Japan approved Truvada (tenofovir/emtricitabine) as PrEP in August 2024 — the first HIV-prevention drug ever licensed here. Real milestone, but it changed the label, not the bill: insurance doesn't reimburse PrEP. You get it from private, mostly gay-friendly clinics and pay for the pills and the monitoring yourself. The route is solid in Tokyo and the big cities and thins out fast beyond them.

💊 How to Get PrEP

The practical path is a private sexual health / HIV clinic running a PrEP programme. No referral needed. The clinic will:

  1. Test your HIV status first — PrEP only starts when you're HIV-negative. Start it during an undiagnosed infection and you risk drug resistance.
  2. Check kidney function and screen for hepatitis B and other STIs at baseline.
  3. Prescribe branded Truvada or, more often and more cheaply, a generic.
  4. Monitor you roughly every three months: repeat HIV test, kidney function, STI screen.

Prices vary a lot between clinics and shift over time. Generic daily PrEP at Tokyo clinics has run in the low tens of thousands of yen a month, with the blood tests billed on top. Confirm the current pill price and the monitoring fees with the clinic before you start — ask for the all-in monthly figure.

🗓️ Daily vs On-Demand (2-1-1)

Both are used here:

  • Daily — one pill every day. Simplest to take reliably, and the only option if you have hepatitis B or want continuous cover.
  • On-demand (2-1-1) — 2 pills 2–24 hours before sex, 1 pill 24 hours later, 1 pill 24 hours after that. Offered by clued-up clinics for guys who have sex less often and can plan ahead. Not for anyone with hepatitis B.

Don't relearn the mechanics here — the general PrEP mechanics guide, linked below, covers exactly how each protocol works. What matters locally: both are available, but on-demand depends on finding a clinic that actively supports it, so ask for it by name.

🏥 Where to Start (Tokyo)

  • Personal Health Clinic (Ueno) — PrEP, PEP, rapid HIV testing, English-speaking. Tel: 03-5817-4415.
  • Private Care Clinic Tokyo (Shinjuku) — English service; ACC-linked and infectious-disease doctors.
  • Other Shinjuku and Ueno sexual-health clinics run PrEP programmes; the akta community center in Ni-chōme can point you to providers the community currently trusts.

For access beyond the capital, use the Outside Tokyo guide below.

Personal importation of generic PrEP for your own use is legal, and it's how some men here source cheaper pills. If you do it, you still need monitoring — get your HIV test, kidney function, and STI screen at a clinic no matter where the tablets come from. PrEP without baseline and ongoing testing is the one genuinely risky way to run it.

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