Center for Health and Rights of Migrants

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About CHARM

 CHARM’s Goals

Programs Provided by CHARM

 a) Multi-language program
 b)HIV program

If you become sick in Japan

Japanese Health Insurance

If You Feel You Might Have Been Infected by HIV

HIV Positive Foreigners Living in Japan

Testing

HIV Test Sites with Language Support


About CHARM

CHARM (Center for Health and Rights of Migrants) is a citizen’s group that supports HIV-positive people and non-Japanese speakers working cooperatively with the purpose of allowing everybody to live in a healthy manner.

CHARM was established in 2002 by a group of medical doctors, counselors, and social workers who were involved in HIV treatment.

CHARM supports HIV-positive people through cooperation, regardless of nationality nor language, so that everyone live their own lives.

We cooperate with healthcare organizations and healthcare centers to provide multilingual support. This will ensure all people can access the medical and subsidy systems despite the language barriers.

CHARM collaborates with the core hospitals speicalizing HIV treatment in the Kansai region as well as other healthcare organizations in Osaka City and NGOs supporting foreigners throughout Japan.

We are entrusted to undertake projects by local authorities such as Osaka City, Kyoto City and Osaka Prefecture as well as the Health, Labour and Welfare Ministry.

CHARM’s Goals

CHARM is an organization that works together with foreigners, HIV-positive people, healthcare professionals, and general citizens so everybody living in Japan can live in a healthy manner. It aims realize a society where people respect each other regardless of their nationality, language, sexual preferences, or health status.

We support people who face difficulties because of language or not treated fairly, on visas or application for various social security services.


Programs Provided by CHARM

There are programs that foreigners and HIV-positive people living in Japan can use:

  1. Consultation, counseling, and language interpreting support required to solve each person’s problem.
  2. Peer support by people with the same condition.
  3. Providing information about health in a language you can understand.
  4. Holding lectures and research to deliver actual conditions and recommendations.
  5. Providing places where various people can meet and get involved.
  6. Accepting interns and providing training to nurture people who can assume healthcare, medicine, and welfare centered around people.

In cooperation with the Japanese government and local autonomous bodies, such as healthcare centers and NGOs, our aim is to build a society where every HIV-positive person (both Japanese and foreigners) have full access to healthcare and medical services.

a) Multi-language program

1. Telephone consultation for HIV/sexually transmitted disease

【English/Spanish/Chinese/Portuguese】

We provide telephone consultation to HIV-positive people and 4 languages.
We can provide you information about places where you can be tested for HIV and other sexually transmitted diseases in Osaka and hospitals/clinics where you can get medical attention.
Consultation is confidencial and free of charge.

Tuesdays 4:00 p.m. ~ 8:00 p.m. English/Spanish/Portuguese
Wednesdays 4:00 p.m. ~ 8:00 p.m. Chinese
Thursdays 4:00 p.m. ~ 8:00 p.m. English

06-6354-5901


2. Face-to-face consultation for HIV-positive persons and their partner

【Japanese/English/Spanish/Thai/Filipino(Tagalog)/Portuguese, and others】

You can talk to a social worker, counselor, nurse, etc. in a secure environment.
You can use the service when you want to solve problems or even when you simply want to talk with someone.

If you would like to have a consultation, please contact CHARM.

Inquiry Form


3. Accompanying service to government offices and hospitals

【Japanese/English/Spanish/Thai/Filipino(Tagalog)/Portuguese, and others】

If you have to go through various procedures at a city office, go to a hospital for the first time, or go to a place you are not familiar with, our staff member will accompany you.

If you would like to have a consultation, please contact CHARM.

Inquiry Form


4. HIV Medical Interpreting Service

【Japanese/English/Spanish/Thai/Filipino(Tagalog)/Portuguese, and others】

When you go to see a doctor and receive explanations at the hospital you regularly visit for HIV treatment, you can use our interpreter service in a language you can understand.
Hospitals are limited to those in Osaka, Kyoto, Hyogo, Shiga, Nara, and Wakayama prefectures. If your hospital is outside of these prefectures, please consult us.

To apply for this service, please contact CHARM or tell your doctor or nurse at the hospital.

Inquiry Form


b)HIV program

5. HIV counselor dispatching service

【Japanese/English/Thai/Filipino(Tagalog), and others】

We dispatch trained counselors for AIDS for HIV-positive people who want to have counseling at municipal hospitals in Osaka.
If you would like to receive this service, please request your doctor or nurse at the hospital.

