MANILA, Dec. 10 (Xinhua) -- Unsafe injecting practices linked to the absence of harm reduction or safe protection services are putting people who inject drugs in Fiji at significantly higher risk of HIV infection, the World Health Organization (WHO) warned on Wednesday, as the Pacific island nation confronts one of the fastest-growing HIV epidemics globally.
A new rapid assessment, funded by The Global Fund, found widespread reuse and sharing of needles and syringes due to the lack of needle and syringe programs (NSPs) in the country.
All interview participants reported having reused injecting equipment previously used by someone else, a behavior that sharply heightens the risk of HIV, viral hepatitis, and other injection-related infections.
The study provides the most detailed picture yet of drug use and health-seeking behaviors among people who inject drugs in Fiji. It draws on quantitative data, 56 one-on-one interviews, and five talanoas-traditional community dialogue sessions, with 50 key informants from civil society, healthcare, law enforcement, faith-based groups, and government ministries.
Fiji, with a population of under 1 million, has seen HIV cases surge rapidly in recent years.
The country recorded 1,583 new HIV cases in 2024, while 1,226 cases were reported in just the first half of 2025.
UNAIDS estimates show the total number of people living with HIV climbed from around 2,000 in 2020 to an estimated 6,100 in 2024. Nearly half (48 percent) of people who began treatment in 2024 were people who inject drugs, underscoring the disproportionate toll on this community.
Methamphetamine was identified as the most commonly injected drug.
Alarmingly, many participants said their first injection, often using potentially contaminated equipment, occurred the first time they tried methamphetamine. Low awareness of HIV and limited access to testing and treatment further compound the risks.
While media reports have highlighted "bluetoothing," a dangerous practice involving the sharing of blood between users after one person has injected drugs, researchers found little evidence of its occurrence. The far more prevalent threat, they said, is routine needle sharing driven by a lack of sterile supplies.
The assessment's top recommendation is the urgent rollout of sterile needle and syringe distribution, a cornerstone of harm reduction strategies proven globally to prevent HIV transmission.
In response to the escalating crisis, Fiji's Ministry of Health and Medical Services, together with WHO, the United Nations Development Programme, and other partners, is implementing an HIV Surge Strategy (2024-2027) and an HIV Outbreak Response Plan.
These initiatives aim to expand testing and treatment services, strengthen outreach to key populations, and accelerate the introduction of harm-reduction measures, including NSPs.
Health authorities warn that without swift action, Fiji could see HIV cases rise dramatically in the coming years, deepening health and social consequences across the country. ■
