HIV / STI Prophylaxis
HIV/AIDS can be prevented by oral medications. The method of taking it before the potential exposure is called PrEP (Pre-Exposure Prophylaxis), and the method of taking it after is PEP (Post-Exposure Prophylaxis).
Immediate in-hospital prescription is available throughout our open hours.
Those purchasing our PrEPcan contact us 24/7 via LINE with any questions about PrEP
We also offer telemedicine consultations and delivery service of PrEP, PEP and other medications.
Please select the section to jump.
Note that the prices indicated in this page are all inclusive of tax.
HIV Prevention Medicine (PrEP)
What is PrEP?
PrEP (Pre-Exposure Prophylaxis) is the use of an HIV-prevention medication before a potential exposure to HIV such as sexual activities. This approach is now even endorsed by the World Health Organization (WHO) as “One can take control of their own protection unlike condoms”. We offer a few kinds of generic PrEP at an affordable price together with follow-up medical check-ups, so please feel free to contact us!
IMMEDIATE in-hospital prescription of PrEP/PEP is available throughout our open hours.
Patients who purchase PrEP at our clinic can contact us 24/7 via LINE with any questions about PrEP interactions with other medications, how to take PrEP, and more. Please don’t hesitate to reach out.
Recommended for those:
– Engaging in sex without proper protection
– Having anal intercourse
– Having an HIV-positive partner
– Engaging in sexual contact with multiple partners
– Working in the sex industry
Price of PrEP
For those who use it on demand, it is recommended to start with a one-month package (30 tablets) or a three-month package (90 tablets). All the packages include the price of blood tests necessary for the use and continuation of PrEP.
Always ensure that you undergo appropriate tests when starting and/or continuing PrEP. Prescriptions from facilities that do not conduct various tests, or personal imports without testing, carry the significant risk of HIV resistance and worsening of hepatitis B.
Price: 11,000 JPY
Including:
– 1 bottle of PrEP (30 tablets), Descovy or Truvada
– HIV rapid test
– Hepatitis B rapid test
– Syphilis test (results notified via e-mail)
– Renal function test (results notified via e-mail)
Price: 22,000 JPY
Including:
– 3 bottles of PrEP (90 tablets), Descovy or Truvada
– HIV rapid test
– Hepatitis B rapid test
– Syphilis test (results notified via e-mail)
– Renal function test (results notified via e-mail)
Price: 40,000 JPY
Including:
– 6 bottles of PrEP (180 tablets), Descovy or Truvada
– HIV rapid test
– Hepatitis B rapid test
– Syphilis test (results notified via e-mail)
– Renal function test (results notified via e-mail)
– Extra tests to take in 3 months (HIV, hepatitis B and syphilis)
For those who purchase a 6-month package and do not wish to revisit for testing after 3 months, we can provide a self-test kit.
Those who have been tested for HIV and Hepatitis B within a week can be prescribed PrEP at the following prices.
Make sure to bring your test results.
When starting or continuing PrEP, always ensure to undergo appropriate testing. Prescriptions or personal imports without undergoing the necessary tests at facilities can be dangerous, posing a risk of HIV resistance and worsening of Hepatitis B.
Tests conducted outside our clinic are also eligible.
For those using the regular testing 3-package, prescription is possible on the day of testing as it includes HIV and Hepatitis B tests.
