HIV Awareness in Japan:
Has anything changed?

Thus far, we have two articles about HIV and AIDS in Japan on stippy.com (the first and the second). Another year has passed since we last touched on this issue, but a recent episode in my own life drove home that things still are really not changing fast enough with regard to the blurry awareness of HIV/AIDS in Japan, and the studied nonchalance of the Japanese people whenever the topic arises.

In Japan, everyone knows the word AIDS, but still very little is known *about* HIV or AIDS by the general public. This giant disparity of awareness was brought clearly to my attention one day after overhearing the following conversation between a physical education teacher and a young math teacher in her early twenties in my office (I work in a Japanese School):
Ms. Math: So wait, I don’t understand; what is the difference between HIV and AIDS?
Mr. PE: If you are infected with the HIV virus, it will eventually lead to AIDS and if you catch another less serious illness you can die because the virus weakens your body. If you have HIV, it doesn’t mean you have AIDS, but that you will eventually get AIDS. As long as you don’t catch the virus, you don’t need to worry.
Ms. Math: I don’t understand. What is HIV?
Mr. PE: It’s the virus that causes AIDS. If you have HIV, you will get AIDS.
Ms. Math: I still don’t understand.

The fact that this conversation could occur between two adults in a First World country nearly 12 years after I can recall asking the same questions of my teachers in America is absolutely baffling to me. Japan is slow to catch the news because the virus has only just recently started to increase within the population despite its low numbers; here is an article explaining the situation, including the country’s reaction to its .02% prevalence rate of the virus reported. However recent statistics are showing that the virus is on the rise in the country, due mainly to increased contact with foreigners abroad and within the country, and the government is scrambling to inform and educate the public about HIV.

This year my junior school has become one of presumably many which are currently including information about the disease in its annual curriculum. In early December 2007, they distributed red ribbons at the weekly student body meeting and included information about it both spoken and in print.

The following is a translation of a PTA Bulletin from November that is sent out to students of our school and their guardians each month:

December 1st is World AIDS Day. We ask for the student body cooperation in accepting a red ribbon. The red ribbon is a symbol of support and understanding for people who are suffering from AIDS. We are distributing the ribbons to promote the message that we will not discriminate against or have a narrow-minded view of AIDS.

AIDS is a sickness that leads to death. However, the infection rate is very low, and there are three main ways of contracting the virus:

1. Sexual transmission
2. Transmission during birth from mother to child
3. Shared intravenous needles

You cannot contract it from touching the body or sweat of an infected person. It is very important that each of you have understanding about this disease.

By the way, do you know the difference between AIDS and HIV? AIDS stands for “acquired immune deficiency syndrome” and HIV stands for “human immunodeficiency virus.” In other words, if you contract HIV, the resulting disease is called AIDS. We would like you to understand and have proper knowledge about the people in the world infected by this virus. Please wear these ribbons on your school uniform during this period of time.

This information is new for the children at my school, as well as for the adults who are teaching them. How it can be new so late in this age is an indicator of extreme isolation. I am always curious just how this isolation still exists.

Even when Japanese people enter into adulthood, awareness about AIDS and its prevention never seems to be high on anyone’s agenda. Women Japan is a popular site amongst “around 30″ girls in Japan. It features several 相談室 (consulting rooms) where girls can ask doctors, and several prominent personalities questions about almost anything they like. One of the rooms is a セックス相談室 (sex consultation room) where people can ask “Dr. Seiko先生” their deepest and darkest questions about their sex lives that they could never share with their friends or colleagues.

Dr. Seiko self-professes herself as, 性に関して日夜研究。研究結果をみなさんの悩み解決のために役立てたいと願っています。 (Translation: “I am researching sexuality day-and-night. I hope the fruit of my research can help you solve your sexual hang-ups and problems”). It is a semi-serious, “Ask the Doctor” type site, generally keeping a down-to earth approach on proposed solutions – except however for some of the condom usage advice given to the girls (who assuming from their questions, had the math teacher above for sex-ed class) where it is inappropriate and dangerous.

Here where a 22 year old girl asks for advice about her コンドームをつけてくれない彼 (Boyfriend who wont ever wear condoms), Dr. Seiko answers with three not very well thought out solutions. 1. Don’t have sex, 2. Get on the pill, and 3 Ask another guy to tell him to wear condoms. There is not one mention of STDs in her response, or any of the other reader’s comments. The Doc even goes so far as to say, 私の場合は医者にピルを処方してもらった (“One time when I had a boyfriend like yours, I just got my Doctor to give me the pill”). Hmmm.