Inquiry Form


6. Overseas HIV information

【Japanese/English/Thai/Filipino(Tagalog), and others】

These are the people who can use this service:
1) HIV-positive persons who live outside of Japan and will come to Japan for business, who want to know about hospitals that they can go to for HIV treatment, medical fees and support groups, etc.
2) HIV-positive persons who are returning to their country/region, and want to know about HIV treatment and the types of medicines they can obtain after going home.
3) HIV-positive persons who live in Japan and plan to live in a country/region outside of Japan in the future.
4) Healthcare personnel who need to have overseas medical information.

<For inquiries, please contact CHARM>

For those who want to know about overseas medical information involving HIV, please write down following information on the form of inquiry.
・Country/Region and area (state, province, city, etc.) you are going.
・What will your visa status (working, student, spousal, etc.) be?
・How long are planning to stay there?

Inquiry Form


7. Women’s Network

【Japanese/English, and others】

Female HIV-positive people can meet their women peers.
Individual consultation by members, small group meetings, and national women’s exchange meetings are held.
You can join the gathering no matter what language you speak.

To participate, please contact CHARM.

Inquiry Form


8. SPICA

【Japanese/English, and others】

SPICA is a group for people who are HIV-positive and are trying to recover from drug addiction. The group meets twice a month.
Participants talk, learn, and do recreations together.
・We welcome people who speak any language, or are of any religion and sexuality.
・You can join even for single session.
・We strictly observe your privacy.

Second Sunday of every month: 16:00-18:00
Fourth Saturday of every month: 16:00-18:00

To participate, please contact CHARM.

Inquiry Form


●If you become sick in Japan

(1) If you become sick in Japan, first, visit a local clinic and not a general hospital.
There are different types of clinics depending on your symptoms.
If you cannot decide which type of clinic to visit, go to internal medicine doctor.

・Internal medicine (内科; ないか; Nai ka) : General symptoms including cold-like ones, fever, stomachache, etc.
・Surgeon (外科; げか; Ge ka) : Cuts and abrasions, pus formation, etc.
・Orthopedics(整形外科;せいけいげか; Sei kei Ge ka) : Pain in bones, joints, muscles, etc.
・Obstetrics/Gynecology (産婦人科;さんふじんか; San fu jin ka) : Pregnancy, child delivery, women’s diseases
・Otology (耳鼻科; じびか; Ji bi ka) : Ear, nose, and throat related symptom
・Ophthalmology (眼科; がんか; Gan ka) : Eye symptoms
・Pediatrics (小児科; しょうにか; Shou ni ka) : For children up to elementary school age (around 12 years old)

(2) If your symptoms require a more complete examination and/or a specialist’s diagnoses, a doctor at the clinic will write a referral letter for specialized examination.
There is a chance that a larger hospitals do not accept you to see a doctor unless you have a referral letter.
Even if they allow you to see their doctor, the medical fee will be about ¥5,000 higher and you may have to wait for a long time.

(3) What you need to see a medical doctor

①Health insurance card (Public or National)
②Cash (Many medical clinics do not accept credit cards)

Initial visit fee: ¥2,000 ~ ¥3,000 (you have to pay for the first visit to a clinic).
Medical fees and fees for examinations and medicine differ at each clinic, and doctor’s assessment.
If you don’t have enough money consult with the doctor.

Every person who lives in Japan must be covered by health insurance (public or national health insurance).
If you are not covered by health insurance, medical fees can become very expensive.
If you use the travel insurance of a private company, you must pay the medical fee at the clinic/hospital and be reimbursed later. So initially, you have to pay the full amount.


●Japanese Health Insurance

(a)Type

 (a-1) Public health insurance
  The company/office you work at enrolls you in a health insurance plan.
  Half of the coverage is deducted from your salary by the company/office and the other half is covered by the company/office.

 (a-2) National Health Insurance
  This insurance is for those who are self-employed, students and not working.
  You can sign up for National Health Insurance at the National Health Insurance Division of the local government office where you registered as a resident.
  Insurance premium fees are determined by the amount of residential tax you paid the previous year.
  For foreign residents, only those who are registered as residents (who have resident status for 3 months or more) can become a member of National Health Insurance.
  Those with short term stay residence status or with a Visa for Medical Stay cannot be a member of National Health Insurance.

(b)Benefits of becoming a member of health insurance

 (b-1) If you are covered by health insurance, you pay only 30% of the actual medical fee when you become sick and/or hospitalized.

 (b-2) When your medical fee becomes very high due to having surgery and/or long term hospitalization, you do not have to pay more than a maximum amount.