Price: 8,000 JPY
Only for those who bring their test results for HIV and Hepatitis B conducted within a week
Included:
– 1 bottle of PrEP (30 pills) Descovy or Truvada
– (Optional) Kidney function test (by email): Additional 500 JPY
Price: 18,000 JPY
Only for those who bring their test results for HIV and Hepatitis B conducted within a week
Included:
– 3 bottles of PrEP (90 pills) Descovy or Truvada
– (Optional) Kidney function test (by email): Additional 500 JPY
For those who import PrEP on their own, we have a package of routine check-ups.
for those importing PrEP on their own
Price: 6,000 JPY
Including:
– HIV rapid test
– Hepatitis B rapid test
– Syphilis test (results notified via e-mail)
– Renal function test (results notified via e-mail)
PrEP is nothing more than an HIV prevention measure. Since it does not have a preventive effect against STIs other than HIV, it is recommended to take STI tests regularly. Infection with syphilis, gonorrhea or chlamydia makes you more vulnerable to HIV. This is because inflammation of the mucous membranes caused by infection to the urethra, vagina, oral cavity or anus allows HIV to penetrate where the mucosal barrier is weak.
We offer syphilis tests for free and gonorrhea and chlamydia tests at a special price to those purchasing PrEP or PEP for the purpose of comprehensively reducing the risk of HIV infection.
Gonorrhea and Chlamydia (genitals, throat, anus): 3,000 JPY (>8,000 JPY)
Discharge test (vaginal candida, vaginal trichomonas and bacterial vaginosis): 3,000 JPY (4,500 JPY)
To start PrEP
Japanese guideline requires prior test for HIV, hepatitis B, kidney function and more when starting PrEP medication. (For more information, please see the Reference written in Japanese language.)
In starting PrEP, we perform rapid tests for HIV and hepatitis B, as well as tests for kidney function and quantitative syphilis.
Always ensure that you undergo appropriate tests when starting and/or continuing PrEP. Prescriptions from facilities that do not conduct various tests, or personal imports without testing, carry the significant risk of HIV resistance and worsening of hepatitis B.
Our clinic is the only one in Kansai region recognized by PrEP in Japan, the Ministry of Health, Labour and Welfare’s AIDS Policy Research Project.
You cannot use PrEP. After the confirmed diagnosis for HIV, treatment for HIV is necessary.
PrEP can be used, but the on-demand medication (method of using only right before and after sexual intercourse) is not available. Please consult our doctor for details.
PrEP is available while being treated with other STIs. Please ask your doctor for more detail.
It is strongly recommended to go through tests for other STIs such as gonorrhea and chlamydia when starting PrEP and afterwards. We offer the following tests at a special price for those who purchase the PrEP package.
Gonorrhea / Chlamydia (genitals / throat / anus): 3,000 JPY (8,000 JPY)
Vaginal discharge tests (Candida, Trichomonas, Bacterial vaginosis): 3,000 JPY (4,500 JPY)
Those who take the gonorrhea and/or chlamydia test at our clinic will be able to take a monkeypox test for free.
How to take PrEP
There are 2 ways to take PrEP. If you have sex twice a month or more, we recommend Daily PrEP (taken every day). If you have any questions about how to take it, please consult doctors.
This is a method of taking 1 tablet once a day at your own set time regardless of sexual intercourse. This is a proven method with a preventive effect of over 99% as well as the established safety.
This is a method of taking a medication right before and after sexual intercourse. Take two tablets 2 to 24 hours before sexual intercourse, one tablet 24 hours later and one more tablet 24 hours after that.
If you have sex for several days: Continue taking it every 24 hours and one tablet each for two days from the last day you had sex.
Kinds of PrEP
We adopt Descovy (new medicine) and Truvada (existing medicine) as PrEP.
Nausea, diarrhea, etc.
Short-term: Nausea, abdominal pain, diarrhea, headache, rash
Long-term: Kidney disorder, bone salt decrease, etc.
Comparison
We prescribe Descovy (generic medicine) as our standard. The widely used existing medicine Truvada has a risk of renal impairment and osteoporosis if used for a long time. From 2019, when Descovy was approved by the US FDA, there has been a gradual move to switch PrEP from Truvada to Descovy, which has fewer side effects.
Truvada can still be prescribed if you prefer medicine with evidence for on-demand use (method of using PrEP before and after sexual intercourse). Ask our doctors for detailed explanations about side effects and medication itself.
