To understand the effectiveness of Japan's health care system for HIV/AIDS, including prevention, diagnosis, access to antiretroviral treatment, and treatment outcomes, clinical information on HIV/AIDS cases was collected through questioners sent to 377 registered HIV/AIDS clinics in Japan. The data were collected in 2009 and 2014, and 9,040 and 14,569 cases were obtained, respectively. Prevalence of on-treatment cases linked to care were 69.6% and 87.8% in 2009 and 2014, respectively, demonstrating improvement in treatment coverage over the recent 5 years. The proportion of cases with undetectable HIV RNA in the 2014 survey was 87.7%. Thus, our survey revealed that the two of the UNAIDS Fast-Track targets, 90% treated and 90% virally suppressed, are close to being reached. However, Japan appears to have fallen short of the upstream cascade target of 90% diagnosed. Japan needs to radically reform its strategies for attracting people to HIV testing and to develop a system for estimating the number of people living with HIV.
