Delegates attending the Pacific HIV Symposium in Fiji next week will be confronting one of the region’s most urgent health challenges: the fastest growing HIV outbreak in the world
HIV prevalence among adults in Fiji is now 1.6%. This means about one in 60 adults lives with the virus
This is likely the tip of the iceberg: just one-third of people living with HIV in Fiji know their status, and only a quarter are receiving treatment
Experts project yearly infections will triple by 2030. Sadly, the equivalent of one child every week is born with HIV in Fiji, while one dies of AIDS-related complications every month
This is a public health emergency whose causes and consequences extend well beyond Fiji’s islands. In a region connected by travel, work, study and family ties, the challenge demands attention, support and informed engagement from its neighbours
An outbreak with many causes
The crisis is already gaining international attention, with Fiji in the spotlight at the AIDS2026 conference in Rio de Janeiro in July. The head of Fiji’s national HIV outbreak cluster response task force, Jason Mitchell, told delegates:
It’s important to talk about what’s happening in Fiji, as it can happen anywhere in the world
No single factor explains the outbreak
Health authorities and experts point to a combination of rising methamphetamine use and needle sharing, disruptions to funding for prevention and treatment services, health system pressures and a culture of silence and stigma surrounding HIV
Since declaring the outbreak in January 2025, Fiji has established a dedicated HIV response task force and expanded testing and treatment. There is increasing emphasis on prevention tools
PrEP (pre-exposure prophylaxis), a highly effective medicine taken to prevent HIV, is now available. Fiji is now also in the queue for the long-acting HIV prevention drug Lenacapavir, as the Global Fund – a worldwide partnership to defeat AIDS, tuberculosis and malaria – expands access
Fiji is also working with international partners to strengthen its response. Australia recently announced a contribution of more than US$10 million to support Fiji’s HIV response. UNAIDS, the World Health Organization and many other international agencies are providing financial, technical and on-the-ground support
Why this matters beyond Fiji
Despite this progress, Fiji’s outbreak represents a significant health security risk to the region. Many New Zealanders and Australians have close connections to Fiji through tourism, seasonal employment, education and family networks
Fiji is also a major regional hub, connecting communities across the wider Pacific. This does not mean travellers should be alarmed. HIV is not transmitted through casual contact or everyday social interactions
Just as importantly, it is no longer the death sentence it was once perceived to be. With early diagnosis and effective treatment, it is managed as a chronic health condition, and people living with HIV can expect to live long, healthy lives
Understanding the situation in Fiji is not about avoiding travel. It is about encouraging informed and responsible behaviour (including condom use), access to HIV prevention tools and regular testing for those who may have been exposed to risk
Such precautions are relevant whether someone is travelling to Fiji, Auckland, Sydney or anywhere else. HIV is a global health issue, not a uniquely Fijian one
But one of the greatest challenges facing the response is social stigma, which research shows discourages people from testing, delays treatment and undermines public health efforts
A regional response is vital
Concerns about confidentiality, shame and discrimination can make it difficult for people to seek support, particularly in smaller and more closely connected communities
Similar barriers can affect Fijian health professionals diagnosed with HIV, as well as Pacific peoples living in New Zealand and Australia
This is why culturally safe services that recognise the realities of Pacific communities and reflect Pacific values are so important for supporting confidentiality and trust
Similarly, health authorities in New Zealand and Australia prioritise their own domestic preparedness and security in an outbreak so close to home. But these measures also need to avoid creating further stigma
Public health challenges in the Pacific – be they caused by HIV, other infectious diseases or climate change – are increasingly regional in nature. Fiji cannot do this alone and is still calling for support, funding and technical and capacity-building assistance
It is hoped this week’s Pacific HIV Symposium can build on what has already been offered and help the country’s health workers, community leaders and people living with HIV to confront this urgent challenge