 (b-3) If you have a disease which is a specified as incurable or have a disability, you can receive special medical expense support while you are covered by health insurance.


●If You Feel You Might Have Been Infected by HIV

The Difference between HIV and AIDS

HIV (Human Immunodeficiency Virus) is the name of a virus. If a person infected HIV neglects treatment, his/her immune function can gradually be compromised over a number of years.
AIDS (Acquired Immune Deficiency Syndrome) is a condition in which various infectious diseases develop due to compromised immune function resulting from HIV infection.

About HIV Infection

HIV is a weak virus. It can be found in blood, semen, vaginal fluids and breast milk. In many cases, it is transmitted by sexual activity.
HIV can enter the human body through cuts and wounds which are deep enough to bleed.
Other possible HIV transmission points are the mucous membranes of the eye, inside the mouth, inside the vagina, urethra, and rectum.
One may be infected through direct contact with infected blood/semen/ vaginal fluids, cuts and wounds.
Infection can easily occur from sharing syringe needles because of the high possibility of infected blood directly entering a blood vessel.
Transmission from HIV positive mothers to their child may occur during vaginal delivery because babies come in contact with infected blood.
Also, breast feeding may cause a baby to be infected.

How to Reduce Your Risk of HIV Infection

a Sexual Activity

The risk of infection can be reduced during sex by avoiding direct contact of your partner’s blood, semen and vaginal fluids with your genitals, anus and mouth.
Condoms are one way to avoid direct contact with a partner’s blood, semen and vaginal fluids.
Condoms that can be put over a penis or inside a vagina are being sold.
If you are in a situation where condom use is difficult, the risk of infection can be minimized by at least limiting the amount as well as the period of time the blood, semen and vaginal fluids are in contact.
For example, if semen is ejaculated inside the mouth, vagina or anus, or in case penal or vaginal fluids enter your mouth, the risk of infection is lower if you immediately wash the part(s) and do not swallow the partner’s semen or vaginal fluids.
Also, cuts and wounds on the mucus membrane can allow the virus to easily transmit, raising the risk of infection.
Before engaging in oral sex, avoid brushing your teeth which may cause open wounds inside your mouth. Just gargle instead.
Other STIs (Sexually Transmitted Infections), canker sores or cold sores can cause open wounds in your mucous membrane or skin, allowing the virus to transmit more easily. Therefore, make sure to treat such sores immediately and avoid sexual activity until they cure completely.
When sex toys are inserted into the anus or vagina, they are covered with bodily fluids and blood.
When sharing sex toys, blood, vaginal fluids, etc. can come in contact with the mucous membrane. Avoid sharing them or if they are shared, wash them before a different person uses them or put condoms on them.

b Sharing Syringe Needles

When injecting drugs, the sharing of syringe needles can cause infection. Always use new needles or keep a needle for personal use.
Infection risk can be lowered by washing and disinfecting sex toys after use, if they are shared. So, due to both HIV and hygienic concerns, avoid sharing sex toys as much as possible.

c Delivery by Pregnant HIV Women

A pregnant HIV positive woman can reduce the risk of infecting her unborn child by taking antiretroviral drugs at the appropriate time to reduce the amount of virus in the body, having a caesarian section, and not feeding the baby infected breast milk after childbirth.
By combining these methods, the risk of HIV infection from mother to child can be reduced to less than 0.5%.


●HIV Positive Foreigners Living in Japan

1. A person who is already on ARV drugs moving to Japan.

ARV (antiretroviral) drugs is not free in Japan.
However, there are subsidy for medical expenses. The first step is to be a member of health insurance system.
Only members of health insurance system can apply for the subsidy.
There are procedures to receive this medical aid.
You must prepare the following documents before you come to Japan.

①Required Documents:

 a) Two examination results which show a CD4 of 500 or lower together with viral load, amount of white cells, blood platelets, and hemoglobin at those time.
 b) Results of an examination up to the time you entered Japan.
 c) A referral letter from your medical doctor.

②Selecting a Hospital

There are medical institutions designated as specified hospitals for HIV treatment throughout Japan.
If you don’t know which one to go, please contact CHARM.

Inquiry Form

③Become a member of health insurance(public or national)
You need to become a member of health insurance(public or national) and bring your insurance card with you to the hospital.

④If you are living in the Kansai Area, you can use CHARM medical interpreter and accompanying services.
If you are living outside the Kansai Area and need interpretation support, please consult with us.
*The Kansai Area includes Osaka, Hyogo, Kyoto, Shiga, Nara, and Wakayama prefectures.

