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STI Testing and Sexual Health Services in Japan
STI testing in Japan runs on two tracks: a free HIV test, often paired with syphilis, offered anonymously at public health centers, and clinic testing that is either billed to public health insurance or paid out of pocket.12 Which track you choose decides what you pay, whether your name is attached to the result, and whether the visit appears in your insurer's records.34
Procedures, fees, and requirements can change. Confirm current details at the Ministry of Health, Labour and Welfare (MHLW) site and its HIV Testing and Counseling Map. This article is general information, not medical advice; for symptoms, a possible recent exposure, or a positive result, consult a licensed physician such as a urologist, a gynecologist, or an HIV specialist at a designated AIDS core hospital.
Overview
Sexual health services in Japan are split between the public health system and ordinary medical care. Public health centers test anonymously and for free, while clinics test as part of diagnosis and treatment.12
Neither track depends on nationality. Public health center testing needs no name, insurance card, or residence card, so it is open to every resident.31
The main ways to get tested
There are five routes, and each suits a different situation:
- Public health centers. A 保健所 (hokenjo, "public health center") is run by a prefecture, a designated city, or a Tokyo ward. HIV tests there and at municipal special testing sites are free and anonymous nationwide.1 A growing number of centers test for HIV and syphilis in the same visit.5
- Municipal mail-in programs. From fiscal 2025, MHLW added an HIV mail-in testing program to the services public health centers can run (as of June 2025; confirm current figures with MHLW).6 Only some prefectures and cities offer one.
- Clinic visit billed to insurance. Testing to diagnose symptoms is insured care at a urology, gynecology, dermatology, or STI clinic, at your standard co-pay.527
- Self-pay clinic screening. Routine screening without a medical need is not billable to insurance, so it is paid in full as 自費 (jihi, "self-pay").2
- Commercial mail-in kits. Private laboratories sell kits independently, and MHLW notes that their methods and accuracy vary.6
MHLW runs two national search directories, the HIV Testing and Counseling Map (「HIV検査・相談マップ」) and the STI Testing and Counseling Map (「性感染症検査・相談マップ」), both searchable by prefecture and both in Japanese (as of October 2026).18 The STI map covers HIV, syphilis, chlamydia, and gonorrhea testing sites.8
The first decision is whether you have symptoms, because that determines whether insurance can pay; the second is whether you want anonymity and a free test.21 The flowchart below maps those two questions onto the routes.
The syphilis surge in context
梅毒 (baidoku, "syphilis") is a notifiable disease, and national case reports are collected through 感染症発生動向調査 (kansenshō hassei dōkō chōsa, "national infectious-disease surveillance").910 The surveillance data is now published by the Japan Institute for Health Security (JIHS, 国立健康危機管理研究機構).9
Reports rose year after year from about 1,700 in 2014 to about 7,000 in 2018, and passed 10,000 in 2022 (as of August 2025).11 The table below gives the annual counts from MHLW's August 2025 surveillance summary.11
| Year | Reported syphilis cases | As of | Notes |
|---|---|---|---|
| 2014 | About 1,700 | 2025-0811 | |
| 2018 | About 7,000 | 2025-0811 | |
| 2021 | 7,978 | 2025-0811 | |
| 2022 | About 13,200 | 2025-0811 | First year above 10,000 |
| 2023 | 15,055 | 2025-0811 | Highest since notification began under the Infectious Diseases Control Law |
| 2024 | 14,663 (provisional) | 2025-0811 | Reports received by 2025-01-07; slightly below 2023 |
A later surveillance summary gives a somewhat higher 2024 count than the provisional figure, and reports that 2025 declined again while staying above 10,000 (as of July 2026).12 The 2024 figure above is the provisional count, so expect small revisions.
