Fiji’s National HIV outbreak response has sounded an urgent alarm after officials warned that low condom use, hidden infections and a worrying new transmission pattern are accelerating the spread of HIV across the country. Dr Jason Mitchell, chair of the National HIV Outbreak and Cluster Response, said inconsistent condom use remains a major driver of ongoing transmission and that official case numbers likely understate the true scale of the epidemic.
“In this country, as it is in other Pacific Island countries, we are poor at using condoms,” Dr Mitchell said, warning that weak condom programmes are allowing infections to continue unchecked. He said the issue is compounded by other high‑risk behaviours and by gaps in diagnosis: while 2,016 new HIV cases were recorded in 2025, he said that figure falls well short of where testing should be. “We should have diagnosed at least 3,000 people with HIV last year,” he said, adding that for every case identified there are multiple undetected infections.
The shortfall in diagnoses is particularly concerning because it masks transmission chains and reduces opportunities for early treatment and prevention. Dr Mitchell said undetected infections mean that the actual number of people living with HIV could be far higher than official statistics indicate, complicating efforts to limit spread and to provide antiretroviral therapy to those in need.
Health authorities have also identified an emerging pattern of HIV spread linked to shared injecting practices within tight social and family networks. Dr Mitchell described a social context in which communal sharing — “like we share food in groups, we share kava, one bowl, we share alcohol, one glass” — extends to needles and syringes, creating group infections. That dynamic, he warned, can produce rapid clusters of transmission that are harder to control with standard contact‑tracing approaches.
Taken together — low condom use, hidden cases and group-based injecting — the situation demands urgent intervention, Dr Mitchell said. He urged an intensified public health response focused on expanding testing to find undiagnosed infections, strengthening condom promotion and distribution, and addressing unsafe injecting through harm-reduction measures and targeted outreach within affected communities. Improved surveillance and cluster investigation, he said, are needed to break chains of transmission in family and social networks.
The chairman’s warnings mark a sharp call to action for Fiji’s health system and community partners. Without rapid scale‑up of prevention and testing services, Dr Mitchell cautioned, the country risks continued growth in infections that will be harder and more costly to reverse. Public health officials and civil society groups have previously advocated for stepped‑up efforts; the new data and the identified transmission pattern underline why those measures are now urgent.
Dr Mitchell concluded that controlling the outbreak will require both stronger programmes and greater community engagement to change practices around sex and injecting. “If we don’t have good effective condom programme, we will continue to have HIV infections,” he said, urging coordinated action to find undiagnosed cases and protect vulnerable networks before the epidemic widens further.
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