Sat, Jul 10, 2004 - Page 9 News List

AIDS tests in nightclubs fight denial by Japanese

By Elaine Lies  /  REUTERS , Yokohama

As midnight nears, lights flash and rock music throbs as a line forms in one corner of the busy nightclub near Tokyo.

Faces tense, each person is ushered behind a curtain, steeling themselves as Tsuneo Akaeda draws their blood.

Akaeda, a doctor, is casual in a baseball cap, t-shirt and purple-striped shorts, head bobbing to the music, but his mission is deadly serious: free AIDS tests, an attempt to check what experts say may be a looming explosion of the disease.

Some say it may already be too late, noting that while the numbers still are relatively small, Japan is one of the only advanced nations where AIDS cases have not dropped dramatically.

"There is no sense of urgency," said Akaeda, 60. "But there are many people who have HIV, and in five years lots will get sick and everyone will be surprised.

"Right now AIDS is like a ghost. It's sort of scary, but since it's still noon it's far from everybody's mind."

But it is there. Last year 976 new HIV/AIDS cases were reported, the highest annual figure yet, and equal to about a tenth of all cases since 1985.

Some experts warn cumulative numbers could jump to 50,000 by 2010 due to increased youth sexual activity, less condom use and official indifference, symbolized by falling budgets.

Worse though, may be public apathy.

"It's impossible for people to think AIDS has anything to do with them," said Masahiro Kihara, a professor at Kyoto University. "AIDS is Africa. It's America. It's gay.

"The ignorance is huge ... so this is a very dangerous situation," he said. "I think the estimate of 50,000 by 2010 might be an underprediction."

Japan's view of AIDS was colored by a scandal in the late 1990s that led to around 2000 hemophiliacs becoming infected and several hundred dying because Green Cross, a pharmaceuticals company, continued to sell HIV-tainted blood products for years after testing and safer products had been made available.

"More than 90 percent of young people say they're aware of AIDS, but they think of blood, not a sexually transmitted disease," said Masako Kihara, an associate professor at Kyoto University and Masahiro Kihara's wife.

In addition, when AIDS first appeared in Japan in the mid-1980s, it was portrayed mainly as a "foreigners' disease," an attitude that still lingers.

But while in the past many cases involved foreign women in the sex trade or men who picked up the virus on sex tours overseas, the sources of infection now are almost all domestic -- and spreading from major centers like Tokyo to cities around Japan.

Homosexuals made up the majority of new 2003 HIV cases, and though they are a high-risk group, experts say more of them are tested than the general population, perhaps raising the numbers.

All of this, though, reinforces the idea that AIDS is limited to special groups.

The rising figures are "a matter of real urgency," says Health Ministry official Go Tanaka.

But only four people in the ministry work full-time on AIDS policy, and budgets are falling steadily. According to the Yomiuri Shimbun, funds for dealing with AIDS in major cities have fallen by 70 percent since 1995.

Most worrisome is the increase among youth. Of new HIV cases last year, at least 33 percent were in people under 29, a reflection of increased sexual activity.

Some 20 to 30 percent of 16-year-olds have sex, and nearly a quarter of these have four or more partners, said Masako Kihara.

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