By age, women are reported mostly in their 20s, while men are reported across a broad range from their 20s to their 50s (as of August 2025).11
Infection is not always visible. Primary syphilis lesions appear after an incubation of 3–6 weeks, and infection can also be asymptomatic, which is why testing matters even without symptoms.10
Free and anonymous testing at public health centers
Public health center testing is the route most residents mean when they search for a free HIV test. The terms below appear on almost every center's booking page.
| Term | Reading | Meaning |
|---|---|---|
| 保健所 | hokenjo | Public health center run by a prefecture, designated city, or Tokyo ward3 |
| 匿名 | tokumei | Anonymous3 |
| 即日検査 | sokujitsu kensa | Same-day (rapid) test13 |
| 通常検査 | tsūjō kensa | Standard test, results in about 1–2 weeks13 |
| 郵送検査 | yūsō kensa | Mail-in test6 |
What is tested and how anonymity works
The national framework dates to a 1991 MHLW notice: public health center HIV testing is anonymous, meaning you do not give a real name or even an alias, and a number or code is enough.3 The application form must not ask for your name, date of birth, contact details, or other identifying items, and specimen containers carry only a specimen number.3
These are screening tests, not diagnoses.14 A reactive result leads to further testing at a medical institution, covered under "If a result is positive" below.
HIV testing is offered nearly everywhere; syphilis is common, and other infections depend on the municipality. The examples below are dated to each source page and are not nationwide rules (as of March 2025 to September 2026 depending on the site; confirm current figures with each public health center).
| Site (example) | HIV | Syphilis | Other tests | As of |
|---|---|---|---|---|
| Tokyo Metropolitan Shinjuku East Exit Testing and Counseling Office | Yes | Yes, with HIV | Gonorrhea and chlamydia only during June 1–30 and November 16–December 15 | 2026-0915 |
| Shinjuku City Public Health Center (ward) | Yes, required | Optional | Hepatitis B and chlamydia optional | 2026-0416 |
| Higashimatsuyama Public Health Center (Saitama Prefecture) | Yes | Yes | Hepatitis B, hepatitis C, chlamydia | 2026-0814 |
| Osaka Prefecture public health centers | Yes (antigen-antibody test) | Optional, with HIV | None listed | 2025-0317 |
| Tondabayashi Public Health Center (Osaka Prefecture) | Yes | Yes | Chlamydia | 2026-0718 |
Some tests are free only as part of a bundle. Tokyo's metropolitan sites do not offer syphilis-only testing; syphilis is tested together with HIV (as of February 2021 and August 2023).1920
At Tondabayashi, syphilis and chlamydia tests are free and anonymous only when taken with an HIV test; taken alone, they are a paid service, with exceptions for engaged couples and husbands of pregnant women (as of July 2026).18 Shinjuku City cannot run a chlamydia test during menstruation or when there is blood in the urine (as of April 2026).16
Booking, session times, and rapid vs. standard tests
Public health centers offer two kinds of test. A standard test returns results 1–2 weeks later, while a rapid test returns results the same day.13
Session frequency and booking rules vary widely. The table below shows five examples (as of each date listed).
| Site (example) | Test type | Sessions | Results | As of |
|---|---|---|---|---|
| Tokyo Metropolitan Testing and Counselling Office (Tama area), Tachikawa | Rapid HIV and syphilis | Every Saturday and Sunday, 20 people per day, reservation required | Same day | 2023-0820 |
| Tokyo Metropolitan Shinjuku East Exit office | Standard | Weekdays 15:00–20:00; weekends 13:00–17:00 | One week later, same weekday and time, in person | 2026-0915 |
| Ibaraki Public Health Center (Osaka Prefecture) | Rapid | 1st, 2nd, and 4th Thursdays, 9:30–10:30 | Same day | 2025-0317 |
| Tondabayashi Public Health Center (Osaka Prefecture) | Standard | 1st and 3rd Wednesdays, reception 13:30–14:30 | In person, in principle the Wednesday one week later | 2026-0718 |
| Shinjuku City Public Health Center | Not stated | Online reservation; session times not stated in the notice | In person | 2026-0416 |
In Osaka Prefecture, four public health centers (Ibaraki, Shijonawate, Fujiidera, and Izumisano) offer same-day results (as of March 2025).17 Check your own center's page for which type it runs before you book.
