and socially sanctioned silence.

Keeping your opinions to yourself so as not to upset your group has been a long-held tradition; but with something like sexual health and wellness, what you don’t know and don’t discuss might hurt you. Parents don’t want to talk to their kids about these things; when communication is already so stilted and strained, when would the opportunity even arise?

Should the responsibility go to the schools? Many teachers think so, but their principals and administrators disagree. It seems that almost any variety of sex education is deemed too graphic for “children” in middle and high school—45% of whom have had sex before graduating high school, and only about 35% of whom used protection regularly. With minimal sex education comes minimal awareness of HIV/AIDS and other STDs and what can be done to prevent them. One university student was quoted as saying, “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.” Many who could be susceptible choose not to make the effort to learn more, worried that others will be suspicious of their motives.  

Underlying motives or not, the proof is in the proverbial azuki-bean-flavored pudding. The Report to UNAIDS—HIV/AIDS Trends in Japan (February 2012) sites some unsettling figures for Japan:

  • A total of 12,648 cases of HIV and 5,799 cases of AIDS (late 2010)
  • On average, 70% of new cases were in their 20s and 30s
  • The number of cases increases year over year

The UNAIDS report sites the need for early detection and early treatment, but I think this is not comprehensive enough. What does this mean for the Japanese? Truvada could help, but will it ever get to Japan—probably not. It may be the first preventative treatment for HIV, but for Japan, perhaps the first preventative treatment should be education.