Health experts are raising alarms over a disturbing new trend in which drug users exchange blood to experience a shared high. Known as “bluetoothing,” this new practice is driving a sharp increase in HIV infections in regions such as Fiji and South Africa. Doctors warn that the recent rise in reported cases may only reveal a fraction of the potential damage linked to this dangerous act, which is also called “hotspotting.” But what exactly is behind this risky phenomenon, and why is it spreading?What Is Bluetoothing and How Is It Linked to Rising HIV Cases?Bluetoothing is a hazardous street practice where a person injects a potent drug such as heroin or meth, then withdraws a small amount of their own blood, now mixed with the drug, into a syringe and injects it into someone else to share the high. This process can continue from one person to the next, often using the same needle.According to Brian Zanoni, a professor at Emory University who has studied drug-injecting behavior in South Africa, “it’s a cheap way to get high, but it comes with serious consequences as you’re essentially getting two doses for the price of one.” However, experts note that the effectiveness of this method is uncertain. Some believe the secondary injection produces only a mild high, while others argue it is just a placebo affect.Why Is Bluetoothing So Dangerous for Health?The idea of passing around drug-laced blood is so shockingly unsafe that for years, health professionals questioned whether it actually happened. Yet even if practiced by a small number of people, it can rapidly spread bloodborne diseases like HIV and hepatitis, prompting calls for an urgent public health response.In Fiji, authorities have identified bluetoothing as a key factor behind an alarming rise in HIV rates. According to UNAIDS data, new HIV infections there increased tenfold between 2014 and 2024, leading to an official outbreak declaration in January.About half of newly diagnosed individuals receiving antiretroviral treatment in Fiji reported contracting HIV through needle sharing, though it remains unclear how many knowingly exchanged blood. Most of these new cases were among people aged 15 to 34.How Dangerous Is HIV and What Are Its Stages?Without treatment, HIV gradually weakens the immune system, making the body vulnerable to serious infections. Over time, untreated HIV can develop into acquired immunodeficiency syndrome (AIDS). The progression of HIV occurs in three key stages for people who are not on treatment:Acute HIV InfectionThis first stage usually appears two to four weeks after exposure. Many people experience flu-like symptoms such as fever, rash, and headache. During this phase, the virus multiplies quickly and attacks the immune system’s CD4 cells, leading to a very high viral load and increased risk of transmission.Chronic HIV InfectionIn this second stage, the virus continues to replicate at low levels. People often do not show symptoms, but without antiretroviral therapy (ART), this stage can advance to AIDS within a decade or sooner. With proper treatment, individuals can live in this stage for many years.AIDSThe final and most severe stage occurs when the immune system is badly damaged. The body becomes unable to fight off infections and certain cancers. A diagnosis of AIDS is made when CD4 counts fall below 200 cells/mm³ or specific infections appear. At this stage, the viral load is high and transmission risk increases sharply. Without treatment, life expectancy is typically around three years.Since “bluetoothing” is not a wireless or digital act but an extreme form of intravenous drug use, protection begins with avoiding environments where it might occur. The safest approach is never to start injecting drugs. Acknowledge that this practice is real and extremely dangerous, rather than dismissing it as an online rumor, especially in communities where drug abuse and poverty are common.
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