A same-day result is not always final. At the Tama-area office, about 1 in 100 rapid HIV results is inconclusive; a confirmation test is then run and the result is given after the next testing day (as of August 2023).20 A positive rapid result is referred to a medical institution for further testing.20
To book in Tokyo, use the Tokyo HIV Testing Information Web (東京都HIV検査情報Web) reservation site. The reservation center's phone number changed on 2026-07-28, so numbers printed in older guides may no longer work (as of July 2026).21
Dedicated testing centers in large cities
Tokyo's anchor site is the Tokyo Metropolitan Shinjuku East Exit Testing and Counseling Office (東京都新宿東口検査・相談室). It was formerly the Minami-Shinjuku Testing and Counseling Office and began operating at its current site on 2021-03-06 under the new name.19
The office is at SIL Shinjuku Building 2F, 2-46-3 Kabukichō, Shinjuku-ku, one minute from Seibu-Shinjuku Station's North Exit and ten minutes from JR Shinjuku Station's East Exit (as of September 2026).15 It opens weekdays 15:00–20:00 and weekends 13:00–17:00, is women-only on Wednesdays, and closes on national holidays and over the year-end and New Year period (as of September 2026).15
Testing covers HIV and syphilis, free and anonymous, with gonorrhea and chlamydia added during two set periods each year (as of September 2026).15 Results are given one week later in person, and counseling is available on request (as of September 2026).15
Language support is less certain. When the office moved in 2021, Tokyo announced English support every day and new Chinese and Korean support on the 2nd and 4th Tuesdays from April 2021, with web reservation in English, Chinese, Korean, and Easy Japanese, and phone and fax reservation in Japanese only (as of February 2021).19 The office's current page does not restate that schedule, so confirm it when you book.15
The Shinjuku East Exit office runs standard tests, with results one week later in person. Same-day rapid testing for HIV and syphilis is at the separate Tama-area office in Tachikawa, on weekends only, and Tokyo's English-language leaflet describes that Tama-area office (as of September 2026 and August 2023).1520
The Tama-area office is on the 2nd floor of the Tokyo Metropolitan Tachikawa Welfare and Health Office in Tachikawa (as of August 2023).20 Separately from the metropolitan offices, ward public health centers run their own programs: Shinjuku City's center offers free, anonymous HIV testing with optional syphilis, hepatitis B, and chlamydia tests, and lists English support (as of April 2026).16
Other large cities run their own sites and session patterns. Search the HIV Testing and Counseling Map by prefecture to find them.1
Free mail-in test programs
A municipal mail-in program lets you test at home without the free test losing its public oversight. Under MHLW's June 2025 guidance, you apply through a public health center, collect your own sample, mail it to a contracted laboratory, and receive the result through the center (as of June 2025).6 Because the finger-prick lancet is a medical device, its use must be explained to you under a physician's supervision (as of June 2025).6
The flow below follows that guidance.6
MHLW treats mail-in testing as a pre-test (プレ検査, pure kensa), not a replacement for screening: a small, self-collected blood sample may lower sensitivity, so any positive or indeterminate result moves on to a screening test (as of June 2025).6
Tracking was the gap that prompted the national framework. An MHLW-funded research report found that when a center hands out ordinary mail-in kits, it cannot see whether the person returned the sample or viewed the result, so it cannot offer follow-up counseling; a 2023 Okinawa pilot used a kit that let staff check return and result-viewing status.22
Programs differ by area. The two examples below show the range (as of June and October 2026).
| Program (example) | Who can apply | Tests | Cost | Results | Application period | As of |
|---|---|---|---|---|---|---|
| Osaka Prefecture HIV and syphilis mail-in program | Residents of Osaka Prefecture outside ordinance-designated and core cities; no prior HIV diagnosis; up to four tests per fiscal year | HIV antigen-antibody (required); syphilis TP antibody (optional) | Free | Online via the application portal; personal information not linked to results | Kits 2026-04-01 to 2027-02-28; samples must arrive by 2027-03-12 | 2026-0623 |
| Fukuoka City home-delivery kit | Fukuoka City residents; kits delivered only to city addresses | HIV and syphilis (blood) plus genital chlamydia (urine), all three together | Test free; ¥594 including tax for delivery, return postage, and payment fees | Online, about one week after the laboratory receives the sample | 2026-10-01 to 2027-02-28 | 2026-1024 |
Fukuoka City's program stays anonymous even though you give a name and address. Those details are used only for delivery, and the sample is returned under an ID and password you choose, with the result linked to that ID (as of October 2026).24
There is no national list of mail-in programs. Check your prefecture's or city's health page, or search the MHLW maps.18
Testing at a clinic
Clinics are the route for symptoms, for infections a public health center does not test, and for screening outside session hours. How the visit is billed depends on why you are there.2
Which department to visit
MHLW lists several departments beyond dedicated STD and infectious-disease clinics, matched to who you are and where the symptoms are.5
| Department | Reading | Typical use |
|---|---|---|
| 性病科 | seibyōka | STD (venereology) clinic, any patient5 |
| 泌尿器科 | hinyōkika | Urology, for men5 |
| 産婦人科 | sanfujinka | Obstetrics and gynecology, for women5 |
| 皮膚科 | hifuka | Dermatology, for skin symptoms5 |
| 耳鼻咽喉科 | jibiinkōka | Ear, nose, and throat, for throat symptoms5 |
Infectious-disease departments (感染症科, kansenshōka) also see STI patients.5 For reading the department signs outside clinics, see Specialty Department Signs: Reading Japan Clinic Placards; for visiting a specialist directly, see The Freedom-of-Access Norm: Seeing Any Doctor in Japan Without a Referral.