As the answer to another 35 year old (!!) reader’s consultation entitled コンドームをつけるタイミングは？ (“At what stage should I put a condom on him?”, Dr. Seiko gives this advice:
1　口でフェラチオ
(First, give him fellatio)
2　一度挿入　※性病が怖い人は挿入する前から
(Put him into you without a condom first – unless you are afraid that he looks at risk of having an STD)
3　プレイとして、口で女性がつけてあげる。　※これはテクニックが必要となりますのでバナナで練習しましょう。
(Then before he comes, roll a condom onto him with your mouth – This takes technique, so practice with a banana first)

Well, advice for champions. This is the state of condom usage and STD prevention awareness in Japan.

Remember the Grim Reaper AIDS campaigns of the ’80s?

Late last year Pink shared with us the eye-opening story of his friend who found out that he had been dating a girl infected with HIV, and the story of his soul search while he waited for his own test results. After reading the number of responses in the comment section to the article, I decided to do a little more work into the state of AIDS and other STDs in Japan.

While most newspaper articles generally do their best to exaggerate the statistics with statements like “AIDS cases in Japan double in the last decade”, the reality is that official AIDS (and HIV) statistics don’t appear that high although part of the reason might be due to the lack of drug use (and syringe sharing) in Japan. I guess it depends on how you define high… there have been approximately 3,750 new cases of HIV and AIDS reported over the past three years (’04-’06). The problem is that this figure alone tells you very little about the real face of AIDS in Japan. According to MHLW (厚生労働省, kouseirodosho) only 93,497 people had AIDS tests last year. Given that 1,304 new cases were found, that means that almost 1.5% of people getting tests are found positive. Isn’t that high?

Let’s put it another way, the sexually active population in Japan is said to be approximately 100 million people. That means that less than one tenth of one percent of the sexually active population are getting tested. Given the amount of sexual activity that goes on outside of the home in Japan, you would hope that the incidence of testing was actually higher than the average country. Some people say that the social pressures of being seen as outcast in Japan might be so great that people don’t have the courage to get a test, just in case they are found positive. My personal view is that such social pressure is (unfortunately) strong regardless of where you live, it is more an issue of lack of sexual education at schools. The fact that a drama series about a girl who got pregnant at the age of 14 was so popular last year is a sign that children are getting sexually active even earlier than they did in our day (My wife assures me that the drama was so popular simply due to the fact that it is no longer unrealistic in today’s society). What does that mean for the sexual safety of our children?

Finally, a word of advice for my fellow gaijin out there. It’s hard enough getting the courage to ask around where to get a check in your own country and your own language, and I can think of a dozen reasons why you might not want to ask your own partner. Here are the names of a couple of places that will give you a free and anonymous AIDS check. Remember, even if your last girlfriend seemed like a well behaved, serious girl, you have no idea what her last boyfriend was like – especially if he was a gaijin – as we all know that it is only gaijin who spread AIDS in Japan. Seriously though, think of the smile on your face if you are one of the 92,193 people who finds out that they are negative. Go get yourself tested, and say goodbye to Mr. Reaper forever. Here is where you can get it done for free:

Tokyo: Minami Shinjuku (南新宿検査相談室)

3F Tokyo Minami Shinjuku Building,
2-7-8, Yoyogi, Shibuya-ku, Tokyo.
Tel: 03-3377-0811

* 1/8 of all AIDS tests done in Japan last year were done here.
Map to Minami Shinjyuku, Tokyo, HIV Testing Centre:

Osaka: Ame-mura (アメ村サンサンサイト日曜日常設即日HIV抗体検査)

4F Shinzu Sankaku Tower
1-7-8, Nishi-Shinsaibashi, Chuoku,
Osaka-shi, Osaka-fu
Tel: 06-6253-3339

* Only open on Sundays from 3PM-5PM. English speakers present.
Map to Amemura, Osaka, HIV Testing Centre:

Kobe: Sannomiya (神戸市保険所)

Room 13-15, 6F Sannomiya Center Plaza Nishikan
2-11 Sannomiya, Chuoku, Kobeshi, Hyogo-ken

* Open between 6-8PM every Monday night. No appointment necessary. Also tests for chlamydia and syphilis.
Map to Sannomiya, Kobe, HIV Testing Centre:

Have you had a HIV test? Tell us about it, or any other concerns, worries you may have on the subject of AIDS in Japan in the comments below.

A friend of mine living here in Japan wrote this to me yesterday. Read it right to the end. It will chill you to the bone. You won’t be disappointed, and may even rethink a few things in your own life, or maybe make a different New Year’s resolution than the one you had in mind.

