Fiji prepares major survey to establish true scale of HIV outbreak

Fiji’s HIV response is still being guided by planning estimates, with the Ministry of Health and Medical Services preparing a major survey to establish validated data on the scale and drivers of the outbreak.

National HIV Outbreak and Cluster Response Taskforce chair Dr Jason Mitchell said the Integrated Biological and Behavioural Surveillance (IBBS) survey was one of the Taskforce’s most important initiatives.

He said the survey would help close the gap between planning estimates and the validated data needed to guide Fiji’s HIV response.

The survey will focus on three key areas — the size of key populations, the prevalence of HIV within those groups and the behaviours driving transmission.

“First, the true size of our key populations, the number of people who inject drugs, sex workers, men who have sex with men, and transgender people, so we know how big the response must actually be.

“Second, how much HIV is already present in each of those groups and third, the behaviours driving transmission, including needle sharing, so our prevention is aimed at reality rather than assumption,” he said.

Dr Mitchell said the survey would replace guesswork with evidence and provide a baseline for measuring whether the HIV response was working.

“Practically, the IBBS gives us the denominators that almost every other target depends on, our reach targets, our PrEP need, our condom-use measures,” he said.

“It sets the baseline against which we will honestly measure whether this response is working. For an epidemic moving as fast as ours, that is not a research luxury, it is the foundation of an effective response.”

He said the data would also help determine whether existing prevention measures were reaching people most at risk.

“That denominator is exactly what our upcoming behavioural survey is designed to produce. So, the honest position is: promising on reach, unproven on impact, and we are putting in place the very data that will let us judge it properly and drop what does not work.”

Rainbow Pride Foundation acting chief executive Asaeli Sinusetaki said he hoped the IBBS would help identify the factors driving HIV transmission in Fiji.

He said the survey could also provide a better understanding of prevention behaviours, the services and prevention commodities people were accessing, the barriers they faced and gaps in the current HIV prevention response.