Insured testing when you have symptoms
Under the national rules for insured care, tests are performed when they are medically necessary for diagnosis and treatment.2 If you have symptoms, testing at a clinic is part of that care and is billed to public health insurance.25
You pay your standard co-pay, which is set nationally by age.7
| Age group | Co-pay share |
|---|---|
| Preschool children | 20%7 |
| School entry (age 6) to under 70 | 30%7 |
| 70–74 | 20% (30% with active-earner income)7 |
| 75 and over | 10% (20% or 30% depending on income)7 |
Your share is that percentage of the fees for the consultation and for the tests the doctor judges necessary, so the total depends on what is ordered.27
Self-pay screening without symptoms
Insurance cannot be used for a health checkup.2 Testing without symptoms or another medical reason is screening, so clinics charge it as self-pay.2 For what else falls outside insurance, see What Insurance Doesn't Cover.
Mixing the two kinds of care in one course of treatment is, in principle, not allowed.25 When it happens, the whole cost becomes self-pay, including the part insurance would otherwise have paid.25
Under Japan's mixed-billing rule, combining insured and uninsured care in one course of treatment makes the entire cost self-pay. If you have symptoms and also want extra screening tests, ask the clinic in advance how it will bill the visit.25
Self-pay prices are set by each clinic. As one example, an English-capable self-pay clinic in Shinjuku lists individual tests at ¥3,850–19,800 including tax, does not bill insurance, and delivers results online (as of October 2026; confirm current figures with the clinic).26 This is a single clinic's menu, not a market survey.
Finding a clinic with English support
MHLW's STI Testing and Counseling Map lets you search testing facilities, including hospitals, by prefecture, but the site is in Japanese (as of October 2026).8 For HIV care specifically, Tokyo lists 43 AIDS core hospitals and publishes first-visit guidance for each (as of February 2026).27
For help in English, TELL (Tokyo English Life Line) is listed by MHLW as an English-language consultation line, open daily 9:00–23:00 (as of October 2026).28 For general strategies on locating English-capable doctors, see Finding an English-Speaking Provider.
Home test kits
Home kits trade a clinic visit for privacy and convenience. Public mail-in programs are covered above; this section covers kits sold by private companies.
Commercial kits: what they are and what they are not
MHLW describes commercial mail-in testing as run independently by private companies, with methods and accuracy that vary, and notes that the number of mail-in tests has grown (as of June 2025; confirm current figures with MHLW).6 HIV testing in Japan is two-stage, a screening test followed by a confirmatory test, and MHLW treats a mail-in result as a pre-test that comes before screening, not a substitute for it (as of June 2025).6
The scale is substantial. An MHLW-funded research report found that 10 mail-in testing companies ran 104,298 dried-blood-spot HIV tests in 2021, already more than public health centers, whose HIV testing had fallen to about 70,000 in 2020 from roughly 130,000 a year as staff shifted to COVID-19 work (as of fiscal 2023).22
Formal mail-in HIV testing is recent. The Japanese Society for AIDS Research issued a statement on appropriate dried-blood-spot HIV testing on 2021-03-15, and in 2022 the regulator approved an HIV antigen-antibody test reagent for dried whole-blood specimens.22
Prices vary by seller and panel. The table shows examples from two sellers (as of October 2026).