〜★〜

Well it’s coming up on another year here in Japan; hard to believe seven or eight years have gone by already. 2006 was a great year as was 1999-2005 here in Tokyo. I’ve got a great life here. Great friends, great job, great fiancée (oh yeah I got engaged to Kyoko last month in Italy) and low-stress which is key to having a great life! Tokyo continues to be a fabulous city. Sure it lacks in architectural finesse (I suspect it was much cooler looking before the Yanks burned it to a cinder 60 years back), but it more than makes up for it in entertainment opportunities, quality of life and the bizarre. Where else can you have thousands of people lining up for the opening day of Japan’s debut of Krispy Kreme!? There are already two huge chains of donut shops in Japan. Why another? And this one is even more fattening! Or canned oden (Japanese chunky soup) from a vending machine- a camera crew and a snaking line 20 people deep waiting for their turn at the machine (these people are so patient!), or a 500-person Japanese orgy flick that is circling the internet (not one of them wearing a condom). I wasn’t in it! Next time.

This past weekend Kyoko and I took the Shinkansen (bullet train) for about 4 hours southwest of Tokyo to Fukuyama, near Hiroshima. We were visiting Kyoko’s family (also visited some of the dead relatives’ graves) whom I have met on a number of occasions, and to meet the father’s side of the family whom I hadn’t met before. Our first stop was at one of her uncles’ house. The Japanese tend to really take to foreigners for the most part and are quite accommodating to them in their homes. We all hit it off right away and had an enjoyable time. Prior to eating, Kyoko prayed in front of the family’s Buddhist shrine (仏壇, butsudan) where the deceased members of the immediate family are honored. These shrines are found in most Japanese homes and are incredibly beautiful, ornate fixtures that are often built into the wall like a niche. There is usually some fresh fruit offered up for their souls and in this case a couple of large red and green apples and a pack of OREOS sat on a metal tray which really got my mouth watering. We had an enormous feast. Temaki zushi, which is kind of a Japanese burrito minus the beans and gas; basically sashimi (raw fish) that you roll into a sheet of dried seaweed along with rice and maybe some salmon eggs, sprouts, etc. also had oden atsukan (which is HOT sake – by the way the bad quality sake is usually heated up) and all kinds of other goodies.

I was seated next to Kyoko’s uncle whose name escapes me… we’ll call him Jessie. Simple man, has a farm that he tends, filthy fingernails, (his thumbnails looked like small inverted teaspoons absolutely caked with dried dirt from the garden) a dog tied-up in the front with muddy paws and mine-like excrement piles surrounding his limited tether (I’m assuming this was the dog’s excrement and not Uncle Jessie’s, after all he is pretty outdoorsy), a wife and three grown children, and two grand children that he just can’t get enough of. Crazy about his grandkids! For some things there just aren’t any cultural divides. Oh and he wouldn’t be seated at my mother’s table thats for sure! We immediately became drinking buddies and I could hardly get one gulp of atsukan down before he filled my glass back up. Granted, sake glasses are thimble-sized but nonetheless it was always spilling over the edge. The more he drank the funnier he got and the more embarrassed his wife looked. But I thought it was great. It was a very memorable time with my future in-laws (wow that gives me the chills) and after we said our goodbyes we were off to see MORE relatives…dead and alive. Basically the entire day was spent going from house to house to grave to rest home making introductions, offering up prayers for dead folks I’ve only seen black and white photos of, and chatting.

Towards the end of the day while in the car I received an e-mail on my phone from an old girlfriend from a few years ago. We’ll call her Keiko. Scratch that, that’s her real name, uh… Kumiko. It was a short message. ‘Hi how have you been?’ I hadn’t heard from her in probably a year and a half or so; we occasionally mail one another to touch base. I wrote back with my regards. And then she wrote back again with a message that rattled my inner core. ‘I have really bad news, I’m 6 months pregnant and I found out I have HIV’. This can’t be real I thought. I mean Kumiko is an office lady who is 26, educated, barely drinks alcohol let alone take drugs, and doesn’t sleep around. She has only had a handful of boyfriends with whom she was monogamous while she dated them. She doesn’t fit the profile. She said she was trying to determine where she got infected. I then began to fear the worst. My God, I might have it. We didn’t always practice safe sex, in fact I think we rarely did. She then said she’s already checked with her other boyfriends who all said they were tested and are HIV negative. I’d never had a test before. It was this that really made me take pause. I could be the carrier of this death-wish.

