Fiji Faces Growing HIV Crisis Among Youth

Ten—that’s the youngest age of someone with HIV that Sesenieli Naitala has encountered. Striking, isn’t it? When she founded Fiji’s Survivor Advocacy Network in 2013, that boy wasn’t even born yet. Fast forward to today, and he’s among the thousands in Fiji who have contracted the virus, many being just teenagers, largely due to intravenous drug use.

“More young people are using drugs,” says Ms. Naitala, who supports sex workers and drug users in Suva. “He was one of those young people sharing needles on the streets during Covid.” In just five years, the situation in Fiji—a small nation in the South Pacific with fewer than a million residents—has escalated into one of the world’s fastest-growing HIV epidemics.

In 2014, fewer than 500 people were living with HIV. By 2024, estimates suggest roughly 5,900 individuals have the virus—an elevenfold increase. That year, Fiji saw a staggering 1,583 new cases, which was thirteen times its average over the previous five years. Disturbingly, 41 of those new cases were among children aged 15 or younger, a significant rise from just 11 in the prior year.

These alarming statistics led the health minister to announce an outbreak in January. Recently, assistant health minister Penioni Ravunawa warned that the number of new HIV cases in Fiji could exceed 3,000 by the end of 2025. “This is a national crisis,” he emphasized. “And it is not slowing down.”

Experts and advocates have been discussing this meteoric rise. Some argue that as awareness grows and stigma declines, more people come forward for testing. However, many more likely go unreported, suggesting that the actual scale of the epidemic is far greater than the records indicate.

‘Sharing the Blood’

The HIV epidemic is deeply intertwined with increasing drug use, unsafe sexual practices, and the alarming trend of “bluetoothing.” This practice involves an intravenous drug user withdrawing their blood after a hit and then injecting it into another person, creating a cycle of sharing dangerous substances.

Kalesi Volatabu, executive director of Drug Free Fiji, recounts a chilling experience: while walking through Suva, she saw a group of seven or eight people huddled together around a needle—blood visible, multiple users lined up for a hit. “It’s not just needles they’re sharing—they’re sharing the blood,” she said.

This bluetoothing method, already noted in countries like South Africa, has become popular in Fiji over the last few years. According to Volatabu and Naitala, its appeal partly lies in sharing the costs of getting high, as multiple people can pitch in for a single hit.

Syringes can be hard to come by in Fiji; pharmacies often require prescriptions, adding to the issues. Although there’s increasing advocacy for needle-syringe programs aimed at reducing infections, changing deeply rooted cultural beliefs in a conservative society remains challenging. Volatabu highlighted a “drastic shortage” of needle-syringe sites, which puts the burden on NGOs to provide syringes and condoms.

Furthermore, in August 2024, Fiji’s Ministry of Health acknowledged bluetoothing as a significant factor driving the surge in HIV cases. Chemsex—using drugs like methamphetamine during sex—has also become a concern. Unlike many countries, crystal meth is commonly injected in Fiji, with recent MOH data indicating that of the 1,093 new HIV cases in 2024, around 20% were linked to intravenous drug use.

Young Users

Over the past 15 years, Fiji has emerged as a major trafficking hub for crystal meth, strategically positioned between major drug-producing regions. The local epidemic mirrors that of HIV, having also been labeled a “national emergency.” Alarmingly, advocacy workers report that the average age of meth users is declining.