The island nation of Fiji is grappling with a dual crisis of rising HIV cases and crystal meth addiction. With HIV cases increasing 12-fold between 2010 and 2025, the government declared a national emergency in mid-September. According to estimates, there are over 9,000 cases of HIV in Fiji, with 1 in 60 adults living with the virus. The country's health minister has expressed concern over the rapid spread of the disease.
The HIV epidemic in Fiji is closely linked to the growing use of crystal meth, particularly among young people. The drug is often injected, leading to transmission through shared needles. Jason Mitchell, a public health specialist leading Fiji's HIV response, described the situation as the fastest-growing HIV epidemic in the world. Two-thirds of cases are in those aged 20-34, with many attributing the rise to the rampant use of crystal meth.
The COVID-19 pandemic has exacerbated the crisis, with rising unemployment and increased accessibility of crystal meth contributing to its growing use. Doctor Sailosi Soqo, working on Fiji's national HIV response team, notes that the pandemic created a perfect storm for the spread of the disease. With many Fijians losing their jobs or experiencing reduced hours, they turned to crystal meth, which was readily available due to travel restrictions and increased border security.
The practice of "bluetoothing" or "hotspotting" – where one person injects crystal meth and then another person injects their blood – has also contributed to the spread of HIV. This practice is often used in settings of extreme poverty as a cheaper way of getting high. However, Mitchell believes that its popularity in Fiji is also due to the cultural practice of sharing things, including communal consumption of alcohol and kava.
In addition to crystal meth use, risky sexual practices are also contributing to the spread of HIV in Fiji. According to Soqo, sexual intercourse accounted for roughly 50% of new HIV cases in 2025. Low condom use is a significant factor, with a 2021 survey finding that only 24% of men and 9% of women used a condom during their last sexual encounter. Mark Lal, a 25-year-old HIV activist, contracted HIV through unprotected sex with a male partner.
The surge in HIV cases has led to an influx of foreign aid to support new HIV testing, prevention, and treatment programs. The Australian government announced a new $48 million funding package in August to support Fiji's HIV response. The goal is to prevent new infections, improve early diagnosis, and expand access to treatment. One of the priorities is to make HIV testing available at all antenatal clinics, where 59 babies were born with HIV in 2025.
Despite the availability of antiretroviral treatments, many people in Fiji are not receiving care. Only 5,676 cases have been officially diagnosed, and even fewer are regularly taking antiretrovirals to control their condition. Doctor Dashika Balak, leading Fiji's national HIV treatment, care, and support efforts, notes that some people stop treatment, and others cannot be reached due to incomplete contact details.
Key points
- Fiji's HIV cases have risen 12-fold since 2010, with 1 in 60 adults now living with the virus.
- The HIV epidemic in Fiji is closely linked to the growing use of crystal meth, particularly among young people.
- The Australian government has announced a new $48 million funding package to support Fiji's HIV response.
