Useful Information

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●(For foreign residents)If you become sick in Japan…

1. If you become sick in Japan

1.1 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)

1.2 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.

1.3 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.

1.4 Language support:
There are local governments that provide interpreting service for foreigners to make receiving medical treatment easier and some that don’t provide such services.
If there is no interpreter service, there are multi-language medical interview sheets and a convenient app to use for translating medical terms.
*You can download multi-language medical interview sheets at the CLAIR and AMDA websites.
*VoiceTra is a translation application.

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2. If You Feel You Might Have Been Infected by HIV

2.1 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.

2.2 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%.

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3. HIV Positive Foreigners Living in Japan

3.1 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.

④ If 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.

3.2 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.

② You learned about HIV status at a hospital
Consult with medical doctors and social workers for the treatment procedures.

③If 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.
Inquiry Form

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

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4. Testing

Testing for HIV and STI (Sexually Transmitted Infections)

4.1 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

4.2 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.

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5. HIV Test Sites with Language Support

5.1 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.