Infection with Hepatitis A virus (HAV) remains problematic in many parts of the world including the U.S. where there have been outbreaks reported since 2016. HAV is transmitted via a fecal-oral route, usually from direct person-to-person contact or consumption of contaminated food or water. The CDC has recommended HAV vaccine for children since 2006 and subsequently for other at-risk persons. This study from Japan looked at seroprevalence of HAV-IgG antibody in 468 persons with HIV (PWH) in 2017. Also recorded was HAV vaccine status and previous HAV infection. After excluding females and persons previously vaccinated, data on 354 MSM were analyzed. Of this group of patients, approximately 20% were HAV-IgG positive and when they looked at those without a previous HAV vaccination only 17% were IgG positive. There was a positive correlation between patient age and HAV seropositivity. The lowest rate of IgG positivity (6%) was in patients younger than age 40.  In men with a median age of 50 years or greater, there was also significantly higher rates of HBV, HCV, and Treponema pallidum consistent with sexual acquisition of HAV in these older persons. Although the overall prevalence of HAV IgG antibody was higher than in the general population, it was well below a rate of 70% which is the estimate needed to prevent sustained transmission of HAV.