Participation report 03 - Fast-Track Cities Workshop Japan 2021 -

10 / 12 / 2021

Expanding HIV testing opportunities in the Post-Corona era

The year 2020 was a year of restraint and self-restraint due to the spread of COVID19 infection, leading to a decline in the uptake of health and cancer screening. This is no exception in HIV antibody testing.
Early detection and treatment of HIV infection is important to prevent the subsequent development of AIDS and the spread of infection to others. This section introduces efforts to expand opportunities for HIV testing.

To promote HIV testing among MSM in Japan

Dr. Noriyo Kaneko (Associate Professor, Nagoya City University Graduate School of Nursing・Faculty of Nursing), who specialises in HIV infection and sexual health, gave a presentation on Strategies to expand testing based on factors that promote and inhibit HIV testing among MSM in Japan.
A study of the relationship between HIV testing and sexual behaviour and other factors among men who have sex with men (MSM: Men who have Sex with Men) in various regions found that older men were less likely to be regularly tested for HIV.
The report points out that "in order to maintain interest in sexually transmitted diseases such as HIV and syphilis, it is important that Community Based Organisations (CBOs) working on HIV control continue to disseminate information, and there is a need to increase options other than traditional testing, such as testing at private medical institutions and self-testing kits."

In particular, during the COVID19 epidemic, the work of health centres was heavily burdened and conventional testing was delayed in some places. There is a need to increase the number of testing options, and as one such option, the expansion of testing through the use of private medical institutions are needed. In fact, the number of tests is said to be growing in the Chugoku and Shikoku regions, where the continuation of testing is being maintained. The need to expand the use of postal self-testing kits and introducing new testing methods are being considered.

There were also great results by the efforts to increased testing opportunities, as postal self-testing kits has shown the potential to deliver tests to people at risk in rural cities by the treach of CBOs and other private organisations.

A new initiative to avoid Three C’s (Closed spaces, Crowded places, Close-contact settings) and safety and safely conduct tests for sexually transmitted diseases

In 2020, the number of HIV antibody tests in health centres was 68,998, the lowest in the last 12 years. This was definitely due to the spread of COVID19 infection.

Dr. Mayumi Imahashi, a specialist in infectious diseases (Head of the Infectious Disease Laboratory, Infection and Immunity Research Department, Clinical Research Centre, NHO Nagoya Medical Centre), introduced a new testing initiative, iTesting. This allows users to book a test using a smartphone or other device, present the ID obtained at the test site, receive a test kit for self-collection of blood, receive an orientation about the test on a tablet, and then have their blood collected on the spot. The results can be checked on the web at a later date and those who test positive will be issued with a referral letter encouraging them to take a confirmatory test. It is also important to note that support groups and others can be consulted by email, chat and other forms.

A survey of those who had been tested under this programme revealed that while some were dissatisfied with the access to the venue, many were 'very satisfied' with the actual orientation provided at the venue and the protection of their privacy. The survey also revealed that many people were unaware that conventional health centre consultations are free of charge, which made them realize that theres a need to for improved distribution of information.
Behind the lack of growth in the number of tests is the fact that people don't know about free anonymous testing at health centres. We need to provide an environment and opportunities that make it easier for people to take tests, such as iTesting. Also, many people mistakenly believe that they can be infected by kissing, theres a need to disseminate correct HIV information.

This HIV testing and early ART was also discussed in a later panel discussion on 'Expanding HIV testing opportunities and early ART in Japan'. The panellists were Dr. Toshifumi Taniguchi (Chiba University Hospital), Dr. Mayumi Imahashi, Dr. Mihoko Yotsumoto (Tokyo Medical University Hospital), Dr. Toshihide Kidokoro (Shinjuku East Exit Testing and Consultation Office, Tokyo) and Dr. Teiichiro Shiino (Clinical Research Centre, National Center for Global Health).

Here, too, many commented on the urgent need to consider introducing other means of testing alongside health centre testing in order to expand opportunities for HIV testing, and to establish a system to promptly link those who test positive to treatment through a possible new 'self-testing kits'.