HIV advocacy calls for better follow-up care

People living with HIV need better access to testing, follow-up care and education to help prevent further transmission, according to Drug Free World Fiji founder Kalesi Toga Volatabu.

Ms Volatabu said limited follow-up and monitoring by the Ministry of Health and Medical Services were contributing to gaps in the response to HIV.

She said her seven years of advocacy on HIV and drug-related issues had given her insight into the challenges.

“I have observed that when people get tested for HIV, they don't go back and get their results,” she said.

Based on her community assessments, Ms Volatabu estimated that more than 300 HIV cases on Vanua Levu were not being monitored or followed up. The figure was her estimate and had not been independently verified.

She said people who used drugs and were living with HIV needed better access to support and follow-up services.

“For drug users who are HIV contracted, there is a lack of information of their full name, residential address and their daily interactions which slowly leads to spread of HIV to others,” she said.

Ms Volatabu called for changes to the existing system, including a case management approach for people living with HIV, particularly those who also used drugs.

She said her organisation had begun distributing HIV self-test kits around the country in an effort to address the issue.

"People who were provided HIV test kits by the line ministry were not well informed of the procedure on effective usage where they injected the needle, but, did not know its full process of usage," she claimed.

She proposed that non-governmental organisations and the Ministry develop a case management plan to accompany the distribution of HIV test kits through the needle and syringe programme.

"When free condom distribution was initiated around the country, there was no reduction in HIV case numbers because of limited education on usage and its critical need to reduce HIV risks," she said.

Ms Volatabu said the Government's decision to classify HIV as a national crisis should have been made several years earlier.

Centre for Democracy and Dialogue executive director Nilesh Lal also questioned the Ministry's HIV awareness campaign, which he believed was limited in scope.

Mr Lal said videos featuring people who had experienced HIV and drug addiction, shared with their consent, could help raise awareness and encourage others to avoid risky behaviours.

He acknowledged Ms Volatabu's advocacy against the spread of HIV and drug use.

"We need to put pressure on government to enhance its awareness and fight against drug usage limiting HIV case numbers," he said.

Ministry clarifies HIV testing protocols

The Ministry of Health and Medical Services has clarified that HIV self-testing has not been introduced in Fiji and that no self-testing kits have been approved for use in the country.

In a statement, the Ministry’s Sexual and Reproductive Health and HIV Unit said official HIV testing was conducted using validated point-of-care testing (POCT) and clinical diagnostic methods administered by qualified health professionals.

The testing services are provided at Ministry health facilities and recognised sexually transmitted infection (STI) hubs.

The Ministry said official testing services included mandatory pre-test and post-test counselling, confidential guidance and direct linkage to HIV treatment.

It also cautioned that unsupervised self-testing lacked essential follow-up care.

The Unit said organisations conducting HIV testing outreach, including civil society groups and non-governmental organisations, were required to follow national diagnostic frameworks and standard operating procedures approved by the Ministry.

The Ministry said it remained committed to expanding safe and confidential HIV testing through authorised health facilities and clinical partners.