I had a very difficult time maintaining my composure for the remainder of the weekend. I continued to e-mail Kumiko for the next day trading information about her current boyfriend, who is the father of her unborn baby, and as to whether or not he has it. He doesn’t. Basically I was the only link missing from the ‘who’s got it?’ I was a mess. In my mind, life as I knew it was done, finished, in the 9th inning with 2 strikes 2 outs. My first thought was Kyoko and how could I tell her I have HIV/AIDS. This would end our marriage plans for sure. Then my mom – that would absolutely break her heart. Then the thought of calling the other old girlfriends and telling them they may have been exposed was horrifying. Then me. Lifespan with the currently available drugs for treating HIV is 24 years. From the time of infection. So that would mean I have a max of 20 years left on big blue, if I contracted this evil from Kumiko 4 years ago. I started to rethink my life’s direction. Nothing had value in my eyes anymore. Everything was superfluous. I started to think about the horrific images we’ve all seen of people dying of AIDS. Skeletal, gaunt. I couldn’t sleep at night and had the sweats and shakes. Literally every waking moment whether I was teaching a class or narrating a job, it has been at the forefront of my thoughts. We all have to die but this just wasn’t in the cards for me, I thought. George has AIDS. Mortifying! I didn’t like the ring of that one bit. I imagined myself having to clarify every time someone learned about my illness that I’m NOT gay and I’m NOT a drug-user. I got AIDS from unsafe heterosexual sex. I envied some of the people I saw on the street. A young mother with her young children in the supermarket; I’m sure she’s safe. Kids playing in a field near my apartment; they don’t know how lucky they are. But I also thought, jeez they could be HIV positive too.

I went to a Catholic church that is on my way home from work on Monday evening and prayed like there literally was no tomorrow. This went on for a couple of days (not the praying but the fear of God) until I could get an appointment to see a doctor yesterday, the 19th Dec. I went to an English-speaking clinic here in Tokyo which I usually visit for other life-threatening illnesses like the common cold and having stitches removed. I had an HIV test done and I figured as long as I was there and as long as the needle was in my arm (which by the way this was the first time I didn’t get light-headed or completely faint from a blood test) I may as well get some more blood drawn and have some other general check-up tests done as well. Never thought it would come to the tune of 50,000 yen! There are free AIDS clinics in town but the wait (one or two weeks) I think would’ve killed me. These results were promised in 24 hours. After the tests were all done I left the clinic and my blood and fate was in God’s hands. I told a friend I hope He (God) switches mine with some nun… certainly not a priest!!

The past 24 hours have been nerve-wracking as you can imagine. I’ve been absolutely on pins and needles. The doctor told me to give him a call after 4 which I did at precisely 4:00:01. The call was transfered to him and he didn’t even say hello, all he said was ‘the test is NEGATIVE.’ He knew how anxious I was about this. I could’ve hugged him. Or at least bought him tea and crumpets. An enormous weight was lifted from my shoulders. I never felt the word negative could in fact be so POSITIVE!

I immediately called Kyoko and told her the good news. She knew I had an AIDS test which I told her was just a ‘routine check, nothing to worry about.’ She doesn’t know yet just how afraid I was, or the REAL reason for the test. I’ll tell her tonight. I also mailed Kumiko. She asked that I not call her because she cries on the phone when she talks about her terrible predicament. She was relieved to hear the news. She has since pinpointed who she believes gave her the disease and has yet to hear back from him. He also is a foreigner living here in Japan. Perhaps he doesn’t know he has it? Perhaps he refuses to get checked for fear of learning he has it. Kumiko is also being rejected by her boyfriend now. They planned to marry after she got pregnant, that was until a month ago when she got the bad news from her doctor. He doesn’t want anything to do with her now that she’s been diagnosed with HIV. She told me that she will give birth to the baby and live in Tokyo for a year before moving back to her hometown to live with her father. She said ‘what about my life?’ I wish I had an answer for her. I told her to focus on the beautiful baby that she will have in a few months and that will help relieve her of the other pain.

Japan. It’s a beautiful place. The people are beautiful and kind and some of the most generous folks I’ve ever met. But these past few days have jaded me a bit. I used to think of Japan as a special place where the evils are forbidden from entering. A playground where you can laugh and sing and play along with life in a carefree and careless way – a Disneyland as such. It’s not that way. And I learned this in a very personal and frightening way. This has been an INCREDIBLY valuable lesson for me and should be for anyone who takes the time to read this. Sorry, I know it’s long but it’s important that we realize just how real HIV/AIDS is! We read about it in the papers. We see it on TV, but folks, this is mainstream. If Kumiko can get it so can I and you and your children and anyone who doesn’t practice safe sex! PERIOD! Take heed people. Please feel free to send this on to anyone you feel would benefit from it.

Oh and I almost forgot… Happy Holidays! Stay safe.