Coverage of the survey conducted.

No updated data on people living with HIV (PLHIV) in Japan have been available since 2015, leaving a critical gap in understanding the current status of care and treatment. Therefore, this study aimed to conduct a nationwide evaluation of the second and third goals of the “90-90-90 target” defined by UNAIDS between 2016 and 2020. The study utilized data from approximately 360 core hospitals through structured questionnaires and the National Database of Health Insurance Claims and Specific Health Checkups (NDB). Key findings revealed that over 95% of diagnosed outpatients were retained in care (second 90), and more than 99% achieved successful viral suppression (third 90). A significant transition to single-tablet regimens and newer, highly effective antiretroviral drugs was observed, optimizing treatment adherence and outcomes. These results underscore the efficacy of Japan’s universal health insurance system in ensuring consistent access to HIV care and treatment, supporting both individual patient outcomes and national surveillance efforts.