Periodic Tests
In continuing PrEP, it is recommended to take a periodic HIV test approximately once every three months. If you don’t take PrEP correctly and thus get infected with HIV without realizing it and keep taking PrEP afterwards, HIV will become resistant to the PrEP medication, which will be a significant obstacle to treatment.
PrEP is proven to have a preventive effect close to 100%, but infections due to forgetting intake have been reported. If you are worried about forgetting to take PrEP, we recommend Daily PrEP.
To Stop PrEP
If you want to quit PrEP, you need to quit after taking it for at least two days after the last potential exposure to HIV. It is safer to take it for about one or two days longer. Please consult our doctor in advance if you are unsure.
Flow of PrEP Prescription
PrEP prescription will take approximately 30 minutes, from your arrival at our clinic to payment.
Visiting us
You can make an appointment via our website or official LINE. If you fill the online questionnaire in advance, you will be able to have a smooth consultation after your visit.
* Walk-ins are also available, but you may need to wait. Please tell the receptionist that you want PrEP.
Consultation
During the first visit, you will discuss with a doctor what kind of PrEP scheme is most suitable for you.
Examination
You will be taking rapid tests for HIV and hepatitis B, as well as standard tests for syphilis and kidney function (taking approximately 20 minutes).
Those who visit us for the second time or later will be taking tests before the doctor’s examination.
Explanation of the results
The doctor will explain the results of the rapid tests. Feel free to ask any questions or discuss any concerns.
Prescription of PrEP
You will receive your medication at the reception after payment. Start taking it as instructed.
For ongoing medication for your second time or later, you can continue to be prescribed as long as there are no problems in rapid testing and the doctor’s examination.
Frequently asked questions about PrEP
What is the difference between generic and brand-name PrEP?
Generic medicines are released after the patent for the brand-name medicine has expired. They contain the same active ingredients, quality, efficacy and safety as the brand-name medicines have. The brand-name PrEP tablets are quite expensive, costing approximately 110,000 JPY for a month. To provide our patients with a more affordable option, we adopt generic PrEP medication.
How can you offer PrEP at a lower price?
We adopt generic medicines and strive to offer medications at an affordable price whenever possible. This is because we have a strong desire to promote the availability of HIV prevention medications in Japan for the purpose of promoting social commitment.
There are 2 kinds of medicine. Which one is better?
Generic medicines of Truvada are common, but recently generic medicines of Descovy are being used more often. Descovy is a newer medicine than Truvada, with fewer known side effects in renal function and bone density. Please consult our doctor for more details.
Which is better, daily or on-demand?
If you have sex twice a month or more, we recommend daily use. Even if you forget to take it by chance, the daily use reduces the risk of HIV more than on-demand PrEP does.
Is a condom necessary even if I take PrEP?
PrEP can only prevent HIV acquisition but not effective for other STIs. Thus, it is still recommended to use condoms during sex and take other measures to prevent STIs even with PrEP.
I forgot to take my medication. What should I do?
Take medication immediately as soon as you realize you’ve forgotten to take it, and resume your medication at the usual time from the following day.
How should I store my medication?
The medicine is in a bottle with a desiccant. Please store the bottle at room temperature. Be careful not to leave it in a cold or warm environment such as in the refrigerator or in a hot car.
HIV Post-Exposure Prophylaxis (PEP)
PEP, post-exposure prophylaxis, is an emergency prevention medication that can significantly reduce the risk of HIV infection when taken within 72 hours after a potential exposure to HIV.
We offer a package that includes mental care and necessary additional tests according to the situation of exposure risk, until HIV negative status is confirmed, at no extra cost.
All-in-one package includes medicine itself, consultation fee, testing fee, follow-up care, and applicable tax. No Hidden fee.
What is PEP?
PEP, post-exposure prophylaxis, is an immediate preventive measure that involves taking medication within 72 hours after a potential exposure to HIV, such as unprotected sex with someone who is HIV positive or at risk of HIV infection.
