Crisis Management of Emerging/Re-Emerging Infectious Diseases in People with HIV in Japan

Emerging and re-emerging infectious diseases have disproportionately affected marginalized groups such as people with HIV (PWH), yet their specific needs are often overlooked. Drawing on the experience of IMSUT Hospital in Minato ward, central Tokyo-a district that includes Roppongi and Ginza, and serves as a referral center for HIV care-during the COVID-19 pandemic, we highlight how structural factors, stigma, and delayed access to care shaped the impact on PWH. While general medical responses evolved rapidly, HIV-specific vulnerabilities such as vaccine non-responsiveness and prolonged infection persisted. The subsequent mpox outbreak in Tokyo, affecting many PWH, further illustrated how emerging infections in marginalized communities can present with population-specific complications influenced by social and epidemiological contexts. Without such measures, outbreaks among PWH and other vulnerable groups may remain undetected for longer periods and spread more widely, thereby deepening existing disparities.