For anyone who is unaware: yes, pre-exposure prophylaxis for HIV, commonly known as PrEP, is available in Japan. Taken to reduce the risk of acquiring HIV through sex or injection drug use, it can be accessed through clinics that offer PrEP prescriptions and monitoring.
Access can vary depending on the medication and dosing approach, your location, English-language support, and clinic fees. This guide explains how to get PrEP in Japan, the differences between daily and on-demand PrEP, what testing to expect, how much it can cost, and where to find English-speaking care.
PrEP in Japan
As mentioned, it is possible today to get PrEP in Japan. Before 2024, it was possible to purchase PrEP medication, but it was not officially recognized as such. This is because drugs had not yet received a PrEP indication from Japan’s Pharmaceuticals and Medical Devices Agency (PMDA).
In August 2024, however, PMDA recognized that Truvada, a drug also used as part of HIV treatment, did have a PrEP indication.
Since then, PrEP has been available at a number of clinics across Japan. Because the regulatory change is fairly recent, you may still come across older English-language information saying that PrEP is unapproved or unavailable in Japan. That information may no longer reflect the current situation.
How to Get PrEP in Japan
Getting PrEP in Japan usually involves these steps:
- Find a clinic or other provider that offers PrEP
- Arrange a consultation using the provider’s current procedure.
- Complete the necessary assessment and tests.
- Discuss the appropriate medication and dosing approach with the clinician.
- Receive your medication through the provider’s supported pathway.
- Complete the recommended follow-up tests and monitoring.
Some providers offer walk-in appointments, online or telephone consultations, mail-in testing, or medication delivery. These options vary by provider, so check the clinic’s current procedure before booking.
For Those Visiting Japan
Most of the process above also applies to visitors. However, short-term visitors should check a few details before assuming that a particular clinic can provide PrEP.
First, confirm whether the provider accepts short-term visitors and what identification or contact information it requires. Payment procedures, remote-care requirements, and follow-up arrangements can also differ between clinics. English-language service does not necessarily mean that every visitor can use every pathway offered by the clinic.
If you already take PrEP, try to avoid running out during your trip. Have the exact name of your medication and any recent relevant test information available if you need to see a provider in Japan. A Japanese clinic may not necessarily use the same medication or monitoring arrangement as your provider at home.
Daily vs On-Demand PrEP in Japan
One major issue that you may already be anticipating is: what kind of PrEP can you get in Japan?
As the names suggest, daily PrEP requires you to take medication every day, whereas on-demand PrEP is taken around anticipated sex. Japanese professional guidance discusses both, but they are not simply interchangeable options for everyone.
Daily PrEP in Japan
Daily PrEP means taking your prescribed PrEP medication every day rather than only around anticipated exposure.
Daily oral PrEP has evidence across a broad range of people at risk of HIV through sex or injection drug use. Truvada, which contains TDF/FTC, has a Japanese PrEP indication for daily use.
Descovy, which contains TAF/FTC, may also be prescribed as PrEP by some clinics. However, its approval status and the strength of evidence differ depending on how it is used and for whom, so medication choice should be discussed with a clinician.
On-Demand PrEP in Japan
On-demand PrEP, also known as 2-1-1 PrEP, is taken around anticipated sex rather than every day.
According to the current Japanese Society for AIDS Research guidance, the strongest evidence for on-demand PrEP applies to cisgender men and transgender women who are not using gender-affirming hormone therapy. TDF/FTC, the combination used in Truvada, has the strongest evidence for this approach.
On-demand PrEP is not recommended for people with chronic hepatitis B. The evidence for using TAF/FTC, the combination used in Descovy, as on-demand PrEP is more limited, so this should be discussed with a clinician rather than treated as a straightforward alternative.
The 2-1-1 method starts with two tablets 2 to 24 hours before sex. You then take one tablet 24 hours after the first dose, and another 48 hours after the first dose.
So, if you planned to have sex on a Saturday evening, an example schedule could look like this:
| 时间 | Number of Tablets to Take |
|---|---|
| Saturday Noon | 2 |
| Sunday Noon | 1 |
| Monday Noon | 1 |
If you continue having sex over several days, you continue taking one tablet every 24 hours. For people for whom on-demand PrEP is appropriate, dosing continues until two daily doses have been taken after the last sexual exposure.
Because on-demand PrEP is not suitable for everyone, you should discuss this approach with a clinician rather than choosing it solely because it may use fewer tablets.
Tests Before and While Taking PrEP
According to the Japanese Society for AIDS Research and PrEP in Japan, before starting or restarting PrEP, you must get tested for HIV and have your hepatitis B status and kidney function checked.
This is because if you already have HIV, the risk of developing drug resistance means you will need to be treated for HIV itself rather than taking PrEP alone. Chronic hepatitis B also matters because on-demand PrEP is not recommended in these cases. Kidney-function tests help your clinician decide whether the medication is suitable for you.
PrEP in Japan also recommends getting tested for other sexually transmitted infections (STIs) at the same time, so that they can be treated if necessary.
