HIV testing and attitudes among the working-age population of Japan: annual health checkups may offer an effective way forwards

Ishimaru, Tomohiro; Wada, Koji; Smith, Derek R.

doi:10.2486/indhealth.2015-0087

Cited by 14 publications

(16 citation statements)

References 20 publications

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“…Although most of the results were novel in Japan, my findings on waning public interest and inconsistent knowledge about HIV, barriers to testing and late testing, gaps and deficiencies in sex education, and obstacles to safer sex complement research in Japan by other authors ( Kihara et al, 2003 , Kihara et al, 2002 , Iwamuro, 2007 , Nosaka and Chigusa, 2008 , Japan International Cooperation Agency, 2010 , Horino et al, 2016 , Ishimaru et al, 2016 ). My data on how the swine flu pandemic of 2009 was a factor in curtailing HIV testing were also supported by Japan's National Institute of Infectious Diseases, which speculated that a reduction by 16% in HIV consultations and testing might have occurred for this reason ( National Institute of Infectious Diseases, 2010 ).…”

Section: Discussionmentioning

confidence: 51%

HIV in Japan: Epidemiologic puzzles and ethnographic explanations

DiStefano

2016

SSM - Population Health

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Japan is widely perceived to have a low level of HIV occurrence; however, its HIV epidemics also have been the subject of considerable misunderstanding globally. I used a ground truthing conceptual framework to meet two aims: first, to determine how accurately official surveillance data represented Japan's two largest epidemics (urban Kansai and Tokyo) as understood and experienced on the ground; and second, to identify explanations for why the HIV epidemics were unfolding as officially reported. I used primarily ethnographic methods while drawing upon epidemiology, and compared government surveillance data to observations at community and institutional sites (459 pages of field notes; 175 persons observed), qualitative interviews with stakeholders in local HIV epidemics (n = 32), and document research (n = 116). This revealed seven epidemiologic puzzles involving officially reported trends and conspicuously missing information. Ethnographically grounded explanations are presented for each. These included factors driving the epidemics, which ranged from waning government and public attention to HIV, to gaps in sex education and disruptive leadership changes in public institutions approximately every two years. Factors constraining the epidemics also contributed to explanations. These ranged from subsidized medical treatment for most people living with HIV, to strong partnerships between government and a well-developed, non-governmental sector of HIV interventionists, and protective norms and built environments in the sex industry. Local and regional HIV epidemics were experienced and understood as worse than government reports indicated, and ground-level data often contradicted official knowledge. Results thus call into question epidemiologic trends, including recent stabilization of the national epidemic, and suggest the need for revisions to the surveillance system and strategies that address factors driving and constraining the epidemics. Based upon its utility in the current study, ground truthing has value as a conceptual framework for research and shows promise for future theoretical development.

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Section: Discussionmentioning

confidence: 51%

HIV in Japan: Epidemiologic puzzles and ethnographic explanations

DiStefano

2016

SSM - Population Health

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“…Age was not found to be a predictive factor in the present study, a finding that was inconsistent with some other research conducted in Japan, which found that older age (≥40 years) was independently associated with decreased discriminatory attitudes, although the participants of that particular study were not healthcare workers) 30) . Nevertheless, employers will still need to consider the confidentiality of healthcare workers with infectious diseases to help these workers cope with potentially discriminatory attitudes 31) .…”

Section: Discussionmentioning

confidence: 99%

Barriers to the acceptance of work colleagues infected with Hepatitis B and Hepatitis C in Japan

