World's fastest-growing HIV epidemic is linked to crystal meth : NPR

Key Points:

• Fiji is facing a rapidly escalating HIV epidemic, with cases increasing 12-fold from 2010 to 2025, prompting the government to declare a national emergency; currently, 1 in 60 adults are estimated to be living with HIV.
• The surge in HIV is closely linked to a parallel epidemic of crystal methamphetamine use, especially among youth who often inject the drug, leading to HIV transmission through shared needles and the dangerous practice of "bluetoothing."
• Social and economic factors such as rising unemployment, mental health deterioration during COVID lockdowns, and limited access to clean needles have exacerbated drug use and HIV spread, with low condom use further fueling sexual transmission.
• Efforts to combat the crisis include increased foreign aid, notably a $48 million Australian funding package, expanded HIV testing (especially in antenatal clinics), and introduction of new prevention tools like injectable PrEP, but challenges remain in reaching vulnerable populations across Fiji's dispersed islands.
• Controversies persist around harm reduction strategies, such as sterile needle distribution, which faces government resistance, while innovative approaches like mobile clinics, peer support workers, and new drug delivery methods offer hope to curb the epidemic before it overwhelms Fiji's healthcare system.