“They’re Not Just Sharing Needles, They’re Sharing Blood”: How HIV Cases Soared in Fiji

“They’re Not Just Sharing Needles, They’re Sharing Blood”: How HIV Cases Soared in Fiji

Fiji is facing an escalating HIV emergency. Over the past few years, reported HIV cases have surged dramatically, largely driven by injecting drug use, risky blood-sharing practices, and a growing culture among young people that puts them at extreme risk. With the country now having one of the fastest-growing HIV epidemics in the Asia-Pacific region, officials are scrambling to respond.

In this article, we explore how HIV in Fiji has nearly exploded, what’s fueling it, how dangerous practices like sharing needles and a trend called “bluetoothing” are part of the spread, and what health authorities are doing (or must do) to prevent further devastation.

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The Alarming Numbers: How Big Is the Problem?

• From January to September 2024, Fiji recorded 1,093 new HIV cases, nearly triple the number in 2023. Fijivillage+2Fiji Sun+2
• Over the last five years, the rate of reported HIV cases rose nearly nine-fold, from about 13.56 per 100,000 in 2019 to 123.52 per 100,000 in 2024. Fijivillage
• UNAIDS estimates roughly 5,900 people are living with HIV in Fiji as of recent reports, up considerably from fewer than 500 a decade ago. Fijivillage
• Demographic data show more than 50% of new HIV infections are now linked to injecting drug use. Fijivillage+2Fiji Government+2

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What Is Driving the Surge?

Several overlapping factors are behind Fiji’s rapid HIV increase:

1. Injecting Drug Use & Needle Sharing

• A major contributor: people injecting methamphetamine and sharing needles. This is especially pronounced in remand centres (prisons) and among street-youth or marginalized communities. FijiGlobalNews.com+3Fiji Sun+3ABC+3
• Needle sharing is dangerous enough, but Fiji has seen the rise of “bluetoothing” — a practice where after one person injects a drug, others draw out some blood and inject it into themselves or others to amplify the drug effect. This is a major vector for HIV, because it mixes blood between individuals. ABC+1

2. Young People Affected

• Many new cases are among youth aged 20-29, but alarming instances among younger adolescents (10-13 years) have also been recorded. Fiji Sun+1
• Some of these youths are not sexually active yet but are becoming infected through injecting practices or family/sharing networks. Fiji Sun+1

3. Under-Detection, Stigma, and Insufficient Prevention

• A significant percentage of people living with HIV are unaware of their status, delaying treatment and further spreading the virus. Fijivillage+1
• There is limited access in some areas to HIV testing, harm-reduction services, clean needles, and community awareness programmes. ABC+2Fijivillage+2
• Social stigma, lack of knowledge, and traditional attitudes around drug use or sexual health hinder open discussion and prevention. ABC

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Dangerous Practices: Beyond Needle Sharing

While needle sharing is well known to spread HIV, certain practices unique or particularly entrenched in Fiji are making matters worse:

• Bluetoothing: This deeply risky method of sharing blood among users, often to stretch the effect of drugs, is now acknowledged as fueling a large number of new HIV infections. ABC+1
• Sharing of needles and injecting equipment in remand centres: prisons have seen a 60% increase in HIV cases. Injecting drug use and shared needles among detainees contribute significantly. Fiji Sun+1
• Injecting drug use within homes or families: Reports suggest that fathers, children, and siblings are sharing needles or injecting equipment within households. This blurs lines of safe/non-safe environments. Fiji Sun+1

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The Human Cost

The health impacts and societal cost are already significant:

• HIV/AIDS morbidity and mortality are rising. Deaths attributed to HIV have also increased. Fiji Sun
• Individuals face not only illness but mental health stress, stigma, and isolation. Stories like that of Mark Lal, a young Fijian discovering multiple friends dying and now navigating treatment, show the emotional burden. ABC
• The risk to children: infections in very young people, some under age 15, highlight how vulnerable populations are being affected. Fiji Sun+1

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What Is Being Done: Fiji’s Response Strategy

Recognising the seriousness, Fijian authorities have launched several initiatives:

• HIV Outbreak Response Plan and HIV Surge Strategy 2024-2027: These frameworks aim to respond immediately and also build long-term prevention, treatment, and community support systems. Fiji Government+1
• 90-Day Plan: A focused approach to quickly roll out harm-reduction programmes, treatment access, testing, and public awareness. Fiji Government+1
• Intent to introduce needle-syringe programmes (clean needle exchanges), improved testing, and better outreach especially in hotspots and among youth. Fijivillage+1

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Challenges Ahead

However, the path forward is not easy. Key obstacles include:

• Funding and resources: Many prevention programmes, supply of clean needles, rapid HIV tests, and support services are underfunded or stretched thin. Fijivillage+1
• Social stigma and cultural resistance: Drug use is stigmatized, and the idea of needle exchange, bluetoothing, or openly discussing HIV is resisted in some communities. Fijivillage+2ABC+2
• Logistical barriers in testing and treatment: Many who are infected are not identified, or once identified do not receive consistent access to antiretroviral therapy. ABC+1
• Youth outreach: Younger populations may lack education about injecting risks, safe practices, or access to clean supplies. Fiji Sun+1

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What Needs to Happen: Solutions & Public Health Recommendations

To reverse the trend, Fiji (and similar-affected places) must consider the following actions:

1. Expand harm reduction programmes
• Clean needle/syringe exchange programmes
• Safe injectable drug use education
• Access to drug treatment and rehabilitation
2. Increase testing and early diagnosis
• Mobile testing clinics in hotspot areas
• Routine testing in remand centres, youth centres
• Ensure people know their HIV status
3. Improve treatment access and retention
• Ensure antiretroviral therapy (ART) is available, affordable, and accessible
• Support for adherence: helping people stay on treatment
4. Public education and stigma reduction
• Community outreach to explain HIV transmission, including via sharing needles and blood
• Involvement of families, churches, and leaders to reduce stigma
5. Youth-focused interventions
• Educate young people in schools/community about risks of bluetoothing and unsafe injecting
• Safe spaces, mental health and addiction support
6. Policy and funding support
• Government and international aid to fund prevention and treatment infrastructure
• Law or policy changes to support needle exchange programmes and drug addiction services

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Conclusion: A Public Health Turning Point

Fiji is at a critical juncture. The HIV epidemic is no longer only a concern for sexual transmission; injecting drug use, needle sharing, and blood-sharing practices are now major drivers. Without drastic, evidence-based intervention—from governments, health authorities, and communities—Fiji risks losing control of an epidemic that’s growing at an astonishing rate.

This isn’t just a health statistic—it’s thousands of lives affected, many preventable deaths, stigma, and suffering. But with awareness, harm reduction, testing, and community action, Fiji has a chance to turn things around. The urgency is high, and the time for action is now.