Fiji's HIV epidemic is surging and babies are paying the price

Fiji's HIV crisis killed 18 babies last year, as social stigma fuels national emergency Berenadeta* was 23 when she tested positive for HIV. She had lost weight and discovered boils that wouldn't go away. She suspected she'd picked up an infection, one that was likely sexually transmitted. Her father told her not to panic, suggesting she visit the sexual health clinic near where she lived. "They tested me three times, and all came up positive," she said. "I had to accept it." But the same visit uncovered something else she didn't know — she was three months pregnant. Her partner, who was also HIV-positive, had been on tablets to suppress the virus, but had stopped taking them and hadn't told her. Berenadeta's father advised her not to blame herself or her partner, telling her the virus could be managed with medication. But her wellbeing wasn't her only concern. "That's the only thing I was curious about, was the baby's result, not mine," she said. Her medication consisted of one tablet a day, which she never missed. The antiretroviral tablet suppresses the virus to a level that protects the mother's own health and reduces the risk of passing it on to their baby during pregnancy, birth or breastfeeding. When Berenadeta gave birth months later, doctors found no sign of the virus in her baby. "When the result came out, they told me it's negative. I was so happy,"she said. Since then, Berenadeta, now 25 years old, has had a second child and is pregnant with her third. The ABC has changed her name and masked her identity to protect her from the social stigma involved with being HIV-positive in Fiji. The young mother has bottle-fed both her children on medical advice and kept them safe from the virus. But others haven't been as lucky. Last year, 59 babies were born with HIV at Fiji's largest hospital, 18 of which died before their first birthday. They were born to pregnant women living with HIV, many of whom weren't taking medication out of fear of being stigmatised. National infection rates meanwhile are skyrocketing, with new statistics showing one in 60 adults are living with the virus. Five years ago it was one in 167 people. The crisis has prompted Fiji's government to declare a national HIV emergency, with officials predicting it would take "upwards of five years" to bring the epidemic under control. Growing crisis According to Fiji government figures, 2,016 people were diagnosed with HIV in 2025, representing a 27 per cent increase in positive cases from the previous year. UNAIDS estimated that 9,100 Fijians were living with HIV last year and only 39 per cent knew their status. Transmission between mothers and babies is also on the rise. Priya Kaur, who leads Fiji's work on eliminating mother-to-child transmission of HIV, said the 59 babies who tested positive in 2025 was the highest number in a single year. "They were born to about 332 women who were pregnant and had HIV infection," she said "That puts a vertical transmission rate at 18 per cent." Vertical transmission is the term used when HIV passes from a mother to her baby during pregnancy, childbirth or breastfeeding. The World Health Organization's recommended rate is below 5 per cent where mothers breastfeed, and below 2 per cent where they do not. Dr Kaur said Fiji's high transmission rates were preventable because HIV testing and treatment were free to access. "If you are positive, go on treatment and your children will be negative,"she said. But many people aren't taking the medicine. Social stigma Nationally, only 22 per cent of people living with HIV are receiving antiretroviral treatment. This means many people with HIV are unable to suppress the virus to a level that protects themselves and any baby they might be carrying. Berenadeta, who is due to give birth to her third child early next year, said accessing treatment was not always easy. She said for many HIV-positive women, it could require multiple consultations and transportation costs. "You have your first check-up, and then you go back home, and you are coming back in a week or two, provided you have bus fare to come and your husband has given you money and you don't have four other children to look after at home," she said. Privacy and confidentiality are also issues. In the antenatal clinic at Fiji's largest hospital, one-on-one counselling takes place in booths that seat four or five women next to each other. The booths are divided by a partition, but Dr Kaur said much of what was said could be overheard by the person next to them. She said the lack of privacy could deter women living with HIV from seeking treatment or getting tested because of the risk of being exposed. Privacy can also be an issue at home, where it's common for women to live with relatives. A bottle of tablets can invite unwanted questions from aunties, cousins, in-laws and grandparents, discouraging women from taking treatment and placing their babies at risk of infection. "They don't want the other family members to know that they are taking this particular medication," Dr Kaur said. Lethal injection Stigma and a lack of privacy are not the only barriers driving Fiji's HIV crisis. About half of all new infections are due to intravenous drug use, mainly methamphetamine, while the other half were linked to sexual transmission. Much of it arrives in Fiji through international drug traffickers, who use Fiji as a transit point to access lucrative markets in Australia and New Zealand. For many people who inject drugs, there is no easy, anonymous way to access clean needles. Fiji sex worker Nora, who chose not to give her real name, said she contracted HIV after sharing a needle with her cousin. She said many drug users shared needles and were unaware of the dangers. "We just do it, and then wash it with the water, and then pass it to somebody else to use it," she said. Fiji's government recently announced plans to introduce a needle and syringe program (NSP) as part of its response to the growing epidemic. The program, which is used in more than 90 countries, will make sterile needles and syringes available to people who use drugs to reduce the risk of HIV transmission. Meanwhile, a national sexual and reproductive health and HIV unit was created 18 months ago, and HIV testing is moving out of laboratories and onto cartridges, similar to the way COVID-19 tests work. Dr Kaur said a national list of HIV positive mothers had been developed so their treatment could be monitored. "We know who they are, where they are, what phone numbers they have," Dr Kaur said. "We go to that extent to look for them if they have missed clinic [appointments]."