| Issue/Objective |
In Japan, HIV is a concentrated epidemic among men who have sex with men (MSM). MSM comprise an estimated 4-5% of adult men yet account for 62.9% of newly diagnosed HIV cases and 51.2% of AIDS cases in 2024, despite underreporting. The proportion of new HIV diagnoses made at the stage of AIDS has remained persistently high, increasing from 30.2% in 2016 to 33.4% in 2024, while both HIV and AIDS diagnoses have risen again since 2022. |
| Methodology/Approach |
We analysed the largest cross-sectional survey of MSM ever conducted in Japan (n=8,150), collected in 2025 via in-person recruitment at a large community event and geo-social networking app advertisements. Multivariable
logistic regression examined correlates of HIV testing in the past 6 months. |
| Results |
Overall, only 32.7% of participants reported HIV testing in the past 6 months. Recent testing was more common among older participants (25-34 years AOR 1.84, 95% CI 1.36-2.50 vs. 18-24 years) and among those born outside Japan (AOR 1.57, 95% CI 1.14-2.16). Compared with in-person recruitment, testing was more common among men recruited via male-model app advertisements (AOR 1.45, 95% CI 1.07-1.95) and community-oriented app advertisements (AOR 1.36, 95% CI 1.02-1.83). Participants living in northern regions outside Greater Tokyo had significantly lower odds of recent testing (AOR 0.63, 95% CI 0.44-0.90). Awareness of an LGBT and AIDS prevention community non-profit organisation (NPO) (AOR 1.72, 95% CI 1.50-1.96), participation in NPO programmes in the past 12 months (AOR 2.20, 95% CI 1.70-2.86), and receipt of HIV prevention materials (AOR 2.27, 95% CI 1.96-2.63) were the strongest independent correlates of recent testing. |
| Discussion/Conclusion |
In the context of rising AIDS diagnoses, only one third of MSM in Japan reported recent HIV testing. Regional disparities indicate reduced access outside major urban centres. Community-based prevention infrastructure is strongly associated with timely testing, yet national gay men's NPO HIV prevention funding remains critically limited. Strengthening regional testing access and sustainably funding MSM-focused NPOs are essential to reducing late diagnosis and advancing the UNAIDS 95-95-95 targets in Japan. |
| Presenters and Affiliations |
UWASE NKUSI DIANA Society for Family Health (SFH) |
