Sexual Health

Not your average birds and the bees. Some attitudes about sex and sexuality are different in Japan than in our home countries. As with most places in the world, the most important to things are to be informed and be careful! It’s usually not appropriate to discuss sexual issues at school, work or in social situations. For the most part, when you first arrive and don’t know people very well, as much as some people might want to know more about you, try to creatively brush off any inappropriate questions or remarks.

Condoms
Japanese condoms for men tend to be smaller than their western counterparts. You can buy them at most drug stores, convenience stores and places like the Don Quixote (ドンキホテイ) in Shimotori. Some JETs get Western-sized condoms sent from home or order them on the Internet (try www.condomania.com). The female condom is sold under the name “MyFemy.”

The Pill
The Pill is fairly easy to obtain. It is available at private hospitals and at women’s clinics. Picking up the prescription monthly is fairly easy: There is a brief consultation with the doctor (“Has anything changed?”, “How are you feeling?”, etc. It is not a full examination.) and your blood pressure will be measured. It is covered by your insurance and the price runs from 2,000 to 3,000 yen.

If you do not want to deal with a clinic or hospital monthly, you can see if your preferred brand is available online. You can have it shipped to you; however, you will need to include a written prescription from your doctor.

Alternatively, you can check out Japan Healthcare Info‘s online consultation service for the pill. The consultation is in English and they can mail the pill anywhere in Japan. You can request up to a 12 month supply at a time, with the doctor’s approval. JETs who have used the JHI Online Consultation for Birth Control Pills have reported ease and satisfaction with the service. For more information and to schedule an appointment, check out Japan Healthcare Info.

The Morning-After Pill
In Japan the “Morning After Pill” is officially only given in emergencies as it is viewed by many Japanese doctors as unsafe. In Japanese, it is called ‘kei kou shinin yaku’ or in katakana ‘moruningu afuta piru.’ It must be taken within 72 hours after the incident. This pill is not covered by national insurance, it requires a prescription and Fukuda Women’s Hospital is one of the only places in Kumamoto willing to administer this pill.

There are English speaking doctors at Fukuda Women’s Hospital – Dr. Saito, Dr. Fukuda, Dr. Yamamoto, Dr. Hagiwara and Dr. Obaru. They are used to foreigners so it is easy to explain what you need from them. It’s located near the central post office and the Kotsu Center in central Kumamoto and the clinic is open Monday to Saturday 9:00am – 6:00pm. You cannot make an appointment ahead of time, so be prepared for a long wait. The phone number is 096-322-2995.

Pregnancy Tests
The home pregnancy test called “Clear Blue” is available from pharmacies and major drug stores for about 500 Yen. It is reportedly quite accurate and comes with English instructions.

Pregnancy
If you decide to have a baby in Japan, you need to register the pregnancy at your city/town/village office within the first month. You will be given a mother and child information booklet and the Tokyo Childbirth Education Association (see the JET Diary) has information about pregnancy and childbirth in Japan.

Abortion
Abortion seems to be the most common way of dealing with an unwanted pregnancy in Japan. It is not covered by insurance and cannot be done after the second trimester. Again, Fukuda Hospital in Kumamoto City is best for this as they are able to do abortions and the location in the city offers you anonymity.

While abortion is still a big decision for women and their partners to make, there is often minimal counseling offered at the clinic. There are dozens of counseling resources available online as well as hotlines.

HIV/AIDS and other STD Tests

There are various reasons for wanting to get tested for STDs, but if you are ever in a situation where you would like to get tested, there are many health institutions that offer services. Please note: There is an incubation period of 8 weeks for the HIV virus, and 4 to 6 weeks for Chlamydia and Syphilis. This means that it may take up to 8 weeks from the possible exposure date for the HIV Virus to appear in your blood. You should not go in for a test until it has been 8 weeks since the possible exposure date since immediate testing after possible exposure may lead to false negatives.