| Kit (example) | Seller | Price (tax included) | As of |
|---|---|---|---|
| HIV kit, low-cost package | GME医学検査研究所 | ¥3,740 | 2026-1029 |
| HIV kit, standard package | GME医学検査研究所 | ¥5,110 | 2026-1029 |
| HIV/AIDS kit (Type J) | STD Checker | ¥5,430 | 2026-1030 |
| Throat chlamydia and gonorrhea (Type N) | STD Checker | ¥6,350 | 2026-1030 |
| Men's basic panel, 5 items (Type E) | STD Checker | ¥10,430 | 2026-1030 |
| Women's basic panel, 6 items (Type Q) | STD Checker | ¥11,825 | 2026-1030 |
Sellers set their own timing guidance. One HIV kit seller advises testing one month after the exposure, with a true negative confirmed only after three months, offers an anonymous option, and refers positive results to cooperating medical institutions (as of October 2026).29
HIV prevention: PrEP and PEP
Two medication strategies prevent HIV: taking medication before possible exposure, and starting it urgently after one. Access and cost differ sharply between the two.
| Term | Reading | Meaning |
|---|---|---|
| 曝露前予防 | bakuro-mae yobō | Pre-exposure prophylaxis (PrEP)31 |
| 曝露後予防内服 | bakuro-go yobō naifuku | Post-exposure prophylaxis (PEP)32 |
| 自費診療 / 自由診療 | jihi shinryō / jiyū shinryō | Self-pay (uninsured) care3334 |
| 公知申請 | kōchi shinsei | Approval route for a new use based on established medical knowledge35 |
PrEP approval status and cost
On 2024-08-28, Truvada (emtricitabine and tenofovir disoproxil fumarate) received approval in Japan for HIV-1 pre-exposure prophylaxis, the first oral HIV prevention option approved in the country.31 The approval came through the 公知申請 route after a request from the Japanese Society for AIDS Research, and PrEP is recommended for people at high risk of HIV.35
PrEP is not covered by public health insurance and is paid in full by the patient (as of May 2026; confirm current figures with HIVマップ or your prescribing clinic).33 Truvada's official drug price is ¥2,414.7 per tablet, which puts daily branded PrEP at roughly ¥70,000–80,000 or more per month (as of April 2026).33
Only branded Truvada, taken daily, was approved for PrEP; generic versions and Descovy were not (as of May 2026).33 HIVマップ reports that clinics and domestic distributors can no longer import Truvada generics since the approval, and that personal importation, while theoretically possible, carries quality and legal risks (as of May 2026).33 For the rules on importing medicine for personal use, see The Yakkan Shomei Import Certificate.
PrEP requires regular monitoring: HIV testing, hepatitis testing, kidney function, bone density, and testing for other STIs.33 A prescribing doctor sets the schedule for your case.
PEP after a possible exposure
PEP is a 28-day course of HIV medication started within 72 hours of a possible exposure.32 At the national AIDS Clinical Center (ACC, now part of JIHS), the service is mainly for people who had sex that could transmit HIV, such as sex without a condom, with a partner who has or may have HIV (as of November 2022).32
ACC does not offer PEP if the partner is confirmed HIV-negative or if you are already HIV-positive (as of November 2022).32 Occupational exposures such as needlestick injuries among health workers are handled separately.32
PEP is offered only within 72 hours of the exposure, and after-hours access is limited. At ACC, weekday outpatient hours are 8:30–14:00, after-hours patients go through the emergency window, and no after-hours phone consultation on PEP is available (as of November 2022).32
The timeline below follows ACC's guidance, which recommends HIV testing at 1 month and at 3–4 months after the exposure and offers hepatitis B and C screening.32
PEP has no insurance coverage, and few facilities prescribe it (as of October 2026).34 The only primary cost figures available are ACC's, from a page last updated in November 2022, so current charges may differ (as of November 2022).32
| Item at ACC | Amount | As of |
|---|---|---|
| Initial consultation | ¥20,000 | 2022-1132 |
| Medication | ¥10,000 per day (¥280,000 for 28 days) | 2022-1132 |
| After-hours surcharge | ¥10,000 | 2022-1132 |
Comparing costs and turnaround
The table compares the routes on cost, anonymity, coverage, and speed, with each row dated to its source (as of the date in each row; confirm current figures with MHLW and the provider named in the source).