Brand-name PEP is extremely expensive, costing around 10,000 yen per tablet. And clinics offering brand-name PEP normally charge around 300,000 yen, including initial consultation and testing fees. We offer generic PEP, which is significantly more affordable, and the package includes rapid blood tests and follow-up care at approximately one-fourth of the price of brand-name PEP.
Recommended for those:
– Engaged in sex without proper protection
– Experienced condom breakage during sex
– Who had sex with multiple partners
– Engaged in sexual contact with an HIV-positive individual
– Sexually assaulted
– Involved in needlestick injury
Contraindicated to those:
– Whose sexual partners have tested negative for HIV
– Already being HIV positive
– Who have tested positive for hepatitis B (as PEP may worsen the condition)
Steps
PEP prescription will take approximately 30 minutes, from your arrival at our clinic to payment.
Visit us within 72 hours of the potential exposure
Walk-ins are welcome. Please inform the reception that you are seeking PEP.
Consultation
Our doctor will interview you to determine your eligibility for PEP.
Examination
Blood tests will be conducted to confirm that you are not already infected with HIV and can safely take anti-HIV medication. It would take approximately 20 minutes.
Explanation and Consent
The doctor will explain the use of PEP and request you to sign a consent document.
Prescription
You will receive the medication at the reception after payment. Start taking it as instructed.
Follow-up
If you are able to visit our clinic one month after starting PEP, we will conduct follow-up tests for HIV, syphilis, and hepatitis B free of charge (these tests are included in this package). Even if it is difficult for you to visit our clinic, we strongly recommend undergoing these tests.
Additionally, we also recommend periodic testing for HIV and hepatitis B in 3 months and 6 months (additional fees apply).
It is crucial to start taking PEP within 72 hours to minimize your risk.
We will accommodate you, even outside normal clinic hours. Get in touch now!
Price of PEP All-in-One Package
We prescribe generic PEP, ensuring safety and minimizing patient burden in taking PEP.
Brand-name PEP is extremely expensive, costing around 10,000 yen per tablet. And clinics offering brand-name PEP normally charge around 300,000 yen, including initial consultation and testing fees.
We offer generic PEP, which is significantly more affordable, and the package includes rapid blood tests and follow-up care at approximately one-fourth of the price of brand-name PEP.
We accept payment in cash (Japanese yen), credit cards, and various electronic payment methods such as WeChatPay, AliPay and UnionPay. We do not accept payment through Travel Insurance.
– Consultation Fee
– 30 tablets of generic PEP (including 2 extra tablets)
– HIV rapid test
– Hepatitis B rapid test
– Syphilis test (Results notified via e-mail)
– Renal function examination (Results notified via e-mail)
– Follow-up tests after 1 month (HIV, syphilis and hepatitis B)
– Applicable tax
To receive included follow-up tests, you need to visit our clinic. Even if you cannot come to our clinic, we still strongly recommend to undergo these tests at your preferred location.
Frequently Asked Questions
What is the difference between PEP and PrEP?
PEP involves taking medication “after” a potential exposure to HIV, while PrEP is taken continuously “before” sexual contact to prevent HIV.
How effective is PEP?
Since the introduction of PEP, there have been no reported cases of HIV transmission in advanced countries among healthcare workers who experienced needle stick injuries (accidental self-injection of a needle contaminated with HIV), which is known to entail a higher risk than sexual contacts. Starting PEP as soon as possible significantly increases the effectiveness of HIV prevention.
I’m unsure whether I should take PEP. Is it necessary?
If you have had a contact or potential exposure to bodily fluids (such as semen, vaginal secretions, blood, etc.) from an HIV-infected individual, it is advisable to consider taking PEP. However, please consult a doctor for a specific assessment.
What is the difference between generic and brand-name PEP?