Ishimaru

Wada

Arphorn

et al. 2016

Journal of Occupational Health

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Background: Healthcare workers infected with Hepatitis B (HBV) or Hepatitis C virus (HCV) may undertake patient care activities if provider-to-patient transmission risks have been assessed in terms of viral load and clinical procedures. The present study investigated potential barriers to the acceptance of colleagues infected with HBV/HCV in healthcare settings after appropriate risk assessment. Methods: We conducted an anonymous, internet-based survey of Japanese nurses. Multivariate logistic analysis was used to assess factors associated with willingness to accept colleagues infected with HBV/HCV after risk assessment. Results: In total, 992 nurses responded to the survey, with 16% indicating that colleagues infected with HBV/HCV should not have patient contact after risk assessment. Willingness to accept HBV/HCV-infected colleagues was negatively associated with attitudes regarding the avoidance of contact with HBV/HCV-infected colleagues (OR: 0.49; 95% CI: 0.28-0.85). Previous professional contact with HBV/HCV patients (OR: 1.73; 95% CI: 1.36-2.12), experience of accidental injection from or personal exposure to HBV/HCV patients (OR: 2.00; 95% CI: 1.42-2.61), knowledge of HBV/HCV (OR: 2.00; 95% CI: 1.52-2.49), and female sex (OR: 1.60; 95% CI: 1.17-2.09) were positively associated with a willingness to accept HBV/HCV-infected colleagues. Conclusions: This study suggests that attitudes regarding the avoidance of contact with HBV/HCV-infected colleagues may be barriers to accepting these colleagues even after risk assessment has been performed. To protect the employment of nurses infected with HBV/HCV, employers should provide comprehensive education for nurses to reduce stigma and improve understanding about the management of staff infected with infectious diseases, such as HBV or HCV.

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“…In Japan, public health centers known as Hokenjo provide free and anonymous HIV testing. The Japanese AIDS Prevention guidelines recommend voluntary counseling and testing for high-risk groups [18]. However, HIV testing in Japan has decreased by 35% from 177,000 in 2008 to 118,000 in 2016 [19].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with access to HIV testing among international students in Japanese language schools in Tokyo

et al. 2020

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Japan has been recognized for its excellent universal health coverage system. However, the migrant population faces many barriers in accessing health services in Japan. Japan hosts around 260,000 international students, mostly from developing countries. Among them, language school students tripled from 2011 to 2017, against the backdrop of labor shortage in Japan. Most of these students are also engaged as cheap laborers and are vulnerable populations with poor access to health services. Several socioeconomic and behavioral factors may increase their vulnerability to HIV and prevent them from accessing HIV testing in Japan. We examined the factors associated with access to HIV testing among international students in language schools in Tokyo. We conducted a cross-sectional study among international students studying in Japanese language schools in Tokyo. We collected data from 769 Chinese, Vietnamese, and Nepalese students using a self-administered questionnaire. We measured their access to HIV testing through questions on their knowledge of where to receive HIV testing and utilization of HIV testing. Bivariate and multivariable logistic regression models were used to analyze the data. Nepalese students were less likely to know where to receive HIV testing in Japan than Chinese students (AOR = 0.12, 95% CI 0.01-0.96). Students who did not need Japanese language interpreters during visits to health facilities were more likely to know where to receive HIV testing (AOR = 1.93, 95% CI 1.14-3.25). Students who did not have knowledge of free and anonymous HIV testing in Japan were also less likely to know where to receive HIV testing in Japan (AOR = 0.18, 95% CI 0.08-0.42). Students who did not have knowledge of free and anonymous HIV testing (OR = 0.05, 95% CI 0.02-0.10) and who had not utilized HIV testing in their home country (OR = 0.12, 95% CI 0.06-0.27) were less likely to utilize HIV testing in Japan. Factors associated with access to HIV testing among Japanese language school students in Tokyo are nationality, need for Japanese language interpreters, perceived access to doctors/health workers, utilization of HIV testing in the home country, and knowledge of free and anonymous HIV testing. These findings may help to design interventions for improving access to HIV testing among international students in Japan.

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HIV testing and attitudes among the working-age population of Japan: annual health checkups may offer an effective way forwards

Cited by 14 publications

References 20 publications

HIV in Japan: Epidemiologic puzzles and ethnographic explanations

HIV in Japan: Epidemiologic puzzles and ethnographic explanations

Barriers to the acceptance of work colleagues infected with Hepatitis B and Hepatitis C in Japan

Factors associated with access to HIV testing among international students in Japanese language schools in Tokyo

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