A dangerous drug trend called “bluetoothing,” in which people inject themselves with the blood of other drug users to get a cheap high, is contributing to spikes in H.I.V. rates in infection hot spots around the world.
The blood-sharing practice, which is many times riskier than sharing needles, has helped fuel one of the fastest-growing H.I.V. epidemics in Fiji and grown widespread in South Africa, another infection capital, according to public health authorities and researchers.
The idea of sharing drug-laced blood is so unthinkably dangerous that for years, experts have questioned how common it is. But even if relatively few people do it, the practice can spread diseases like H.I.V. and hepatitis so quickly that experts say it requires a strong public health response.
While the scale is hard to quantify, blood sharing has emerged in high-poverty areas in Africa and Asia, driven by tougher policing, spiking prices and falling drug supplies.
“In settings of severe poverty, it’s a cheap method of getting high with a lot of consequences,” said Brian Zanoni, an Emory University professor who has studied drug injecting behaviors in South Africa. “You’re basically getting two doses for the price of one.”
In Fiji, the authorities have identified bluetoothing as one force behind an alarming spiral in H.I.V. rates. The number of new H.I.V. infections rose 10-fold between since 2014 and 2024, according U.N.AIDS, a United Nations program, and an outbreak was declared there in January.
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