| Route | Cost | Anonymity | Infections covered | Result time | Language | As of |
|---|---|---|---|---|---|---|
| Public health center, standard test | Free | Anonymous, no name | HIV; syphilis commonly; others vary | About 1–2 weeks, in person | Varies; mostly Japanese | 2026-103113 |
| Public health center, rapid test (Tokyo Tama-area example) | Free | Anonymous | HIV and syphilis | Same day | English leaflet available | 2023-082013 |
| Tokyo Shinjuku East Exit office | Free | Anonymous | HIV, syphilis; gonorrhea and chlamydia in set periods | One week, in person | English daily, Chinese and Korean on 2nd and 4th Tuesdays, per the 2021 announcement | 2026-09 / 2021-021519 |
| Municipal mail-in (Osaka Prefecture example) | Free | Not linked to name or address | HIV; optional syphilis | Online | Not stated | 2026-0623 |
| Municipal mail-in (Fukuoka City example) | Test free; ¥594 for postage and fees | ID and password, anonymous | HIV, syphilis, chlamydia together | Online, about one week after lab receipt | Not stated | 2026-1024 |
| Clinic, with symptoms (insured) | 30% co-pay for ages 6–69 | Insurance claim generated | As the doctor orders | Varies | Varies | Stable7 |
| Clinic, screening (self-pay) | Example: ¥3,850–19,800 per test | Depends on clinic | Per clinic menu | Example: online | Example: English | 2026-1026 |
| Commercial kit | Example: ¥3,740–11,825 | Anonymous option | Single HIV test to 5–6 item panels | Example: day after arrival | Mostly Japanese | 2026-102930 |
If a result is positive
A reactive result starts a sequence of confirmation and treatment, not an immediate diagnosis. Where you go next depends on the infection.63
Confirmatory testing and treatment
HIV testing has two stages. A positive or indeterminate screening result goes on to a confirmatory test, such as a Western blot or nucleic-acid test.6 If a public health center screening test is positive, the center explains that a detailed examination is needed and introduces you to a medical institution it has arranged in advance.3
The path from screening to care looks like this.6327
Syphilis is treated with penicillin-class antibiotics, given by mouth, by drip, or by injection.9 Japan approved ステルイズ (Suteruizu, "benzathine benzylpenicillin, a long-acting penicillin injection") on 2021-09-27; it launched in January 2022 and is indicated for syphilis other than neurosyphilis.3637
For early syphilis in adults and children aged 13 and over, ステルイズ is a single intramuscular injection of 2.4 million units.37 The Japanese Society for Sexually Transmitted Infections positions it as equivalent to oral amoxicillin, long Japan's standard first-line drug, with different dosing for early (under one year) and late syphilis, and notes that the Jarisch-Herxheimer reaction may occur after treatment.38
Chlamydia is treated with antibiotics, and MHLW advises avoiding sex until treatment is complete.39 HIV care is concentrated at designated エイズ診療拠点病院 (eizu shinryō kyoten byōin, "AIDS core hospitals"); Tokyo publishes its list with first-visit guidance for each hospital (as of February 2026; confirm current figures with the Tokyo Metropolitan Government Bureau of Public Health).27
HIV treatment costs and public support
Two public programs reduce what people living with HIV pay for antiretroviral therapy: a physical disability certificate, and the medical-expense support it unlocks.4041 The general monthly cap on insured medical costs is explained in The High-Cost-Catch (Kogaku Ryoyohi) System.
| Term | Reading | Meaning |
|---|---|---|
| 身体障害者手帳 | shintai shōgaisha techō | Physical disability certificate42 |
| 免疫機能障害 | men'eki kinō shōgai | Immune dysfunction, the certificate category for HIV43 |
| 自立支援医療（更生医療） | jiritsu shien iryō (kōsei iryō) | Medical-expense support for people aged 18+ with a physical disability certificate4042 |
| 重度かつ継続 | jūdo katsu keizoku | "Severe and continuous" category, which receives lower caps41 |
The certificate comes first. HIV-related immune dysfunction is certified in grades 1–4 for people aged 13 and over, based on CD4 count and a list of clinical and laboratory findings; for example, grade 1 requires a CD4 count of 200/μl or less plus six or more listed items, and grade 4 requires 500/μl or less plus one item.43
People already on treatment can be certified using their pre-treatment test values, and while treatment continues, re-certification is in principle not required.43
With a certificate, adults aged 18 and over can use 更生医療, which MHLW states covers antiretroviral therapy and other treatment for HIV infection; municipalities administer it.4042 Immune dysfunction falls in the 重度かつ継続 category, so you pay 10% of medical costs or the monthly cap below, whichever is lower (as of January 2026).41
| Household income bracket | Monthly cap (重度かつ継続) | As of |
|---|---|---|
| Public assistance (生活保護) | ¥0 | 2026-0141 |
| Low income 1 (municipal-tax-exempt, income under threshold) | ¥2,500 | 2026-0141 |
| Low income 2 (municipal-tax-exempt, other) | ¥5,000 | 2026-0141 |
| Middle income 1 (municipal income-tax portion under ¥33,000) | ¥5,000 | 2026-0141 |
| Middle income 2 (¥33,000 to under ¥235,000) | ¥10,000 | 2026-0141 |
| Higher income (¥235,000 or more) | ¥20,000, a transitional measure through 2027-03-31 | 2026-0141 |
The low-income-1 threshold was ¥809,000 a year and is reset from July 2026 to about ¥826,500 (as of January 2026).41 Outside the 重度かつ継続 category, the higher-income bracket is excluded from 更生医療 altogether (as of January 2026).4142
Health insurance also has a separate ¥10,000 monthly cap for certain long-term "specified diseases" (特定疾病, tokutei shippei), but its HIV entry is limited to cases designated by the Minister of Health, Labour and Welfare.44 Whether it applies in a given case is a question for the insurer.
