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.
"Only 20 percent use condoms every time," she added. "They think they have a set partner, so it's safe."
Not surprisingly, other sexual diseases such as chlamydia, which can cause infertility, are on the rise as well.
"Young people, myself included, feel that using a condom is a real pain," said Akira Sasaki, 30, out clubbing with friends.
This attitude frustrates people such as Tanaka at the Health Ministry, who noted that a traditional reluctance to talk frankly about sex in many schools stymies educational efforts.
"Telling people to use condoms is the most important thing," he said. "But of course we can't actually go to where they're having sex and tell them to put them on."
Another problem is a dearth of places to go for testing.
Hospitals require people to give their names, a move that puts off those fearing prejudice after a positive result, and while public health centers offer anonymous testing, their hours are extremely limited and results can take a week.
As a result, experts say, there may be thousands who do not realize they carry -- and transmit -- HIV until they actually become ill.
Enter Akaeda, who began free testing in several clubs around Tokyo a few years ago.
"If you just wait in a clinic, young people won't come," he said, snapping his rubber-gloved fingers to the music in between the 40 tests he did on a recent Saturday. "Here, I tell them like a friend to be tested."
Akaeda uses a blood test that gives results in 15 minutes, with manicures and makeup tips offered as people wait. Others dance or drink. One man got his results while clutching a beer.
"In other places you wait a week, but here you know fast," said Sasaki, who described himself as "very relieved" after his test was negative. "A week would be scary.
"I didn't used to think AIDS had anything to do with me, but now it's different," he added. "I'll be more careful now."
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