The island nation of Fiji is confronting a dual public health emergency combining rapidly expanding HIV infections with widespread crystal methamphetamine abuse among its youth population. Government officials reported that HIV cases increased 12-fold between 2010 and 2025, prompting a national emergency declaration in mid-September. Health authorities estimate approximately 9,000 cases exist in the country, with official statistics indicating that 1 in 60 adults currently live with HIV. At the July AIDS 2026 conference in Rio, public health specialists characterized Fiji’s outbreak as the fastest-growing HIV epidemic globally, with two-thirds of infections occurring in people ages 20-34.
Experts attribute the outbreak’s severity to the intersection of crystal methamphetamine use and injection practices that facilitate viral transmission. Crystal meth availability in Fiji intensified significantly following the COVID-19 pandemic, when economic disruption and job losses coincided with drug supplies becoming stranded in the country rather than reaching their intended destinations in Australia and New Zealand. Health professionals note that unemployment, mental health deterioration from lockdowns, and increased drug accessibility combined to drive meth adoption, including among children as young as 9 years old. A particularly concerning transmission method involves “bluetoothing” or “hotspotting,” practices where users share infected blood through injection. Law enforcement efforts to restrict needle availability, intended to limit drug use, have inadvertently encouraged these high-risk sharing practices.
Sexual transmission also contributes substantially to new infections, accounting for roughly 50% of 2025 cases. Survey data from 2021 indicated that condom use rates remain critically low among sexually active populations, with only 24% of men and 9% of women using protection during recent sexual encounters. One documented case involved mother-to-child transmission, with 59 babies born with HIV during 2025.
International response has mobilized significant resources to address the crisis. Australia announced a $48 million funding package in August to support testing, prevention, and treatment initiatives. Priority interventions include expanding HIV testing at antenatal clinics to prevent perinatal transmission and increasing access to antiretroviral medications that suppress viral loads. However, challenges persist in reaching vulnerable populations, as meth use concentrates in impoverished communities with unstable housing. While estimates suggest between 9,100 and 12,000 people carry HIV, only 5,676 cases have received official diagnosis, highlighting substantial gaps in case identification and treatment access.
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