⑤Japanese Immigration Bureau issues visa regardless of HIV status thus to enter the country is not a problem.
Renewal of visa status is also possible.


2. If you find out you are HIV positive while in Japan.

① You learned about HIV status by a blood test.

Go to a hospital introduced by the examination site and go through the procedure for first-time patients.

What is the procedure for first-time patients?。。。Near the hospital entrance, there will be a counter for first-time patients(in Japanese sho-shin-te-tsu-zu-ki, 初診手続き). You have to do the following:

① Fill out the application form.
② Take the form to the receptionist for first-time patients. Hand them a referral letter.
③ Receive your hospital card and documents.
④ Give the documents and the card at the reception counter of the department.
⑤ Doctor’s check and other examinations.
⑥ Ask the medical doctor questions.
⑦ Paying your bill.

Bring with you:

a) Your health insurance card
b) Referral letter you received at the site of your HIV examination.
c) About 10,000 yen in cash

② You learned about HIV status at a hospital

Consult with medical doctors and social workers for the treatment procedures.


3. If you are living in the Kansai Area, you can use CHARM’s medical interpreter and accompanying services.

If you are living outside the Kansai Area, please consult with us.
For inquiries, contact CHARM.

CHARM offers accompanying service to hospitals and local government offices for foreigners who are HIV positive.
The service is FREE for HIV positive people. If you are a foreigner and need a language support at hospitals and administrative offices, please use this service.
Please let us know at least a week before you need the service for us to make arrangement.
Please know that we may not be able to meet all your needs.
There are some languages we cannot provide services for. For more information, please contact CHARM.

Inquiry Form


●Testing

Testing for HIV and STI (Sexually Transmitted Infections)

1. Where to Get Tested for HIV/STIs?

The only way to tell if you are infected with HIV is to get tested.
You can get tested for HIV at a public health center in your community. The test is free of charge and anonymous (there is no need to reveal your real name ).
Some public health centers also offer other STI tests such as for syphilis and chlamydia at the same time.
HIV can be tested for at some medical institutions, but it is not free of charge.
Search the “HIV Test/Consultation Map” (Japanese language), or ask CHARM for more information.

Inquiry Form

2. Understanding Your HIV Test Results

HIV test results are shown as “Negative”(-) or “Positive”(+).

HIV Negative (-) result means one is not infected with HIV.
An HIV Positive (+) result means one is infected with HIV.

For most people, if they are infected with HIV, the state of the infection can only be reflected in the HIV test about 4 weeks after possible HIV exposure.
Therefore, if your result is “negative” and you took the test 4 weeks after possible exposure to HIV, you are most likely not infected.
However, the span of time for the test to reflect the state of infection differs depending on the individual.
Periods to obtain accurate results from the time of possible HIV exposure to the blood testing are different at each public health center or test site. Ask the center what the window period is for possible exposure at the time of taking the HIV test.
For example, the method Kyoto City uses for their night time HIV test requires of window of more than 3 months to obtain a correct result.
One possibly exposed less than 3 months prior can take the HIV test, but it is recommended to take the test again after 3 months have passed.


●HIV Test Sites with Language Support

1. Kyoto City (English)

Free, anonymous HIV test in the evening. Twice a month on Monday.
HIV test is Rapid test. The test result comes back in about an hour.
The results of the STI test (syphilis, gonorrhea, chlamydia) will be given by the staff at the same place in about two weeks.
An appointment is required for the HIV test.
And if you wish to take the STI test, you also need to make an appointment for the day you come back to get the test results.

The tests are available for a limited number of people. Please note that there may not be an appointment slot available.

For more information, please check the Kyoto City website.
  (In Japanese) Kyoto City Evening HIV test

Place: Kyoto Industrial Health Association [MAP]
Date and Time: Twice a month on Monday 5:30 p.m. – 6:30 p.m.
(Please check the Kyoto City website for the schedule. Click here (in Japanese))
Test contents:
 (1) Only HIV test
  *Rapid test (Know your result in about 60 minutes)
 (2) HIV test + STI test (syphilis, gonorrhea, chlamydia)
  *HIV test is Rapid test. However STI test results will be given by the staff at the same place in about two weeks.

Appointment/Inquiry
(English) :CHARM 06-6354-5902 Monday – Thursday 10 a.m. – 5 p.m.
(Japanese) : Kyoto Industrial Health Association Weekday 8:30 a.m. – 4:30 p.m.

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