Before going to the health institution, keep in mind that they will ask that you refrain from urinating for at least two hours prior to your visit. When you arrive at the health institution, the receptionists will ask for your reason for visit. You should let them know that you would like to have a STD screening (性病検査, seibyou kensa) as well and the area of the body in which you are concerned about. Once you head into the room with the nurse and doctor, they may ask you of your recent sexual activity and the symptoms you may be having. Keep in mind that most health institutions will not accept your health insurance if you do not show symptoms or have not had an sexual encounter with someone who has reported having a STD, and some may even refuse to screen you for STDs. Depending on what STDs you would like to screen for, the price and whether you will have a blood and/or urine test performed varies. Your test results will not be available until at least 3-7 days after the screening, and you will need to make another visit to receive the results and consultation from the doctor.

In the case that you require medication for your symptoms, keep in mind that the medication dosage or type of medication available in Japan may differ from that of your home country. Even after you finish taking the prescribed medication as instructed, there are some cases in which the body expresses antibodies and can lead to false positives when screening for STDs in the future. It is recommended that you fully and honestly communicate your health and sexual history with your doctor.

For more information about HIV and STD testing in Japan, please refer to this website. The website also offers information on where you may be able to find free testing sites and available hours across Japan (extensive information available only in Japanese). For locations in Kumamoto, check here.

Testimonials and information from JETs who have taken tests for STDs can be found below.

Getting a HIV Test at Kumamoto City Public Health Center

Kumamoto City Public Health Center (Kumamoto-shi Hokenjo / 熊本市保健所) (Google Maps)
Cost: Free
English: No
Address: 5-1-1 Oe Chuo-ku, Kumamoto (熊本市中央区大江5丁目1番1号)
Phone: 096-364-3185
Hours: Weekdays from 9am-12pm and 1pm-5pm
Tests Available: HIV, chlamydia, syphilis

No appointment is necessary if you arrive at least an hour before closing, but they prefer if you call ahead to make an appointment. There are other Public Health Centers in Kumamoto, but their hours vary.

Getting there:

In Kumamoto City, take the street car to Kotsukyokumae Station. The building is on the north side of the road (the same side as Daiei, the pharmacy), and contains the Kumamoto Public Health Center (熊本市保健所). It’s a grey building with 5 floors and vertical gardens in strips on the outside.

A testimonial:

“Go in and turn right at the information desk. Past the washrooms there will be an elevator. Take it to the 4th floor. Outside the elevator there will be a telephone. Pick it up, and say “HIV kensa, yonkai ni imasu” (“HIV test, I’m on the 4th floor”)

Someone will come and show you to a testing room, where a counsellor will ask you to put down a nickname. This can be your name, a number, or any word at all. This is for you to use when getting your results.

At this point you can ask for syphilis and chlamydia testing as well, for which they use the same blood sample. The counsellor will inform you that the test will not pick up anything contracted in the last two months, and that the results will be in one week.

I had a nice chat with the counsellor because she was friendly, but my Japanese is limited, so I think less questions regarding sexual history were asked then might be routine.

Finally, a nurse took my blood both quickly and painlessly, and they sent me on my way.

To pick up results, you’ll have to go back to the same place on a weekday between 9-11AM or 1-3PM. Just pick up the same phone, and say “HIV kekka” (Results) and someone should either come, or ask over the phone for the nickname you gave when they took blood.

A doctor will then match your sample number to your result number. I speak little Japanese, so I just gave a thumbs up and a thumbs down and said “daijobu desu ka?”

After a nice smile, a relieved and hearty thumbs up, and some bowing, I was sent on my way, both happy and disease free.”

Another Testimonial:

“The day of the test, I went in and the testing guy asked me a few questions in Japanese, which I didn’t really understand, but he got across that I should come back in a minimum of one week for the results. The HIV test was indeed free. They ask you to write a “password” on a sheet of paper which you should bring back with you when you come to get your results. The guy stuck me with a needle, which I didn’t even feel, and took a sample of my blood, assigning it a number which was also on my “password” sheet. The whole ordeal took about 15 minutes.

