Last Updated: Tuesday, 13 July, 2004, 15:57 GMT 16:57 UK

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Japan's Aids time bomb

By Jonathan Head
BBC correspondent in Tokyo

The focus of most of the delegates to the International Aids Conference in Bangkok is on the enormous problems posed by the disease to developing countries.

It's always been somewhere in the back of my mind, HIV, but I'm afraid I've never done much to protect myself in the past Kuki Uchikawa, university student

But it is not just the poor who are unprepared to deal with Aids.

In Japan, one of the world's wealthiest societies, awareness of the risks posed by the disease is almost non-existent among many young people, and yet their sexual behaviour is increasingly risky.

While HIV infection rates in Japan remain officially low at around 6,000, experts fear the real total could be higher, and will get a lot worse unless attitudes begin to change to a disease many Japanese believe only foreigners can catch.

One Friday a month, gynaecologist Dr Tsuneo Akaeda visits Club Jamaica, one of dozens of places in Tokyo where young Japanese party till sunrise. He gives free blood tests for HIV - with almost immediate results.

University student Kuki Uchikawa, who has taken the test, said: "It's always been somewhere in the back of my mind, HIV, but I'm afraid I've never done much to protect myself in the past. This is the first time I've decided to come and find out more about the disease."

Among the volunteers helping Dr Akaeda is Mariko - she is 18, and has only just become aware of the risk HIV poses to her generation.

Poor education

"We never had much sex education at school. We were taught little about contraception, or how you catch HIV or other diseases. Teachers just don't feel comfortable talking about sex," she said.

HIV tests are being offered in Japan's clubs

Her friend, Madoka Izumi, also a high school student, agreed.

"I go to a girl's school, and we've never been able to learn what boys think about sex. They've taught us some of the physical sides of sex, but none of the emotional aspects, so we're not really prepared to deal with it," she said.

Yusuke Izumi, a university student, said: "I don't remember getting any sex education at school - we just talked about it among ourselves, about the things we did with girls."

Adults are probably oblivious about teenagers' sexual activity, Mariko said.

"Parents always think their children are different. They can't imagine them having sex or having abortions. They can only think of them studying hard at school."

By the age of 17, more than a third of teenagers in Japan have already had sex at least once.

There are other statistics which Dr Akaeda finds even more alarming. Sexually-transmitted diseases are rising rapidly among young women - a sure sign of having sex with multiple partners but without using condoms.

"Teenagers these days are very casual about sex. They're happy to have sex with anyone they meet - they use phrases like 'let's play together?'

"I gave away vouchers for free STD tests to girls, and found that 82% them were infected.

"It's incredible. I suspect a lot of them may have HIV as well."

In Japan, sex has become a freely-traded commodity, seemingly unconstrained by moral concerns.

Dozens of pornographic cable TV channels on sale here, and yet sales of condoms have been falling for several years.

Condom dearth

"We're very concerned about the negative image of condoms among young people, because it's not just HIV, but other sexually-transmitted diseases which are spreading," said Toshiaki Ishii, of the Okamoto Condom Co Ltd.

"We're trying to find ways to make them more appealing, but so far without success. I think the lack of sex education is partly to blame for this," he said.

The absolute number of people infected with HIV in Japan is still quite small - but unlike other developed countries, every year that number keeps rising.

There could be a price to pay for young people's blissful ignorance

And yet there is still a marked reluctance here to discuss the problem openly, or to run the kind of hard-hitting awareness campaigns that would wake this country up to the danger it faces.

That reluctance prevails even in the corridors of Tokyo's city government. Ida Mami, of the Medical Service's Division, is sounding the alarm over Aids awareness, but said getting more explicit sex education in schools is not easy.

"It is a sensitive issue. We have to start with what's possible, and avoid provoking a reaction from conservatives. If we push too hard on discussing condoms and safe sex in classrooms, some people may demand we stop all HIV education," she explained.

A start of sorts has been made in one of Tokyo's most elite girls' schools. They invited Dr Akaeda to educate, not the pupils, but their mothers - though only a handful turned up.

His use of graphic illustrations and even more graphic statistics had its intended effect - to shake any illusions they may have that their daughters are somehow immune to the wave of adolescent promiscuity sweeping Japan.

Social taboo

Actually talking about sex to their children, though, is another matter.

"Well it's rather difficult to bring this subject up in a casual way. If I can find the right opportunity, I hope I will feel able to discuss it," said one mother.

"I think this is a subject our children are already interested in, so I guess they'll understand if we raise it with them," another said.

Young people often seem like Japan's golden generation, unburdened by the work ethic of their parents, enjoying more leisure, more affluence, more security.

In such a cosseted environment it is hard to imagine the spectre of Aids. But it is here, and they don't seem to realise.