'They're not just sharing needles, they're sharing blood': How HIV cases soared in Fiji

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

When she first started Fiji's Survivor Advocacy Network in 2013, that young boy was yet to be born. Now he is one of thousands of Fijians to have contracted the bloodborne virus in recent years – many of them aged 19 or younger, and many of them through intravenous drug use.

More young people are using drugs, Ms Naitala, whose organisation provides support to sex workers and drug users in the Fijian capital Suva, tells the BBC. He (the boy) was one of those young people that were sharing needles on the street during Covid.

Over the past five years, Fiji – a tiny South Pacific nation with a population of less than a million – has become the locus of one of the world's fastest growing HIV epidemics.

In 2014, the country had fewer than 500 people living with HIV. By 2024 that number had soared to approximately 5,900 – an elevenfold leap.

That same year, Fiji recorded 1,583 new cases – a thirteenfold increase on its usual five-year average. Of those, 41 were aged 15 or younger, compared to just 11 in 2023.

Such figures prompted the country's minister for health and medical services to declare an HIV outbreak in January. Last week, assistant health minister Penioni Ravunawa warned Fiji may record more than 3,000 new HIV cases by the end of 2025.

This is a national crisis, he said. And it is not slowing down.

The BBC spoke to multiple experts, advocates and frontline workers about the reasons for such a meteoric rise in case numbers. Several pointed out that, as awareness around HIV spreads and stigma diminishes, more people have been coming forward and getting tested.

Underpinning Fiji's HIV epidemic is a spiralling trend of drug use, unsafe sex, needle sharing and bluetoothing. This practice, where an intravenous drug user withdraws their blood after a hit and injects it into another person, has become increasingly popular in Fiji.

Experts warn that Fiji is ill-equipped to handle the increasing number of cases, with insufficient health resources and support systems in place.

Following its declaration of an outbreak in January, the Fijian government has sought to improve its HIV surveillance and enhance its ability to address the likely underreporting of cases, but the deep-rooted challenges persist.