COMPLETION REPORT
Feasibility of a Culturally Sensitive Communication Strategy to Engage Key Population
in HIV Prevension Awareness and Improve Health Access in Japan: Comparisons
between Japan, Indonesia and Thailand
Chattiya Nitpolprasert
Social and Behavioral Researcher
Adam’s Love Global Foundation for MSM and Transgender Health(ALGO)
Background:
Japan is a developed nation and has a concentrated HIV epidemic among men who have sex with men(MSM).
The antiretroviral treatment (ART) uptake and success after retention in medical care is excellent inJapan. Despite success in exceeding the second and third UNAIDS 90-90-90 targets, Japan has lagged
behind on first 90.
Approximately 30% of new reported cases have been annually identified by AIDS onset, a key unmet
need in Japan is to reach and link key populations to early HIV testing.
Methodology:
Our team conducted a qualitative research with key stakeholders in Tokyo, Kanagawa, Aichi, and Osaka,
such as medical HIV researchers, tertiary healthcare provider, community staffs, and governmentalagencies, to understand HIV testing alternatives for MSM in Japan, reasons behind late HIV diagnosis,
barriers to healthcare access, and identify innovative strategies to increase early HIV testing among atrisk MSM, and compare research outcomes with Indonesia and Thailand.
Results:
Similar to ‘Puskesmas’, government-mandated clinics across Indonesia, municipal healthcare centerscalled ‘Hokensho’ remain key sites delivering free/anonymous HIV/STI testing in Japan with broader
perception of being women/child’s health center, and are not especially preferred by MSM. Primaryreasons for late HIV diagnosis included challenges in engaging MSM in HIV cascades, structural barriers
i.e. testing capacity, schedule/accessibility, lack of MSM-friendly services, and regulatory issues withHIV self-testing, and individual level barriers such as self-stigma, lack of self-care and substance use
issues. Indonesia, and especially Thailand have addressed some of these barriers and implemented MSMfocused HIV prevention interventions i.e. online/offline platforms for HIV counselling and testing,integrating online technologies and HIV self-testing, MSM friendly HIV testing clinics, and ensuring
accessibility of HIV prevention tools like pre-exposure prophylaxis (PrEP).
In Japan, primary HIV prevention initiatives include traditional outreach models including distributionof condoms and testing brochures at gay hotspots, informational web-based resources such as community
websites and social media networks offering comprehensive information, bidirectional email HIV
counseling, and free hotline/in person consultations/counseling. Japanese community organizations are
spearheading HIV testing initiatives by implementing prefecture-based models. For example,
HIVCheck.jp Tokyo, an HIV self-testing research piloted in collaboration with clinical laboratory led toincreased HIV testing uptake among MSM (1,127 DBS samples collected). Japanese MSM actively useInternet for seeking sex partners, e.g. gay dating app 9 monsters has reportedly >300,000 active members.
Thailand and Indonesia have shared similar evidence of high online sex
seeking and subsequent sexual health seeking behaviors and demonstrated the success of intensive realtime interventions for HIV prevention.
Conclusions and Recommendations:
To reach the first 90, Japan needs a diffusion of innovative technology to streamline its HIV service
delivery and implement integrated online-to-offline (O2O) models and intensive real-time interventions.
These models have demonstrated success in scaling-up early HIV testing among MSM in Indonesia andThailand.

Publication of the Results of Research Project:
Verbal Presentation (Date, Venue, Name of Conference, Title of Presentation, Presenter, etc.)
Scientific Abstract Submitted
Title: HIV prevention among MSM in Japan: Current Opinions on achieving the first 90 among
Japanese MSM
Name of Conference: HIV Drug Therapy Glasgow (HIV Glasgow 2020)
Date: 5-8 October 2020
Venue: Glasgow, Scotland
Presenter: Chattiya Nitpolprasert
Thesis (Name of Journal and its Date, Title and Author of Thesis, etc.)

Book (Publisher and Date of the Book, Title and Author of the Book, etc.)