Projecting HIV transmission in Japan.
BACKGROUND
Little is known about the epidemiology of HIV in Japan, though newly-identified cases amongst men who have sex with men (MSM) show an increasing trend. Predictions of future trends in the HIV epidemic are essential to identify suitable interventions.


METHODS
A deterministic, compartmental model was developed that incorporated risk groups, disease stages, and treatment and testing parameters. This model was calibrated against current figures on new infections and run over 30 years to identify trends in prevalence amongst MSM, low-risk men and low-risk women. Multivariate sensitivity analysis was used to estimate sensitivity ranges for all outcomes.


RESULTS
Without new interventions amongst MSM in Japan, HIV prevalence will climb from its current rate of 2.1% to 10.4% (sensitivity range 7.4% to 18.7%), while HIV prevalence among low-risk men and women will likely decline. With small changes in safer sex behavior and testing rates, HIV prevalence can remain stable or even decline amongst MSM.


CONCLUSIONS
Japan is at risk of an epidemic of HIV amongst MSM unless significant changes are made to its current public health intervention framework. More research is necessary to understand the key drivers of the epidemic in Japan.
Department of Global Health Policy, University of Tokyo, Tokyo, Japan. sgilmour@m.u-tokyo.ac.jp
Stuart
S
Gilmour
Jinghua
J
Li
Kenji
K
Shibuya
D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D055815:Young Adult