When I returned a week later, I showed the attendant the password form, and she immediately directed me downstairs to the testing room. A woman came in this time, and I handed her the form. I speak little Japanese, and she spoke little English, so to avoid all confusion, I drew a plus sign and a frowny face, and then a minus sign and a happy face, on a piece of paper which made the explanation process as simple as possible. She pointed to the happy face, and then said that everything was “daijobu” and smiled, showing me the results in Japanese, matching the number on my password paper to the number on the results. Getting the results actually took about 5 minutes total.”

STD Testing at Suizenji Hifuka Iin (水前寺皮ふ科医院)

Suizenji Hifuka Iin (水前寺皮フ科医院) (Google Maps)
Cost: ¥5000-6000 (using health insurance)
English: Yes
Address:  5 Chome-15-8 Suizenji, Chuo Ward, Kumamoto (熊本県熊本市中央区水前寺5-15-8)
Tel: 096-382-4551
Hours: Mon-Sat 9 a.m. – 12 p.m. (This is the only center open on Saturdays)
Mon/Tue/Thur/Fri 2-6 p.m.
Testing: HIV, chlamydia, syphilis, herpes, gonorrhea, genital warts, pubic lice

Testing:
This clinic, unlike the health center, is able to test for herpes, gonorrhea, genital warts and pubic lice in addition to HIV, syphilis, and chlamydia.

They see people on a first-come, first-served basis, and are pretty crowded on Saturdays. Unlike other hospitals and clinics, they don’t call people in the waiting room by name. They assign each patient a number when they arrive and then call that number. It will take one week for test results to come back.

Additional Information:
This clinic is open on Saturdays, so if you’re having trouble getting the time off of work, or if you don’t wish to use nenkyuu you can come here instead of the Kumamoto City Health Center.

It has been reported that some of the staff speak a little English and that they happily work with patients who don’t speak Japanese.

HIV/STD ScreeningVocab and Phrases:

Can I have the HIV test?
HIV検査を受けたいです。
HIV kensa o uketai desu.

STD Screen/Testing性病検査seibyou kensa
Chlamydiaクラミジアkuramijia
Gonorrhea淋病rinbyou
Herpesヘルペスherupesu
Syphilis梅毒baidoku
Pubic lice毛じらみke jirami

How much will the tests cost?
検査はいくらですか。
kensa wa ikura desu ka.

How much is it all together?
全部でいくらですか。
zenbu de ikura desu ka.

When you ask this (or when you say what tests you would like), the clinic will probably explain that testing methods vary by STD. The following are the different tests given:

Blood Test 血液検査ketsueki-kensa
Urine Test 尿検査nyou-kensa
“Discharge Test”分泌物検査bunpibutsu-kensa

Is everything OK?
わたしは大丈夫でしょうか。
watashi wa daijoubu deshou ka.

(Test results)
Negative 陰性 insei
Positive 陽性 yousei

Can I have a copy of my results?
結果のコピー(写し)をもらえますか。
kekka no copii o moraemasu ka.

What should I do next?
これからわたしは何をすればいいですか。
kore kara watashi wa nani o sureba ii desu ka.

What are your recommendations?
先生は何をすすめますか。
sensei wa nani wo susumemasu ka.

Here are some other words/phrases that might come in handy. It may also come in handy to take a J-E/E-J pocket dictionary or electronic dictionary with you if you have one:

Insurance Card保険証hokenshou
Symptoms症状shoujou
City Health Center保健所hokenjo
False Positive偽陽性giyousei

Counseling
Because the language barrier might make it difficult to receive the kind of counseling that goes along with HIV tests in other countries, you might consider calling the Japan HIV/AIDS line. It operates on Saturdays from 11:00-14:00 at (03) 5259-0256 (Tokyo#) and (0720) 43-4105 (Osaka#). They provide a safe, non-judgmental place to discuss any concerns you might have. They have trained telephone counselors who provide emotional support (pre and post HIV testing) as well as counseling, info, and referrals.

For more information on any of these topics, please contact the Prefectural Advisors.

All inquiries are confidential!