The Use of Public Health Surveillance Data for Preventive Control of Diseases That Depend On Individual Risky Behavior: The Case of HIV Infection In Japan

The Use of Public Health Surveillance Data for Preventive Control of Diseases That Depend On Individual Risky Behavior: The Case of HIV Infection In Japan

N. Ghotbi (Ritsumeikan Asia Pacific University, Japan) and W. Claster (Ritsumeikan Asia Pacific University, Japan)
DOI: 10.4018/978-1-60566-266-4.ch016
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Abstract

E-health systems can be used to communicate the risk of significant infectious diseases such as HIV infection to individuals who contemplate taking the risk of the personal behavioral choices they make. Access to an on-line system which communicates this data in a user-friendly format, can help avoid high-risk behavior by informed individuals who live in different areas with various levels of risk. We present the case of HIV infection in Japan where many individuals have voluntarily continued a high-risk behavior because apparently they consider the overall risk of infection too low to forgo the personal benefits of risky behavior such as more pleasure, less inconvenience, etc. We discuss how a user friendly e-health system can provide geographical risk data that are extracted from HIV epidemiological surveillance. This can provide individuals with a rational incentive for behavior change in high-risk areas. It is hoped that such a system helps with the control of not only HIV, but also other agents of disease in situations where individual choices play a significant role in the risk of exposure/disease.
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Introduction

The first cases of HIV infection/AIDS in Japan were discovered in 1985, and were related to the use of contaminated blood products imported to Japan in the 1980s. This exposed many hemophiliacs to the infection so that as of August 1995, 1,803 of the estimated 5,000 hemophiliacs in Japan were discovered to be HIV infected. These constituted the majority of the total number of HIV + cases (62% of 2,893 cases), and AIDS patients (52% of 1,026 cases) in Japan at the time. Subsequently, screening of all donated blood and blood products for HIV infection has changed the situation significantly so that the most common route of infection in Japan is now through unprotected sexual contact. Table 1, extracted from data released by the Japanese Ministry of Health, Labor & Welfare shows the shares of different routes of exposure to HIV infection in Japan in 2005 & 2006.

Table 1.
The numbers of all new (2005 & 2006) HIV cases in Japan by route of exposure, gender, & Japanese/non-Japanese citizenship. The significant number of infected men and of sexually transmitted route of infection (including both homo & heterosexual contact) is worth consideration
Route of exposureJapanese citizens
(88%)
Non-Japanese citizens (12%)Total
200520062005200620052006
Heterosexual1611734250203223
Homosexual5145711533529604
Drug abuse211334
Mother-newborn011011
Other routes9292111140
Unknown556130198580
Total (Men/Women)741
(709/32)
836
(787/49)
91
(60/31)
116
(76/40)
832
(769/63)
952
(863/89)

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