Fiji Faces Rapidly Escalating HIV Epidemic Fueled by drug Use and “Bluetoothing”
A surge in intravenous drug use, coupled with a dangerous practice known as “bluetoothing,” is driving a dramatic rise in HIV cases in Fiji, prompting the island nation to declare a national crisis. The epidemic has seen an elevenfold increase in infections over the past decade, with a particularly alarming spike among young people – including a reported case of a ten-year-old child living with HIV.
Fiji, a South Pacific nation with a population of less than a million, has experienced one of the world’s fastest-growing HIV epidemics in recent years. In 2014,fewer than 500 people were living with HIV in the country. By 2024, that number had soared to approximately 5,900. That same year,fiji recorded 1,583 new cases – a thirteenfold increase compared to its five-year average. Worryingly, 41 of those new cases were among individuals aged 15 or younger, a significant increase from the 11 cases recorded in 2023.
Assistant Health Minister Penioni ravunawa warned in recent weeks that Fiji may record over 3,000 new HIV cases by the end of 2025. “This is a national crisis,” he stated, “and it is indeed not slowing down.”
Experts and advocates attribute the rapid increase to a complex interplay of factors, including increased awareness leading to more testing, but primarily a spiraling trend of drug use and unsafe practices. Sesenieli Naitala, founder of Fiji’s Survivor Advocacy Network, noted the heartbreaking reality of the crisis.”More young people are using drugs,” she said, recounting the case of a boy who was sharing needles on the street during the COVID-19 pandemic. “He was one of those young people.”
the Rise of “Bluetoothing” and Chemsex
Underpinning the crisis is a disturbing trend of “bluetoothing,” also known as “hotspotting.” This practice involves an intravenous drug user withdrawing blood after injecting drugs and then injecting it into another person, who may then repeat the process.Kalesi Volatabu, executive direc
Experts emphasize the critical need for increased education and awareness to combat the epidemic. Though, systemic challenges hinder effective prevention and treatment efforts. A shortage of needles and syringes, coupled with police pressure on pharmacies requiring prescriptions for syringes, drives dangerous practices like needle-sharing and “bluetoothing.” Despite growing support for needle-syringe programs, implementation has been slow due to the country’s conservative social norms.
There is a “drastic shortage” of needle-syringe sites, placing the burden on NGOs to distribute both syringes and condoms. Staffing shortages, communication breakdowns, and equipment malfunctions are also impacting screening, diagnosis, and treatment efforts. Data collection remains slow and unreliable, obscuring the true extent of the crisis.
José Sousa-Santos, head of the pacific regional Security hub at New Zealand’s University of Canterbury, warns of a “perfect storm” brewing. “The concern is across all levels of society and government in regards to Fiji’s HIV crisis – not just what’s happening at the moment, but where it’s going to be in three years’ time and the lack of fiji’s resources,” he explained. “The support systems – the nursing, the ability to distribute or to access the drugs for treatment of HIV – just aren’t there.”
Sousa-Santos predicts an “avalanche” of cases is on the horizon. “What we’re seeing at the moment is the beginning of the avalanche, but you can’t stop it, because the infections are already happening now, or they’ve already happened – we’re just not going to be able to see them and people aren’t going to look to get tested for another two to three years,” he said. “There’s nothing that we can do at the moment to stop the number of infections that have already happened over the past year, and that are happening now. That’s what’s really terrifying.”
