Although Fiji continues to be a low HIV prevalence country, the available data indicates that its population is vulnerable to HIV infection. Specifically, surveys have shown high levels of commercial sex and multiple sexual partners, a low level of condom use among those who engage in higher-risk sex, high prevalence of STIs, low level of HIV knowledge, and violence against women.1; 2; 3
The first cases of HIV were identified in 1989. As of December 2010, a cumulative total of 366 confirmed HIV cases were reported; the main mode of transmission was heterosexual (89%), followed by perinatal transmission (7%) and homosexual transmission (3%). Only one known case due to injecting drug use has been reported (in 1994).4 Sexually transmitted infections (STI) among ANC attendees have been found to be considerably high in Fiji. In 2008, Chlamydia prevalence was 26.8%, followed by syphilis and gonorrhoea with prevalence of 2.7% and 2.2%, respectively (N=448).2
A recent MSM study in 2011 indicated that two-thirds engaged in transactional sex. Consistent condom use was quite low; only 22% of the respondents reported consistent condom use with any MSM or TG partners in the last six months. 5 MSM and TG-specific HIV prevention services are still limited and more than one third of the respondents had neither been approached by outreach workers nor been given condoms and lubricants. Furthermore, only 11% were tested for HIV in the last 12 months and knew the test results.5
Qualitative studies by McMillan and Worth in 2009 and 2011 found that many sex workers did not use condoms with their intimate partners. The clients often determined the terms of condom use and many clients were resistant to it.6 Fear of police harassment or arrest was found to be a disincentive to carrying condoms, especially after the Crimes Decree was enacted in 2010 which affirms sex work as a punishable offence. The study indicated that due to the criminalisation of sex work, sex workers have become less accessible to peers, sex worker advocates and HIV prevention programmes.7
Fiji passed a law decriminalizing consensual homosexuality through the Fiji National Crimes Decree on 1 February 2010 8 and also lifted its restrictions on entry, stay or residence based on HIV status in August 2011.9 Furthermore, the HIV/AIDS Decree 2011 was enacted on January 18, 2011 and it has been acknowledged both locally and internationally as one of the most progressive HIV laws in the world.10
Sources:
1 Ministry of Health. (2010). UNGASS Country Progress Report: Fiji
2 Ministry of Health Fiji, Ministry of Health Kiribati, Ministry of Health Samoa, Ministry of Health Solomon Islands, et al. (2006). Second Generation Surveillance Surveys of HIV, other STIs and Risk Behaviours in Six Pacific Island Countries.
3 Meleisea, P. S., UNDP Pacific Centre, UNDP Regional Project on HIV and Development, UNIFEM Pacific, et al. (2009). Gender and HIV in the Pacific Islands Region: A Literature Review of Evidence with Recommendations: UNDP Pacific Centre.
4 Ministry of Health. (2011). Annual Report 2010.
5 Bavinton, B., Singh, N., Naiker, D. S., Deo, M. N., et al. (2011). Secret Lives, Other Voices: A Community-Based Study Exploring Male-to-Male Sex, Gender Identity and HIV Transmission Risk in Fiji. Suva, Fiji: AIDS Task Force of Fiji.
6 McMillan, K., & Worth, H. (2010). Risky Business: Sex Work and HIV Prevention in Fiji: International HIV Research Group, UNSW, Sydney.
7 McMillan, K., & Worth, H. (2011). Sex Workers and HIV Prevention in Fiji – after the Fiji Crimes Decree 2009: International HIV Research Group, UNSW, Sydney.
8 UNAIDS. (2010). Fiji First Pacific Island Nation with Colonial-Era Sodomy Laws to Formally to Decriminalize Homosexuality. Feature Story Retrieved February 26 from http://www.unaids.org/en/resources/presscentre/featurestories/2010/march/20100304fiji/
9 UNAIDS. (2011). Fiji Lifts Travel Ban for People Living with HIV. Feature Story Retrieved February 26 from http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2011/august/20110826cfiji/
10 Fiji Government Online Portal. (2011). PM Highlights Fiji's Progressive Laws on Health Care. News Retrieved February 26 from http://fiji.gov.fj/index.php?option=com_content&view=article&id=4910%3Apm-highlights-fijis-progressive-laws-on-health-care&catid=67%3Afiji-header-stories&Itemid=155
