People in their teens and 20s account for nearly 40 percent of all Japanese newly infected with AIDS, according to new Health Ministry figures that officials say underline a disturbing new trend. While the overall number of Japanese infected with HIV remains low compared to other countries, the Health Ministry said lax condom use has caused infection rates to spike among young people.
A record high 621 people were newly infected with HIV last year in Japan, an increase of 34 percent over 2000, ministry official Makoto Iwakura said Tuesday citing the annual report of the ministry's disease control division. Of those new cases, 525 were Japanese nationals - with about 40 percent being teenagers and people in their 20s. The others were foreigners living in Japan. Japanese AIDS experts said the new trend should be seen as a wake-up call and warned that the actual number of Japanese infected with HIV is probably about five times higher than the reported figures.
An official from the Japanese AIDS Foundation said on condition of anonymity that the increase is spurred by casual attitudes toward sex among young people as well as misconceptions about the risks. Prejudice against people with AIDS also discourages many young people from getting tested for the virus.
To boost awareness of the danger of HIV, the Health Ministry began airing television commercials this month under the slogan "Stop AIDS" and featuring national soccer team goalkeeper Seigo Narazaki, who gained recent popularity in the 2002 World Cup hosted by Japan and South Korea.
A sex-education booklet for Japanese teenagers has triggered a dispute about whether teaching them contraceptive methods in detail is too radical as abortions among the young continue to rise. At the center of the controversy is the 32-page "Love and Body Book," compiled by the Mothers' and Children's Health and Welfare Association, a privately funded organization supervised by the Health, Labor and Welfare Ministry.
Using diagrams of male and female anatomy to demonstrate what physical changes teenagers experience through adolescence, the booklet also explains contraceptive measures with matter-of- fact illustrations explaining how to use male and female condoms.
The association had distributed 1.27 million copies of the booklet to municipal governments across the nation as of early May targeting students at junior high schools ages 12 to 15. It is part of the ministry's project to curb unwanted pregnancies, the spread of STDs and other sex-related problems among teenagers. The number of abortions among girls under 20 years old reached 46,511 cases in 2001 to hit a record high for the sixth consecutive year, according to a health ministry survey. The number means nearly 13 girls in every 1,000 ages 15 to 19 underwent abortion operations, and eight in 1,000 ages 12 to 19 underwent the procedure. The number of pregnancies brought to term by teenagers less than 19 years old numbered 20,966 in 2001, according to a preliminary report by the health ministry, up 34 percent from 15,621 five years ago.
The controversy prompted some local governments to have second thoughts and stop handing the booklet out to children, while the association scrapped plans for further distribution and collected unwanted copies. Contraceptive methods are not in the ministry's list of items to teach junior high school students. In a bid to appease opponents, the association distributed inserts for the booklet to the local governments in August arguing, "the best way to avoid these troubles (disease infection and unwanted pregnancy), is to refrain from having sex."
Surveys suggest that many young Japanese now maintain multiple sekusutomo - literally "sex friends" - who themselves enjoy numerous liaisons. A joint study by the University of California-San Francisco and Hiroshima University recently found that of 602 teens ages 15 to 19 surveyed in the Shibuya section of Tokyo, 43 percent said they kept five or more sex friends at a time. A similar survey of 16-year-olds in two rural prefectures found 20 percent of boys and 18 percent of girls said that have at least five sex partners.
In the aftermath of the collapse of Japan's early 1990s "bubble economy," many corporations have stopped hiring new university and high school graduates, so ever-greater numbers of young Japanese matriculate each year to the economic margins. They form social groups that - like their jobs - are part-time, low stress and temporary. Their logic: Japan is largely HIV-free, so by having sex within a closed circle of cohorts they can enjoy lifestyles reminiscent of the West after the advent of the birth control pill and before the emergence of AIDS. That flawed reasoning reflects the unwillingness of older Japanese, particularly parents and teachers, to educate kids about the risks of promiscuous behavior. The result, new research shows, is a significant rise in STDs among young Japanese.
According to the Ministry of Health, between 1998 and 2000, the STD infection rate rose 21 percent for Japanese men under 24 and 14 percent for women in the same age group. While Japan's HIV rate remains one of the world's lowest, the International Congress on AIDS in Asia and the Pacific has forecast that AIDS cases in Japan, now at 14,000, could top 50,000 by 2010. Condom sales have dropped 25 percent over the last decade: "Young adults refuse to use them," said a spokesperson for Japan's largest maker of condoms. Japan's abortion rate has nearly doubled since 1999 to 13 per 1,000. Japan's Ministry of Education has outlined a broad sexual education curriculum for high schools, but it is optional.
According to the Japanese Ministry of Health, Labor and Welfare, there were 621 new HIV cases reported and 332 cases of AIDS in 2001, both record highs. Excluding those infected through blood coagulants, the number of new HIV cases surged by 159, or 34 percent, from the previous year, to a cumulative of 4,526 cases. There are an estimated 950,000 HIV-infected people in North America and 550,000 in Western Europe. However, public health experts argue that the situation in Japan is deteriorating faster than anyone anticipated, and they predict there will be 16,000 HIV cases in Japan by 2003 and up to 50,000 cases by 2010. Since 1992, Tokyo Gas Co. has been holding company-wide sessions where an advisor specializing in AIDS education delivers lectures to rank-and-file employees and mid-level managers. The lectures vary from basic knowledge of the disease to human rights in the workplace. "When conveying a message to the new graduates in particular, we emphasize that the number of young sufferers is rising rapidly," said Kazuko Matsuzaki, director of TG's health promotion center. The number of new male HIV cases reached 475 in 2001, up from 108 nearly a decade ago. Males under age 29 accounted for over 38 percent of the total, up from 31 percent on average from 1985 to 2000.
"I can say that Japan is now facing a second wave of AIDS, with a lot of people quite unaware that they can be exposed to the disease through sexual intercourse," said Seiichi Ichikawa, professor of public health at Kanagawa Prefectural College of Nursing and Medical Technology.
Matsushita Electric Industrial Co. offers a free checkup at its health care centers in Osaka and Tokyo not only to its 50,000 employees but also to their families. They can remain anonymous so that there will be no report sent to their superiors at work, and the centers even offer phone and face-to-face counseling services. Hiroshi Hasegawa, representative of Japanese Network of People Living with HIV/AIDS, admits some leading companies are becoming good at maintaining HIV patients' privacy, but he fears many companies still make a grudging response to circumstances, thinking they dare not look into such controversial issues.