Fiji Faces a Growing HIV Crisis

That night, when Clare’s baby’s heart stopped, she couldn’t help but feel guilty. Did she spend too much time outside in the cold? Had she harmed her little one while pregnant by drinking iced water? Rushing her infant, Andi, to a hospital in Fiji for the second time in two days, Clare’s mind raced with worry.

Through those anxious early hours, Andi clung to life. Doctors repeatedly performed CPR, even inserting a drain to remove fluid around her lungs. “She was really, really sick, and they had no idea what was causing it… she just kept getting weaker,” Clare reflects, seated by her daughter’s bed, praying desperately.

Then, the doctors asked to conduct an HIV test. Clare was taken aback, hesitant. “No, I don’t have it,” she replied, recalling her earlier test.

But it wasn’t for her, the doctors clarified—it was for the baby.

Andi tested positive for HIV, as did Clare and her husband. During her pregnancy or while breastfeeding, Clare had contracted the virus and unknowingly passed it on. “I thought it was the end of the world,” Clare, in her early twenties, admits. Her husband, who had a history of drug use, reassured her. “I’ve been cautious,” he insisted. Clare felt adrift. “We don’t really know how this happened. Now, we have to figure it all out—for her sake.”

Clare’s family is one among many affected by Fiji’s escalating HIV crisis, where new cases have more than tripled between 2023 and 2024. Over 1,200 people were diagnosed in the first half of 2025 alone, making it the fastest-growing HIV epidemic globally, amid decreasing international aid. The UN attributes this alarming trend to Fiji’s position as a drug hub and rising local meth use, alongside unsafe injecting practices and a lack of clean needles. Cultural stigma, low health awareness, and inadequate testing and treatment contribute to the dire situation.

It’s become a grim reality for the young and addicted. Roughly half of the new HIV cases are thought to have resulted from sharing contaminated needles. Tragically, infants are being born with HIV and not surviving due to the associated complications.

Health authorities report that one baby is diagnosed with HIV from mother-to-child transmission every week, with many needing life support. Dr. Jason Mitchell, leading Fiji’s HIV response, noted that a child under five is dying each month. “That statistic breaks my heart because it’s preventable,” he says. “It’s unacceptable for more children to be born with HIV.”

However, amidst this crisis, there are glimmers of hope. Medical professionals are working hard to educate communities about seeking treatment to extend lives, despite the persistent stigma.

‘I’ve Seen Walking Skeletons’

Fiji, a picturesque archipelago in the South Pacific, has a population of around 930,000. Steeped in Christian beliefs, many native iTaukei people still prefer traditional healing over Western medicine. This demographic faces higher poverty rates and constitutes approximately 90% of HIV diagnoses.

Christopher Lutukivuya, 38, an HIV activist living with the virus since 2013, explains the stigma. “If you’re HIV-positive, you’re sinful and cursed, period,” he says, echoing the sentiments of many in a society deeply rooted in religious values. He has witnessed friends disowned by their families, unable to seek treatment, sometimes even opting for self-harm.

“Acceptance is a huge challenge. I’ve come across individuals who, desperate to avoid hospital visits, look like walking skeletons,” he shares.

Those working within the World Health Organization and UNAids in Fiji note a significant knowledge gap about HIV. Dr. Mark Jacobs, representing WHO in the South Pacific, points out that the issues faced in Fiji echo what was seen in Australia during the 1980s—misunderstandings about needle sharing, lack of safe needle programs, misguided beliefs around treatment, and discomfort surrounding condom use.

In villages, some leaders remain unaware that HIV can be transmitted from mothers to their babies. Others tend to blame the mothers for their children’s infections, with many assuming HIV is untreatable. Francine, an Indo-Fijian woman in her mid-thirties, discovered she had contracted HIV from her partner while breastfeeding. She would have liked to discuss condom use but felt she couldn’t broach the topic.

Young and Addicted

In Suva, Fiji’s capital, children often find themselves involved in drug use or street crime. Many begin using meth, believing it’s a quicker and cheaper way to get high.

