A recent RNZ Pacific article reported that the number of Fijians living with HIV has risen to at least 9,000—almost one percent of the population. To put this in perspective: New Zealand, with a population five times larger than Fiji’s, has around 3,500 people estimated to be HIV-positive—less than 0.1 percent of our population. Fiji’s HIV prevalence is now roughly ten times higher than ours.
Since 2024, Body Positive has been raising awareness of this escalating crisis. In 2025 alone, Fiji recorded 2,016 new cases, representing a 723% increase in just three years.
The human cost is devastating. One baby is diagnosed with HIV every week, and one child dies each month from advanced HIV disease. In 2025, 59 babies were born with HIV, compared to 31 in 2024. These are entirely preventable deaths.
But more than half of those who are aware of their HIV status are not on treatment. The cases being diagnosed are complex, presenting as late-stage disease because people aren’t accessing testing early or regularly. Reports indicate people aren’t even coming back for their test results.
Multiple layers of stigma are driving this crisis. People avoid testing for fear of being labelled as drug users, even though sexual transmission now accounts for nearly half of cases. But there’s an equally powerful unspoken barrier: the stigma of promiscuity. For Pasifika communities, sex is considered tapu—a topic shrouded in silence, shame, and discomfort. An HIV diagnosis carries the implicit judgment of sexual impropriety.
More than three percent of women attending antenatal care in Fiji are testing positive. These women face the dual shame of HIV diagnosis and the unspoken accusation about their sexual behaviour. This cultural reality, combined with the association of HIV with drug use, creates powerful barriers to testing, to collecting results, and to engaging with care.
HIV is now spreading through families and communities via sexual transmission, but the cultural silence around sex and the fear of being judged—either as a drug user or as sexually promiscuous—keep this reality hidden until people present with advanced disease.
Papua New Guinea declared its own National HIV Crisis in June 2025, with approximately 11,000 new cases in 2024 and around 2,700 infants newly infected. In both countries, most mothers were unaware of their HIV status. These two crises reveal a regional emergency that the Pacific’s fragile health systems are struggling to manage.
Fiji sits at the heart of the Pacific, with constant mobility to New Zealand through seasonal workers, students, and family visits. Fiji experiences 5% net migration annually, mostly to Australia and New Zealand.
New Zealand’s HIV response has been focused on men who have sex with men, people who inject drugs, and specific migrant communities. We are not prepared for significant HIV transmission within heterosexual Pacific communities, where cultural approaches to discussing sex and sexual health differ significantly from mainstream New Zealand health messaging.
In January 2025, Fiji launched a 90-day containment plan and the HIV Surge Strategy 2024-2027. New Zealand, Australia, WHO, and UNAIDS have provided support. A Rapid Assessment by the Kirby Institute found that the crisis is driven by syringe scarcity, unsafe injecting practices, severe stigma, and health services not designed for this scale of transmission. Despite harm reduction strategies being approved in principle, there is still no comprehensive needle and syringe programme fully operational.
With Papua New Guinea and Fiji experiencing major outbreaks, there is genuine risk to the Pacific region, including New Zealand, through established migration and family pathways. As beneficiaries of Pacific labour migration, we have a duty of care for migrants, including culturally appropriate education, screening, and access to preventive treatments.
The Rapid Assessment researchers titled their report: “This is the health crisis of our time.” The 90-day plan provides a roadmap, but are we prepared to act decisively?
A major HIV epidemic is unfolding 2,100 kilometres from Auckland, in a country with deep ties to Aotearoa. Without sustained support to translate plans into action—and, crucially, to address the multiple layers of stigma and cultural silence that keep people from testing and engaging with care—this crisis will continue to grow, with implications for communities here in New Zealand.
Article | Mark Fisher – Executive Director of Body Positive
