Usable access to HIV testing and care among people with migrant backgrounds in Japan: A systematic review

OBJECTIVES: Japan's growing migrant population has increased the need for HIV services usable across linguistic, administrative and social circumstances. We reviewed evidence on access to HIV testing and care among people with migrant backgrounds and related non-Japanese populations, focusing on movement into continuing care. METHODS: PubMed/MEDLINE, Web of Science Core Collection and Ichushi-Web were searched for English- or Japanese-language studies conducted in Japan. Eligible studies reported original data on HIV testing or care among migrant or related non-Japanese populations, as defined within each study. Retention and follow-up search updates were incorporated. Full-text and table-level findings were extracted and synthesized narratively across the HIV care pathway. RESULTS: Nine studies were included. Evidence did not show a single pattern of poor access, but several points where care became harder to use. Before testing, services remained difficult to find despite free anonymous testing through public health centres. Population-level evidence suggested diagnosis gaps among foreign residents or international migrants, while clinic-based studies showed that formal eligibility did not always lead to continuing care. Follow-up evidence linked care interruptions with insurance status, communication difficulty and clinical status at presentation, indicating that administrative difficulty and clinical continuity should not be viewed separately. Interpretation-related findings showed that language support must enable understanding without compromising privacy or trust. CONCLUSIONS: Formal HIV services in Japan may not translate into usable access for people whose care is shaped by migration-related circumstances. Findings support an integrated, people-centred approach that strengthens transitions from first contact to continuing care.