A positive gonorrhoea, chlamydia, or syphilis result is routine and curable, and Japan treats all three well. The thing to understand is a handover: the free hokenjo that flagged your syphilis or HIV result usually doesn't treat you — treatment happens at a clinic or hospital, where it becomes insured care once you've got a diagnosis to act on. Here's the pathway for each infection. For the biology, use the general STI diagnosis guides linked at the foot of this page.

🔀 The Handover: From Testing to Treatment

  • Tested at a hokenjo or metropolitan office: they give you the result and send you to a clinic for treatment. Free anonymous testing sites generally don't hand out STI treatment themselves.
  • Tested at a clinic: you can usually be treated at the same clinic. With a positive result and symptoms, treatment is typically insured (you pay 30%); treatment driven purely by asymptomatic screening may be billed self-pay — ask the clinic how it'll handle it. The health-system guide below explains the split.

💊 Treatment by Infection

Chlamydia

Oral antibiotics — a course of azithromycin or doxycycline. Straightforward, handled at a clinic. If your positive came from a throat or rectal swab, make sure that's the site being treated.

Gonorrhoea

Because of antibiotic resistance, gonorrhoea is treated with an injection of ceftriaxone — oral options are avoided. You get this at a clinic or hospital, not a pharmacy counter. Again, confirm the clinic is covering the throat or rectum if that's where you tested positive, not just assuming a genital infection.

Syphilis

A reactive syphilis blood test usually needs a confirmatory blood draw to tell a new active infection from antibodies left by a past treated one. If it's active, treatment is a long-acting benzathine penicillin injection (now available in Japan) or an oral penicillin/amoxicillin course, depending on the stage.

Get every site treated. Gonorrhoea and chlamydia sit silently in the throat and rectum, so if you were only tested at one site, ask about three-site testing before you consider yourself clear — the hokenjo guide below covers where.

📣 Telling Partners

Japan does not run a clinic-managed anonymous partner-notification service — no health adviser will text your contacts for you. Partner notification here is patient-led: you tell recent partners yourself so they can get tested and treated. It's on you, but it's also the thing that stops the infection bouncing straight back to you after treatment.

Two ways to handle it:

  1. Directly: message or call your recent partners and tell them to get a full screen.
  2. Anonymously, through your own channels: if a direct conversation isn't safe or comfortable — a casual hookup, an app contact — you can send an anonymous heads-up yourself. The general partner-notification guide below has scripts and anonymous methods for doing exactly this.

Syphilis is a notifiable infection — your doctor files an anonymised report for national surveillance. That's a statistics count, not partner tracing: it does not identify or contact your partners. That part stays with you.

Re-testing after treatment matters — a test of cure for gonorrhoea, and follow-up bloods for syphilis to confirm it's clearing. Ask the clinic when to come back before you leave.

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