Telling partners
Partners may need care too. MHLW notes that chlamydia often causes few or no symptoms and spreads unnoticed, so if you test positive, your sexual partners also need to see a doctor and be treated.39
MHLW advises asking hospital staff when and how to explain a diagnosis to partners.5 No anonymous partner-notification service was found in the sources for this article.
Notifiable-disease reporting and privacy
HIV/AIDS and syphilis are category 5 notifiable diseases, and doctors must report every diagnosed case within 7 days.451046 Under the Infectious Diseases Control Law, reports for more serious categories include the patient's name, but reports for these category 5 diseases list age, sex, and items set by ministerial ordinance, and the patient's name is not one of them.47
The official forms match the law. Neither the syphilis form nor the HIV/AIDS form has a field for the patient's name, address, date of birth, or phone number; the only names and addresses on them are the reporting doctor's and the medical facility's.4648
The forms do record other details, and the two differ.4648
| Recorded on the form | Syphilis | HIV/AIDS |
|---|---|---|
| Sex and age at diagnosis | Yes46 | Yes48 |
| Diagnosis, diagnostic method, symptoms, key dates | Yes46 | Yes, including CD4 count at diagnosis and estimated infection date48 |
| Likely infection route, including same-sex or opposite-sex contact | Yes46 | Yes, also injected drug use, mother-to-child, blood products48 |
| Sex-industry work or use in the last 6 months | Yes46 | No48 |
| Area where infection likely occurred (municipality in Japan, or country) | Yes46 | Yes48 |
| Main prefecture of residence in recent years | No46 | Yes48 |
| Nationality (Japan, other, or unknown) | No46 | Yes48 |
Community organizations and counseling
Counseling is built into public health center testing. At the Tama-area office, the visit runs from reception and guidance through the blood draw, a doctor's interview, the result, and counseling, and the Shinjuku East Exit office offers counseling on request (as of August 2023 and September 2026).2015
MHLW lists telephone consultation lines, including several in languages other than Japanese (as of October 2026).28
| Line | Language | Hours | As of |
|---|---|---|---|
| 公益財団法人エイズ予防財団 (AIDS prevention foundation) | Japanese | Mon–Fri 10:00–13:00, 14:00–17:00 | 2026-1028 |
| Tokyo AIDS telephone consultation (東京都エイズ電話相談) | Japanese | Mon–Fri 12:00–21:00; Sat, Sun, and holidays 14:00–17:00 | 2026-1028 |
| ぷれいす東京 (Pureisu Tōkyō), for people living with HIV, commissioned by MHLW | Japanese | Mon–Sat 13:00–19:00 | 2026-1028 |
| TELL (Tokyo English Life Line) | English | Daily 9:00–23:00 | 2026-1028 |
| CHARM | Spanish, Portuguese, English | Tue 16:00–20:00 | 2026-1028 |
| CHARM | Chinese | Wed 16:00–20:00 | 2026-1028 |
| CHARM | Filipino, English | Thu 16:00–20:00 | 2026-1028 |
| TAWAN | Thai | Thu 9:00–16:00; Sat 17:30–22:00 | 2026-1028 |
ぷれいす東京 also runs PrEP in JAPAN, a Japanese-language information site on PrEP and PEP.34 If you are in acute distress rather than seeking health information, see Crisis Resources in Japan.
