Perceived barriers and facilitators to the feasibility and acceptability of a peer-to-peer (P2P) HIV self-testing distribution model among adolescents and young people aged 15-24 years in Uganda: a qu

Alcohol use disorder (AUD) remains a major public health issue worldwide. In Japan, the prevalence of AUD is 5.7% in men and 1.4% in women (3.4% overall), which is lower than in Western and Southeast Asian countries. Although approximately 1.07 million individuals are estimated to have alcohol dependence, only around 75,000 receive treatment, indicating a substantial treatment gap. Historically, AUD treatment in Japan has relied heavily on inpatient psychiatric services. Following the 2013 Basic Act on Measures Against Alcohol‐related Health Harm, 233 specialized facilities were established nationwide. These services are covered by national insurance with minimal costs to patients at the point of service, and referral routes are diverse, including self‐referral, primary care providers, family members, employers, and government agencies. Historically, the treatment of alcohol dependence in Japan was developed primarily focusing on inpatient programs in psychiatric hospitals. Despite these efforts, the proportion of individuals with AUD who receive specialized addiction treatment remains low. Stigma surrounding AUD and psychiatric services is a likely contributor to this treatment gap. The general population is reportedly reluctant to seek psychiatric care as a first‐line option, partly due to low mental‐health literacy. Such attitudes may deter individuals with AUD from presenting to psychiatric services and thus contribute to underdiagnosis. Moreover, drinking with colleagues or friends is a common form of social interaction in Japan, and societal attitudes toward alcohol consumption are relatively tolerant. This societal tolerance toward alcohol consumption is evident from the past‐year drinking prevalence rate of approximately 70% among adults (unpublished data, available on the National Center for Addiction Service Administration; NCASA's website). While heavy drinking is widely tolerated in Japan, being diagnosed with AUD carries a strong social stigma. In fact, another national survey found that 62.4% of respondents considered the development of AUD to be one's own responsibility. These sociocultural factors likely act as barriers to treatment access and contribute to the underdiagnosis of AUD. Overall, the current sociocultural context indicates that the expansion of specialized facilities alone is insufficient to close the treatment gap, highlighting the need for policymakers and healthcare professionals to explore alternative approaches.