The cases of HIV of Fiji are due to Bluetotothing, Chemsex and needle sharing

Ten: It is the age of the youngest person with HIV that Sesenieli Naitala has ever met.

When she launched the Fiji defense network in 2013, this young boy was not yet born. Now he is one of the thousands of Fijians to have contracted the blood virus in recent years – many of them aged 19 or less, and many of them by the consumption of intravenous drugs.

“More and more young people are consuming drugs,” Ms. Naitala told the BBC, whose organization provides support for sex workers and drug addicts in the Fijian capital. “He (the boy) was one of those young people who shared needles in the street during the covid.”

Over the past five years, Fiji – a small nation of the South Pacific with a population of less than a million – have become the place of one of the fastest growth epidemics in the world.

In 2014, the country had less than 500 people living with HIV. By 2024, this number had climbed to around 5,900 – a jump of eleven times.

The same year, Fiji recorded 1,583 new cases – an increase of thirteen times compared to its usual five -year average. Among these, 41 were aged 15 or under, against only 11 in 2023.

These figures prompted the Minister of the country to health and medical services to declare an HIV epidemic in January. Last week, Deputy Minister of Health, Penioni Ravunawa, warned the Fiji could record more than 3,000 new HIV cases by the end of 2025.

“This is a national crisis,” he said. “And it doesn’t slow down.”

The BBC spoke to several experts, defenders and front -line workers reasons for such a dazzling increase in the number of cases. Several have pointed out that, while the awareness of HIV expanding and that stigma decreases, more and more people have come forward and have been tested.

At the same time, however, they also noted that countless others remain invisible for official figures – and that the real scale of the problem is probably much greater than even record figures.

The HIV epidemic of Fiji is a spiral trend in drug use, dangerous sex, the sharing of needles and “bluetooth”.

Otherwise known as “hotspotting”, this last term refers to a practice where an intravenous drug addict removes its blood after a blow and injects it into a second person – which can then do the same for a third party, etc.

Kalesi Volatabu, executive director of NGO’s drugs without drugs, saw that this happens first. Last May, she was one of her regular morning walks through the Fijian capital of Suva, offering support and education for drug consumers in the streets, when she turned a corner and saw a group of seven or eight people snuggle up together.

“I saw the needle with the blood – it was right in front of me,” she recalls. “This young woman, she had already had the blow and she takes out the blood – and then you have other girls, other adults, already aligned to be struck with this thing.

“These are not only needles they share – they share blood.”

Bluetooth was also reported in South Africa and Lesotho, two countries with some of the highest HIV rates in the world. In Fiji, practice has become popular in recent years, according to MS Volatabu and Mrs. Naitala.

One of the reasons for its appeal, they explain, is a cheaper high: several people can participate in a single blow and share it with each other. Another is the convenience of needing a single syringe.

These can be difficult to find at Fiji, where pharmacies, under police pressure, often require syringe prescriptions, and there is a lack of needle syrege programs.

Although there is increasing acceptance and approval for the deployment of these programs – which provide injection equipment specific to drug consumers in order to reduce the transmission of blood infections such as HIV – the implementation of the highly religious and conservative country has proven to be difficult.

Ms. Volatabu says that there is a “drastic shortage” of needle syrege sites, which feeds dangerous practices such as sharing needles and Bluetooth and putting on NGOs to distribute syringes as well as condoms.

In August 2024, the Ministry of Fiji of Health and Medical Services (MOH) recognized Bluetoothe as one of the engines of the country’s increase in HIV. Another was Chemsex, where people consume drugs – often methamphetamine – before and during sexual meetings.

In Fiji, unlike most other countries in the world, crystal methamphetamine is mainly consumed by intravenous injection.

The MOH also noted that of the 1,093 new cases recorded in the first nine months of 2024, 223 – around 20% – came from the consumption of intravenous drugs.

Fiji have become a major Pacific traffic center for crystal methamphetamine over the past 15 years. Much of this is due to the country’s geographic location between East Asia and the Americas – some of the world’s largest drug manufacturers – and Australia and New Zealand – the best remunerated markets in the world.

During this same period, methamphetamine has spread and spread in local communities, which is transforming into a crisis which, like HIV, has recently been declared “national emergency”.

And according to those on the front line, the age of users tends to decrease.

“We see more and more these young people,” explains Ms. Volatabu. “They are becoming younger and younger.”

The most recent national HIV statistics of Fiji cite the consumption of injectable drugs as the most common known mode of transmission, representing 48% of cases. Sexual transmission represented 47% of cases, while mother-child transmission during pregnancy and childbirth was cited as a cause of most pediatric cases.

Everyone to which the BBC spoke agreed that the lack of education is a central factor in the epidemic. Ms. Volatabu and MS Naitala both work to change that – and Mrs. Naitala says that in addition to a greater consciousness of the dangers of HIV is spread throughout the community, “Bluetoot” is, according to her experience, fell into disgrace.

More and more people are tested and are looking for treatment for HIV, leading to more robust data on the crisis scale.

But there is still a concern that the official cases are only the tip of the iceberg – and a fear of what can be below the surface.

José Sousa-Santos, head of the Pacific Regional Security Center at the New Zealand University of Canterbury, said “a perfect storm is preparing”.

“The concern is at all levels of society and government with regard to the Fiji HIV crisis – not only what is happening at the moment, but where it will be in three years and the lack of resources from Fiji,” he said to the BBC. “Support systems – nursing, the ability to distribute or access drugs for HIV treatment – are simply not there.

“This is what terrifies us, the people who work in the region: there is no way that Fiji can face it.”

Following its declaration as an epidemic in January, the Fijian government sought to improve its HIV surveillance and improve its ability to combat the likely sub-declaration of cases.

The global alert and response network, which has been called upon to provide this support, said in a recent report that “attacking these urgent problems thanks to a well coordinated national response is crucial to reverse the trajectory of the HIV epidemic to Fiji”.

This report also noted that staff shortages, communication problems, challenges with laboratory equipment and rapid HIV and drug stocks have had an impact on screening, diagnosis and treatment.

The data collection is slow, difficult and subject to errors, she added-hindering efforts to understand the extent of the VIH epidemic of Fiji and the effectiveness of the response to the epidemic.

This leaves many experts, authorities and everyday faithful in darkness. And Mr. Sousa-Santos predicts an “avalanche” of the coming cases.

“What we see at the moment is the start of the avalanche, but you cannot stop it, because the infections are already happening now, or they have already arrived – we are just not going to see them and people will not seek to be tested two to three years,” he said.

“There is nothing that we can do for the moment to stop the number of infections that have already occurred in the past year, and which occur now. This is what is really terrifying.”