Dr. Dashika Balak mentioned that most street kids prefer living outdoors where drugs are accessible, feeling a sense of community among peers.

As meth flows through Fiji on its way to New Zealand and Australia, transnational crime syndicates increasingly target the country for new users.

At the Kauwai Youth Restoration Home, social workers, led by Pastor Amani Waqetia, strive to rehabilitate young lives affected by drugs. Among them are Isac, 17, and Nemaia, 15, both of whom became addicted to meth and contracted HIV via shared needles.

Isac reminisces, “I used to be fit, but drugs changed everything. I lost weight quickly. Sharing needles brought the virus into my body.” But with the guidance of caring professionals, he’s turned his life around. He’s back in school, training for athletics, and aspires to become an accountant. “I want to change my life,” he states.

Nemaia, who once scavenged for survival, has transformed drastically. After a troubling viral video surfaced, social services intervened and brought him to the restoration home. Now, he shares a hopeful story with new arrivals: “I thought I was going to heaven… Now, I feel fresh.”

‘People Affected Are Completely Innocent’

Delivering an HIV diagnosis to children is a delicate task, one that many adults struggle to understand themselves. Dr. Kesaia Tuidraki notes that often, children don’t grasp the seriousness, even as their parents are distressed. She explains that HIV transmission frequently occurs through shared needles and unsafe sexual practices, often affecting innocent victims, especially young girls. “It’s heartbreaking,” she admits.

Through the efforts of Dr. Tuidraki and her colleagues, progress is being made. Mobile clinics are reaching underserved areas, increasing testing opportunities. Early detection during pregnancy can enable mothers to take antiretroviral medications, substantially reducing the risk of transmission to their infants.

Renata Ram, a UNAids advisor, emphasizes the importance of expanding maternity care and introducing pre-exposure prophylaxis (Prep). “Most women diagnosed are not drug users or sex workers; many are married and powerless to negotiate their safety,” she explains. The initiative aims to empower them with choices.

After surviving seven months on life support, Andi is now a thriving two-year-old, with just a scar hinting at her difficult start. Clare ensures she takes her lifelong medications. Yet, Andi has faced frequent hospitalization. Clare knows the challenges she faces: “If you want your child to survive, you simply have to follow the doctor’s advice.”

Authorities are poised to escalate the pandemic threat level as a general epidemic. While the Fijian government allocated $10 million last year, supported by Australia and New Zealand, there’s a growing demand for increased pressure and action from the community, according to Dr. Mitchell. “It can’t just be business as usual.”

‘You Can Write a New Chapter’

The UNAids estimates indicate about 8,900 individuals live with HIV in Fiji, though experts believe this might not accurately capture the full extent. The 126 recorded HIV-related deaths in 2024 may also underestimate the reality; many families are reluctant to openly associate deaths with HIV, fearing shame.

In rural areas, leaders are acutely aware of the implications of HIV’s spread. During a kava ceremony in Nataleira, a village south of Suva, elders expressed concerns about the threat and their desire to be proactive, considering getting tested. “I don’t want my family affected,” warns Rusiate Togotogorua, a local school head. “This virus has the potential to wipe out entire generations.”

While some villages reject those with HIV, supportive safe houses are emerging. Hidden in the countryside near Nadi, a safe house caters primarily to women and children affected by drugs and violence. “This issue touches all of us,” emphasizes Edwina Biyau, a trans woman who founded the Daulomani Safe House. “People say it’s not their problem, but they need to realize that these issues are interconnected within families.”

Ralulu, a resilient figure who discovered her HIV status after experiencing symptoms misdiagnosed as syphilis, exemplifies the importance of community support. “I initially felt like it was the end. But with treatment, I learned I could lead a fulfilling life,” she shares.

Biyau believes in the healing power of love and hope in their close-knit communities. “You may have HIV, but it’s not the end of your story. You can write a new chapter and share your journey of hope.”

*Names have been changed.