Good to know
Window periods and when to retest
HIV antibodies usually become detectable about four weeks after infection, and nucleic-acid testing can detect the virus from about two to three weeks.13 A negative result soon after an exposure is not final.
Testing sites give different waiting times, so follow your own site's guidance: Tokyo's rapid-test office asks for at least 90 days after the exposure for a reliable rapid HIV result (as of August 2023; confirm current figures with the testing site).20 Saitama Prefecture's Higashimatsuyama center recommends three months or more (as of August 2026), and Osaka's Tondabayashi center says results are reliable from eight weeks, with earlier tests possibly needing a retest (as of July 2026).1418
For syphilis, primary lesions appear after an incubation of 3–6 weeks, and infection can be asymptomatic.10 Ask the testing site or clinic when to test for other infections.
Insurance claims leave a paper trail
An insured clinic visit generates an insurance claim. Kyokai Kenpo's medical-expense information lists the patient's name, the month of care, the care category, the number of days, the facility name, and the costs, but not the diagnosis (as of October 2026).4
The policyholder can view this information for themselves and their dependents (as of October 2026).4 If you are a dependent on a spouse's or parent's plan, they can see the clinic's name and the amount. This describes Kyokai Kenpo; employer insurance societies and National Health Insurance may present the information differently.4
Public health center testing creates no insurance claim, because it is free and anonymous and needs no insurance card.31
HIV status and your residence status
The Immigration Control Act lets Japan refuse entry to people with certain infectious diseases, but the ground covers only category 1 and 2 diseases, novel-influenza-type diseases, and certain designated diseases.49 HIV/AIDS is a category 5 disease, outside those categories.4548
Positive Destinations, an HIV Justice Network database that cites UNAIDS and the US State Department, found no evidence of HIV-related restrictions on entry, short stays, or long stays in Japan (as of July 2026).50 No Immigration Services Agency or MHLW statement specifically addressing HIV status and visa renewal or permanent residency was found for this article.
Results are usually given in person
Plan for a second visit. Under the national framework, a doctor gives the public health center result directly to you after checking your application stub, and results are not given by phone.3
The Tokyo Shinjuku East Exit office does not give results by mail, phone, or email, and you must bring the original application slip (as of September 2026).15 Shinjuku City's center also gives no results by phone and issues no certificates (as of April 2026).16
Tokyo's metropolitan testing offices do not issue certificates either, so a free anonymous test cannot be used where a written result is required (as of August 2023).20 Municipal mail-in programs and some self-pay clinics deliver results online instead (as of June and October 2026).232426
Testing options shrink outside big cities
Session frequency varies widely. Tokyo's Shinjuku East Exit office runs every weekday evening and weekend afternoon (as of September 2026), while Osaka Prefecture's Ibaraki center runs one hour on three Thursday mornings a month (as of March 2025) and Tondabayashi one hour on two Wednesday afternoons (as of July 2026).151718
Mail-in programs are the main workaround, under the national framework introduced in fiscal 2025 (as of June 2025).6 Eligibility is local: Osaka Prefecture's program excludes residents of ordinance-designated and core cities, which run their own testing (as of June 2026), and Fukuoka City's program is for city residents only (as of October 2026).2324
A "free" mail-in test can still carry a small fee. Fukuoka City's test is free, but you pay ¥594 for kit delivery, return postage, and payment processing (as of October 2026).24
Vaccines that prevent sexually transmitted infections
HPV vaccine catch-up vaccination covered women born between fiscal 1997 and fiscal 2008; first doses had to be received by 2025-03-31, and remaining publicly funded doses by the end of March 2026 (as of March 2026).51 Outside the eligible group, HPV vaccination is available voluntarily at full self-pay (as of March 2026).52
Hepatitis B vaccination is routine for infants, with standard doses at 2, 3, and 7–8 months; adult vaccination is not part of the routine program (as of April 2025).53 For schedules and voluntary options, see Vaccinations in Japan: Schedules for Children and Adults.
See also
- Contraception and Emergency Contraception in Japan
- Abortion in Japan: Law, Spousal Consent, and Access
- Mental-Health Disclosure and the Visa-Renewal Question
- Extension of Period of Stay
- Medical Japanese: Intake and Symptom Description