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Japan’s response to the global HIV/AIDS crisis in the 1980s was lukewarm, due mainly to the absence of a domestic perception of AIDS as an immediate threat The key determinants of that perception were rare cases of AIDS infections in Japan, a detrimental media role, and weak civil society. Japanese media contributed to shaping a flawed image of AIDS as a foreign disease or a disease of homosexuality and promiscuity. Moreover, civil society organizations were not strong enough to create momentum for reformulating the distorted perception or catalyzing specific policies. Not until the early 1990s did Japan’s global AIDS funding increase. The policy shift was in tandem with the rising influence of newly emerged civil activist groups.