Fiji's AIDS epidemic can only be described as "explosive". Doctors in hospitals and clinics, who used to diagnosing sporadic cases of HIV infection, are now facing a "flood-like" epidemic.
Three years ago, 245 new cases were reported in the Islands; by 2024, the number has surged by 550% to 1583 cases.That has given Fiji a frustrating new title: After decades of limited transmission, this tropical paradise now has the world's fastest-growing HIV epidemic.
Dr. Tuidraki said frankly: "When we realized what was happening, bang, explosive numbers appeared. To be honest, I think we have become complacent... now we have to catch up like hell."
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This sudden spread is closely related to the surge in methamphetamine. Fiji, with a population of about 900,000 and hundreds of islands, has been a transit point on the Pacific Drug Highway for many years.
But since 2020, the COVID-19 epidemic has disrupted illegal trade routes and led to a surge in domestic drug consumption. Iamon Murphy, Asia-Pacific Regional Director of UNAIDS, pointed out: "The main impact here is the new coronavirus. Drug supply used to only transit Fiji and was not a real domestic market. But during the COVID-19 epidemic, the drug trade was trapped there. At this time, the increase in injecting drug use collided with a previously ignored background epidemic."
Experts have reported using methamphetamine among children as young as 10, and drug-related deaths, whether from addiction or suspected gang activity, are also on the rise. At the same time, local HIV is spreading widely through three main channels:
①Sharing needles and injecting drugs；
②Sexual behavior under the influence of drugs；
③"Bluetooth Group" behavior: It means that after people collect money to buy ice, one person is responsible for injecting it. When the person feels high, others will draw his blood and inject it into themselves to pursue the "secondary pleasure" brought by residual ice in the blood.
Dr. Tuidraki emphasized: "We know from patients that this condition (in the blue bud group) is now common and is one of the factors driving the 'outbreak'. But due to the long incubation period of HIV, we are only now beginning to see the ripple effect of the COVID-19 epidemic."
These ripple effects are "shocking". At the MSP clinic in Suva, the capital, Dr. Tuidraki has witnessed a steady stream of new HIV patients over the past 18 months-unlike in the past, many patients are very young. They often seek treatment only when the disease is severe and often go off surveillance and stop taking antiretroviral drugs.
Dr. Tuidraki observed: "The trend is indeed a change from what we have seen before. Patients 'conditions deteriorate faster-possibly because of the method of transmission. When people share drugs and needles, the viral load is very high." She pointed out in particular: "We also see a younger generation--Previously, most cases were 29 years old and older. But now it has changed to that people aged 10 to 19 are the ones with the largest number of new cases.”
Data released by UNAIDS last month confirm Dr. Tuidraki's observations:Of the new cases in 2024, 60% occurred in young people aged 10 to 29. About 48% of new cases are related to injecting drug use, narrowly surpassing sexual transmission (43%) as the main known cause of infection.
UNAIDS estimates that among the approximately 6000 people living with HIV in Fiji:
① Only one-third of people know their infection status, indicating widespread undetected transmission.
② Only 24% of those affected are currently receiving treatment. Without antiviral drugs, they would almost certainly die.
UNAIDS's Mr. Murphy warned: "This shows that we need to do a lot of work to contain the outbreak and require a different response than in the past. The country has never needed a drug-related response before... but if Fiji does not challenge the community's perceptions of drug use and how to respond to injecting drug use, this epidemic will become even more serious."
Even before the current wave of cases, stigma and stereotypes had complicated treatment and prevention efforts in Fiji. Mark Shahir Lal (who founded the awareness group Living Positive Fiji after testing positive for HIV) explained: "Fiji is a closely connected, faith-based society where privacy is difficult to secure and people are afraid of being judged."
He is one of the few infected people willing to talk openly about his diagnosis and experience. He shared: "Testing positive was a huge shock to me. But I had several friends who died of AIDS, and sadly, they didn't start treatment because of the stigma and shame and the fear of going to the clinic to get their medicine." General conversations about same-sex relationships, sex work and sexual health remain taboo here, and this silence hides HIV and makes prevention and support more difficult.
The government has taken a number of responses, including designating the AIDS epidemic as a national epidemic in January. This allowed more resources to be mobilized, including new funding of 10 million Fijian dollars (about £ 3 million). The Ministry of Health has established a dedicated HIV unit and has embarked on expanding testing and conducting awareness campaigns. Australia and New Zealand have also pledged support.
Fiji's ability to successfully meet these challenges and contain the HIV epidemic is critical not only to the islands itself, but also has significant implications for its regional neighbors. Mr. Murphy emphasized: "Our biggest concern for Fiji is not just the domestic epidemic, it is also the gateway to the Pacific. As early as 2001, everyone expected an outbreak in the Pacific because of the high rate of sexually transmitted infections. It didn't happen at the time. But now, this is an imminent reality."
Content source: Youai Classroom