Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Graduate School of International Co-operation Studies, Kyorin University, Tokyo, Japan.
PLoS One. 2020 Jul 2;15(7):e0235659. doi: 10.1371/journal.pone.0235659. eCollection 2020.
Japan has been recognized for its excellent universal health coverage system. However, the migrant population faces many barriers in accessing health services in Japan. Japan hosts around 260,000 international students, mostly from developing countries. Among them, language school students tripled from 2011 to 2017, against the backdrop of labor shortage in Japan. Most of these students are also engaged as cheap laborers and are vulnerable populations with poor access to health services. Several socio-economic and behavioral factors may increase their vulnerability to HIV and prevent them from accessing HIV testing in Japan. We examined the factors associated with access to HIV testing among international students in language schools in Tokyo. We conducted a cross-sectional study among international students studying in Japanese language schools in Tokyo. We collected data from 769 Chinese, Vietnamese, and Nepalese students using a self-administered questionnaire. We measured their access to HIV testing through questions on their knowledge of where to receive HIV testing and utilization of HIV testing. Bivariate and multivariable logistic regression models were used to analyze the data. Nepalese students were less likely to know where to receive HIV testing in Japan than Chinese students (AOR = 0.12, 95% CI 0.01-0.96). Students who did not need Japanese language interpreters during visits to health facilities were more likely to know where to receive HIV testing (AOR = 1.93, 95% CI 1.14-3.25). Students who did not have knowledge of free and anonymous HIV testing in Japan were also less likely to know where to receive HIV testing in Japan (AOR = 0.18, 95% CI 0.08-0.42). Students who did not have knowledge of free and anonymous HIV testing (OR = 0.05, 95% CI 0.02-0.10) and who had not utilized HIV testing in their home country (OR = 0.12, 95% CI 0.06-0.27) were less likely to utilize HIV testing in Japan. Factors associated with access to HIV testing among Japanese language school students in Tokyo are nationality, need for Japanese language interpreters, perceived access to doctors/health workers, utilization of HIV testing in the home country, and knowledge of free and anonymous HIV testing. These findings may help to design interventions for improving access to HIV testing among international students in Japan.
日本的全民健康覆盖制度得到了认可。然而，移民在日本获得医疗服务方面面临诸多障碍。日本接纳了约 26 万名留学生，他们主要来自发展中国家。其中，2011 年至 2017 年期间，语言学校的留学生人数增加了两倍，这是日本劳动力短缺的背景下出现的现象。这些学生大多从事廉价劳动力工作，属于弱势群体，在获得医疗服务方面处于不利地位。一些社会经济和行为因素可能会增加他们感染艾滋病毒的风险，并阻碍他们在日本进行艾滋病毒检测。我们研究了东京语言学校留学生获得艾滋病毒检测的相关因素。我们在东京的日语语言学校中开展了一项横断面研究。我们使用自填式问卷收集了 769 名中国、越南和尼泊尔学生的数据。我们通过询问他们对在哪里可以接受艾滋病毒检测以及是否利用过艾滋病毒检测的了解程度来衡量他们接受艾滋病毒检测的情况。我们采用单变量和多变量逻辑回归模型对数据进行分析。与中国学生相比，尼泊尔学生更不知道在日本何处可以接受艾滋病毒检测（比值比 [OR] = 0.12，95%置信区间 [CI] 0.01-0.96）。在就诊时不需要日语翻译的学生更有可能知道在哪里可以接受艾滋病毒检测（比值比 [OR] = 1.93，95% CI 1.14-3.25）。不知道日本有免费匿名艾滋病毒检测服务的学生也不太可能知道在日本何处可以接受艾滋病毒检测（比值比 [OR] = 0.18，95% CI 0.08-0.42）。不知道日本有免费匿名艾滋病毒检测服务（比值比 [OR] = 0.05，95% CI 0.02-0.10）或在原籍国没有接受过艾滋病毒检测（比值比 [OR] = 0.12，95% CI 0.06-0.27）的学生，在日本接受艾滋病毒检测的可能性也较小。与东京日语语言学校学生获得艾滋病毒检测相关的因素包括国籍、是否需要日语翻译、对医生/卫生工作者的可及性、在原籍国接受艾滋病毒检测的情况以及对免费匿名艾滋病毒检测的了解。这些发现可能有助于为日本留学生设计改善艾滋病毒检测服务的干预措施。