You will also need follow-up monitoring after starting PrEP. Current Japanese guidance recommends a follow-up after one month and then every three months, with HIV testing forming a central part of that schedule.
Those aged 50 or over, or with an estimated creatinine clearance below 90 mL/min, require additional kidney-function monitoring at six months. Kidney function should also be checked at least annually. Other STI and medical tests may be recommended depending on your individual circumstances.
How Much Does PrEP Cost in Japan?
PrEP is not covered by Japanese health insurance, and so any PrEP you access will need to be paid for out of pocket. The costs themselves may vary from clinic to clinic, but you can expect to need to pay for the following services:
- 初步咨询
- Necessary testing
- PrEP medication
The costs of these can also depend on several variables. For example, at Idaten Clinic in Osaka, an individual HIV test that takes three to four days for results costs ¥4,500, while a same-day test costs ¥6,000. Or, at Private Care Clinic Tokyo, a one-month set of PrEP costs ¥12,100, while a three-month set is ¥22,000 — both including HIV and kidney function tests.
Let’s look at individual clinics, prices, and services more generally.
English-Speaking PrEP Clinics in Japan
To be clear, these three clinics are not intended to be representative of the prices or services offered by any or all clinics in Japan that offer PrEP. These are a small sampling of clinics in two major cities — Tokyo and Osaka — that offer English-speaking services.
| Private Care Clinic Tokyo | Personal Health Clinic (Tokyo) | Idaten Clinic (Osaka) | |
|---|---|---|---|
| In-person/Remote Options | Online appointments and delivery available (initial online consultation fee of ¥3,300 and postage fee of ¥1,100 applies) | Online appointments and delivery available (¥1,500 initial and ¥1,000 subsequent postage fees apply) | Phone appointments and delivery available (¥1,000 postage fee applies) |
| Consultation Fee (¥) | 2,750 | 2,500 (1,000 for follow-up visits) | 2,500 (1,000 for follow-up visits) |
| PrEP Medication Price (¥) | Daily (One Month): 12,100 Daily (Three Months): 22,000 On-Demand (4 tablets): 5,500 On-demand (30 tablets): 12,100 | One Month (30 tablets): 10,000 Three Months (90 tablets): 19,000 Six months (180 tablets): 37,000 | One Month (30 tablets): 10,000 Three Months (90 tablets): 19,000 Six months (180 tablets): 37,000 |
| Tests Included | Initial package: HIV, hepatitis B and kidney-function testing. Repeat testing varies by visit. | HIV, hepatitis B, syphilis and kidney-function testing. Six-month package also includes a three-month follow-up test. | HIV, hepatitis B, syphilis and kidney-function testing. Six-month package also includes a three-month follow-up test. |
| Daily or On-demand Availability | 是的 | 是的 | 是的 |
Private Care Clinic Tokyo
An STI specialist clinic in the central Tokyo ward of Shinjuku. Walk-ins are welcome, and the clinic is open Mondays to Saturdays every day until 8pm.
Personal Health Clinic (Tokyo)
With clinics in Ueno and Yokohama, Personal Health Clinic advertises English-speaking staff and accommodates walk-in clients for PrEP. Closed Sundays and Wednesdays, it is open until at least 8pm every night.
IDATEN Clinic (Osaka)
A clinic in the heart of Kansai, doctors here can give consultations in English and Japanese. Patients can make appointments or make walk-in visits. It is closed on Thursdays and Sunday evenings; all other evenings it is open until 9pm.
Finding PrEP Outside Tokyo and Online
PrEP can also be accessed outside of the two major cities of Tokyo and Osaka. Your first port of call should be the PrEP in Japan online clinic database. It can be searched by location or by services offered, including whether online consultations are available.
Getting PrEP online can also be a relatively simple affair, although each clinic differs in terms of price and process.
Some clinics offer initial consultations online, while others use the phone. Depending on the provider, testing kits, PrEP medication, or both may then be sent through the mail. You complete any required tests according to the clinic’s instructions and return them if necessary.
Be aware that consultation fees may differ from in-person fees, and you may also have to pay extra for postage. Some services have additional requirements: IDATEN, for example, requires a phone number that can be reached within Japan for its telephone consultations.
You may also import PrEP from overseas. However, import rules are separate from clinic access and can change. For up-to-date information, make sure to check with the Ministry of Health, Labour and Welfare.
Other Sexual Health Services
PrEP in Japan’s database also lets you select clinics that offer more than just PrEP, including STI testing and post-exposure prophylaxis (PEP).
These are also vital services for sexual health.
PrEP is taken to prevent HIV infection, but it does not protect from or treat any other STIs alone. Even if you have taken PrEP, if you suspect that you may have contracted another STI, you should get checked as soon as possible.
PEP is used to try to prevent an HIV infection after exposure. It is extremely time-sensitive. If you suspect that you have been exposed to HIV, seek medical advice about PEP as soon as possible rather than waiting to start PrEP. People who seek care within 72 hours of a relevant exposure should be assessed for PEP.
For more sexual health and STI prevention advice, check our guide on hooking up in Japan.