Generic drugs are released after the patent for the brand-name medication has expired. They contain the same active ingredients, quality, efficacy and safety as the brand-name medication. The brand-name PEP tablets are quite expensive, costing approximately 10,000 yen per tablet. To provide our patients with a more affordable option, we offer generic PEP medication.
How can you offer PEP at a lower price?
We utilize generic drugs to reduce costs and strive to offer medication at an affordable price whenever possible. This is because we have a strong desire to promote the availability of HIV prevention medications in Japan for the purpose of promoting social commitment.
Can I take the prescribed PEP medication abroad?
Please check the laws and regulations of your destination, as the regulations may vary depending on countries and regions.
Do you provide medical consultations over the phone?
For the sake of patient safety and accurate prescription, we do not offer telemedicine consultations for PEP prescriptions. If you would not be able to start PEP within 72 hours after a potential exposure due to our business hours, please contact us through our official LINE account.
May I grind the tablets and take them?
It is not recommended because crushing the tablets may result in a bitter taste, and there is no available data on the absorption when the tablets are crushed.
Is there a specific time to take the medication?
PEP should be started within 72 hours after a potential exposure, and the earlier it is started, the higher the preventive effect. However, there is no specific time of day designated for taking the medication.
Are there any side effects?
Reported side effects include nausea, insomnia, irritability, dizziness, and others. In most cases, these side effects are mild. If you have any concerns, please consult with our doctors.
I missed a dose. What should I do?
If you realize you missed a dose, take one dose as soon as possible. However, if the next regular dose is approaching (typically within 12 hours), skip the missed dose and take one dose at the next regular dosing time. Under no circumstances should you take two doses at once.
Are there any beverages that should be avoided?
There are no specific restrictions. However, it is advised to avoid consuming alcohol before or after taking the medication.
I vomited after taking the pill. What should I do?
If you vomit after taking the medication, do not take another dose. Once you feel better, try to take the medication at the next scheduled dosing time. Drinking plenty of water may help alleviate nausea.
Are there any medications or dietary supplements that should not be taken together?
Please avoid consuming products containing St. John’s Wort, as they may reduce the effectiveness of the medication. Additionally, supplements containing minerals such as aluminum, magnesium, iron or calcium may also diminish the effects of the medication.
I have heared 2 tablets for one dose. Is 1 tablet sufficient?
PEP necessitates the intake of three different components, and depending on the healthcare institution, multiple medications may be prescribed to cover all three. However, the PEP medication provided at our clinic contains all the necessary components in a single tablet.
What are 2 extra tablets for?
The medication we prescribe at our clinic comes in a bottle with 30 tablets, leaving 2 tablets as extras. After completing the 28-day course, please dispose of the remaining tablets. It is acceptable to take the additional 2 tablets over the following 2 days if desired, but there is currently no evidence to suggest that taking a total of 30 tablets enhances the effectiveness.
Doxy PEP
Syphilis, gonorrhea and chlamydia can infect not only the genitals but also the throat or anus.
Infections in the throat and anus often have no symptoms but can still be transmitted through sexual activity, leading to a cycle of infection.
Using Doxy PEP, an oral medication, can help prevent these STIs. Recent studies have also shown that a vaccine can be effective against gonorrhea.
Doxy PEP involves taking 200 mg of doxycycline (Vibramycin) within 72 hours after sexual activity to prevent syphilis, gonorrhea and chlamydia.
Effectiveness of Doxy PEP
The infection prevention rates for Doxy PEP have been reported as 87% for syphilis, 88% for chlamydia and 55% for gonorrhea (International AIDS Society Conference, July 2022).
Given that the infection rates for syphilis, chlamydia and gonorrhea are approximately 30%, 50% and 50% respectively when having sexual contact with an infected person, these prevention rates are remarkably high and have gained global attention.
Doxycycline is a commonly used antibiotic beyond STI prevention. Note that itcan have side effects such as abdominal pain, diarrhea and nausea.
