“What Is ‘Bluetoothing’? The Deadly Drug Trend Spreading HIV Worldwide”

Health officials are warning about a disturbing drug practice known as “bluetoothing” — or “hotspotting” — that’s fueling a wave of new HIV infections from Fiji to South Africa. The risky ritual involves injecting a drug such as heroin or meth, drawing drug-laced blood back into a syringe, and then injecting it into another person to share the high. The process is often repeated among several users, frequently with the same needle.

A Cheap High With Deadly Consequences

Experts say the trend has emerged in impoverished communities where people cannot afford their own supply. “You’re basically getting two doses for the price of one,” explained Emory University’s Brian Zanoni, who has studied drug use in South Africa. Yet there’s little evidence it actually works — and even less doubt about its dangers.

Rapid Rise in HIV Cases

Because the method transfers blood directly from one person to another, viruses like HIV, hepatitis B, and hepatitis C spread easily. In Fiji, where the practice has become widespread, new HIV infections have surged tenfold between 2014 and 2024. Health officials now report injectable drug use as the top source of transmission, responsible for nearly half of new cases — many among young adults and even teenagers.

Global Alarm and Limited Resources

Reports of “bluetoothing” date back to Tanzania in 2010, and cases have since surfaced across Africa, the Pacific Islands, and Pakistan. Medical experts warn the most alarming factor isn’t just how quickly infections are rising, but how unprepared health systems are to respond. “What we’re seeing at the moment is the beginning of the avalanche,” said José Sousa-Santos of New Zealand’s University of Canterbury.