HIV Cases Rising in French Polynesia: Experts Warn of Resurgence

A concerning rise in HIV infections is prompting renewed calls for action in French Polynesia, with health officials reporting 25 new cases between January and November 2025. The increase, mirroring levels not seen since the 1990s, has raised alarms among medical professionals who fear a shift in the epidemic’s trajectory.

Dr. Ngoc Lam Nguyen, director of the Centre de Maladies Infectieuses et Tropicales (CMIT) and president of the association Messager contre le Sida (MCS), expressed his concern, noting that whereas 209 people are currently under care for HIV in the territory of 280,000 inhabitants, the recent surge signals a potentially rapid escalation. “It’s the beginning of a steep climb,” he observed, according to sources familiar with his presentations.

The CMIT, the sole center for international vaccinations (specifically yellow fever) in French Polynesia, also serves as the primary reference point for monitoring infectious diseases including tuberculosis, leprosy, and HIV/SIDA. Established in 2010 as a successor to the CCSMIT, the center operates under the authority of the Ministry of Health.

A key factor contributing to the increase appears to be changing behaviors, particularly since the COVID-19 pandemic. Dr. Lam explained that the focus on COVID-19 diverted resources from preventative medicine, while social interactions continued, albeit increasingly online and discreetly. This shift has complicated contact tracing efforts, making it difficult to identify and reach those at risk.

The CMIT has been proactively prescribing PrEP (pre-exposure prophylaxis) to men who have sex with men (MSM), a population disproportionately affected by the virus. Of the 25 new cases reported in 2025, 23 were male. Dr. Lam has also expanded his practice to include hormone therapy for transgender individuals, filling a gap in care left by overwhelmed endocrinologists focused on the region’s high rates of diabetes.

Another significant development is the increasing prevalence of locally acquired infections. Previously, many new cases were linked to individuals arriving in French Polynesia, but the majority of recent diagnoses are among native-born residents.

Karel Luciani, president of the LGBTQI+ rights organization Cousins Cousines, highlighted the role of methamphetamine use, locally known as ‘ice,’ in driving the increase. “Ice disinhibits,” Luciani stated, describing how the drug leads to increased sexual activity and, in some cases, sex work to fund addiction. He suggested a direct correlation between the rise in ice use and the doubling of HIV cases between 2023 and 2024.

Concerns are also growing about potential parallels with the situation in Fiji, where HIV cases have increased tenfold between 2014 and 2024, attributed to ice use and a dangerous practice known as ‘bluetoothing’ – the sharing of contaminated syringes. While this practice has not been confirmed in French Polynesia, health officials are wary of its potential introduction.

Despite reporting that approximately 80% of people living with HIV in French Polynesia are aware of their status, Dr. Lam acknowledged that this figure is not based on rigorous statistical modeling. Still, data indicates that 97% of those diagnosed are on antiretroviral therapy, and 88% of those on treatment have achieved an undetectable viral load. Challenges remain in ensuring consistent adherence to treatment, particularly for patients living on remote islands with limited access to healthcare.

A major obstacle is the lack of financial support for crucial preventative measures. Currently, PrEP, post-exposure prophylaxis (PEP), and hormone therapy are not covered by the Polynesian social security system, leaving patients to bear the full cost. The local government has announced plans to cover these treatments, but implementation has yet to begin.

However, the Directorate of Health of French Polynesia recently designated the fight against sexually transmitted infections as a priority for 2026, a new development for the territory. Associations Cousins Cousines and Agir contre le Sida have submitted funding requests to the Directorate of Health, hoping to expand their outreach and support services throughout the year.