We can prescribe Doxy PEP based on a thorough consultation with a doctor, discussing the risks and benefits to determine suitability for each patient.
In collaboration with the AIDS Clinical Center (ACC) and our partner clinic, Personal Health Clinic based in Tokyo, we prescribe Doxy PEP to patients at high risk of contracting STIs.
We are accumulating data to evaluate the effectiveness of Doxy PEP in Japan and aim to develop new preventive healthcare models and contribute to society.
Teleprescription of Doxy PEP
We offer prescription and delivery services for Doxy PEP via phone.
During the consultation, our doctor will provide the best recommendations for Doxy PEP and necessary tests based on the patient’s risk and frequency of sexual activity.
To ensure proper use of Doxy PEP, we offer necessary tests at significantly lower prices than usual. For more details, please contact us via our official LINE.
We also offer teleprescription of Doxy PEP.
[Total Cost] = [Consultation Fee*] + [Shipping Fee] + [Package Price]
* First visit: 2,500 JPY, 2nd+ visit: 1,000 JPY
Note that PrEP prescription requires doctor’s consulation.
About Shipping Fees
Online PrEP consultation incurs round-trip shipping fees of 1,000 JPY.
* In case of only shipping medication, the fee is 500 JPY for one-way shipment.
Make an Appointment via Official LINE
Select “PrEP・PEP 電話診療 [PrEP/PEP Teleprescription]” from the rich menu on the official LINE, and make an appointment.
Fill in the consultation form
Please be sure to fill out the questionnaire in advance.
Register Credit Card Information
48 hours before your appointment, we will send an e-mail about credit card registration to your registered e-mail address.
Once registered, we will provisionally reserve your credit card limit according to the desired prescription drugs and quantity. Please be assured that payment has not yet made at this time.
A credit card is recommended to use as registering a debit card might temporarily withdraw some amount from your account. Also, depending on your smartphone app, it may show a ‘Payment Completed’ notification, but rest assured that this is only a provisional hold. Our doctor notify you when the payment is made.
Available
Visa / Mastercard® / American Express® / JCB / Diners Club / Discover
Delivery of PrEP
We will ship your order as soon as possible after the payment is completed.
Receive Medication and Test Kits
You will receive the mailed items after the payment is confirmed.
You can designate the address for delivery as you like such as at your home, workplace or a designated post office/Yamato business office.
Conduct Tests and Taking Medication
Use test kits as instructed in the manual.
After returning the samples, you can check the results by e-mail in 3 to 5 days after they reach our clinic.
Gonococcal Vaccine (Meningococcal B Vaccine)
The meningococcal B vaccine was initially used to prevent meningitis, an inflammation of the membranes covering the brain and spinal cord. And since the outer membrane structure of meningococcal B and gonococcal bacteria are similar, it was hypothesized that the vaccine could also prevent gonorrhea.
Since around 2004, there has been progress in its development, and a recent French study reported that the meningococcal B vaccine can prevent 51% of gonorrhea cases.
We believe that using the vaccine in combination with Doxy PEP can provide a higher level of prevention against gonorrhea, which has been difficult to prevent until now.
For individuals allergic to gonorrhea treatment medications, preventing infection with a vaccine is particularly important.
Recommended For
– Individuals who have had gonorrhea or other STIs before
– Individuals allergic to ceftriaxone, the first-line treatment for gonorrhea
– Individuals with multiple sexual partners
– CSWs (commercial sex workers, adult film industry workers, etc.) and those at high risk of infection
No severe side effects have been reported for the vaccine, but the following side effects have been noted:
More than 10%: Pain and swelling at the injection site, fatigue, headache
1-9%: Nausea, fever
The prices are as follows. Two doses are required for effective prevention of gonorrhea.
Price: 26,000 JPY per dose
Doses: 2
Schedule: Initial dose, followed by a second dose one month later
Combining with Doxy PEP is believed to provide higher preventive efficacy against gonorrhea.