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Hotel workers and taxi drivers in the Japanese city of Yokohama have
been given a crash course in virology over the past few weeks. As Japan’s
second-largest city gears up to host the world’s tenth international conference
on AIDS next week, officials are worried about prejudice against those taking
part in the conference. They are also concerned about Japan’s record on
AIDS.

The country offers few medical facilities for AIDS patients, and fearing
social ostracism, many Japanese go abroad for HIV tests and treatment. ‘People
are afraid to get tested in Japan because there is little follow-up counselling
or treatment,’ says Jun Takeda of the Tokyo HIV Centre, a volunteer organisation.
‘If they test HIV-positive, they don’t know the next step.’

Government figures for June show that 3389 people in Japan have tested
HIV-positive. But Takeda says the fear of testing means the actual number
of people infected with HIV could be ten times higher.

Those who develop AIDS are put into virtual quarantine in hospitals.
‘The problem is, hospitals haven’t made the adjustments to cope with AIDS
patients. They put them in isolation wards that are used to treat people
with infectious diseases. It becomes more like a prison,’ says Takeda.

That problem triggered a national scandal last year when an AIDS patient
killed himself by jumping from a hospital window. It was discovered later
that he had been kept in isolation and treated by doctors and nurses wearing
rubber gloves.

The fact that hospitals treat AIDS patients at all is largely due to
a directive issued a year ago by the Ministry of Health and Welfare. The
ministry ordered each prefecture to designate at least two hospitals as
AIDS treatment centres. But a survey in April showed that only four of the
47 prefectures had complied. ‘It’s still common for people with AIDS and
HIV-infected people to be rejected at hospitals,’ says Kyoichi Yashiki,
head of the Tokyo HIV Centre.

Another problem is prejudice at work. Critics say Japanese companies
are more interested in screening their employees for HIV than educating
them on working with HIV-positive colleagues. People who test HIV-positive
are usually sacked.

Government directives were also needed to combat prejudice against people
with AIDS staying in hotels. Last year there was another national scandal
when an American was refused entry to 18 Tokyo hotels because he had AIDS.
He found a room at the 19th only by concealing his illness.

It was to avoid such incidents that the Yokohama City Council embarked
on an education campaign in the run-up to next week’s conference. Videos
were distributed showing hotel staff how HIV is transmitted, and reassuring
them about the safety of cleaning the room of a guest with AIDS. Around
a thousand of the 10 000 participants at the conference are expected to
be HIV-positive or to have AIDS.

‘We have had virtually no refusals from hotels in Yokohama,’ says Kazuya
Shimmura, who is seconded to the AIDS conference secretariat from the Ministry
of Health and Welfare. ‘But there have been refusals from hotels in Tokyo.’
Shimmura points to the difference as an indication of the effectiveness
of teaching people to be sensitive about AIDS.

The government may be in need of a little sensitivity training itself.
Six months ago, Keigo Ouchi, who was then Minister for Health and Welfare,
summed up the ostrich-like attitude of many Japanese when he said, ‘All
the countries around Japan are AIDS countries.’

‘People in Japan just don’t want to know about AIDS,’ says Takeda. ‘To
them, it’s like an old Japanese expression: A fire on the other side of
the river.’