Imagine a trend so dangerous, so shockingly reckless, that it's fueling a resurgence of a disease we thought we were containing. This isn't science fiction; it's a grim reality called 'bluetoothing,' and it's spreading faster than many realize.
'Bluetoothing' is a disturbingly direct method of drug use: injecting oneself with the blood of another drug user in hopes of sharing their high. Think of it as a shortcut, a twisted way to experience the effects of a drug without directly obtaining and using it. But here's where it gets controversial... is it truly about the high, or are other factors at play, like a desperate search for connection or a blatant disregard for personal safety born from addiction?
This practice, also known as 'flashblooding,' has already had devastating consequences in places like Fiji, where HIV cases have skyrocketed eleven-fold in just a decade. Eleven-fold! That's not a gradual increase; that's an explosion. It's a stark reminder of how quickly a dangerous trend can spiral out of control. In South Africa, estimates suggest that around 18% of drug users engage in bluetoothing, contributing to alarming HIV rates within that community. And this is the part most people miss... it's not just about HIV. Sharing blood opens the door to a host of other bloodborne diseases, including Hepatitis B and C, making it a Russian roulette of infections.
Now, the concern is that 'bluetoothing' could make its way to the United States. While new HIV diagnoses in the US have decreased by about 12% over the past four years, the potential introduction of this practice could reverse that progress. Dr. Brian Zanoni, a drugs expert at Emory University, paints a bleak picture: 'In settings of severe poverty, it's a cheap method of getting high with a lot of consequences. You're basically getting two doses for the price of one.' He highlights the economic desperation that can drive individuals to such extreme measures.
Consider this: approximately 47.7 million Americans aged 12 or older admit to using illicit drugs within the past month. That's roughly 17% of the population. Simultaneously, over 1.13 million Americans are living with HIV. While the US has made strides in combating the drug epidemic, with overdose fatalities dropping nearly 24% in the 12 months leading up to April 2025 (approximately 76,516 fatalities compared to 101,363 the previous year), the threat of 'bluetoothing' looms large.
The big question is: has 'bluetoothing' already arrived in the US? It's difficult to say definitively, but some experts believe that the diminished high associated with the practice might deter some users. The effect could even be largely placebo. However, Catharine Cook, the executive director of Harm Reduction International, offers a chilling perspective: 'It's the perfect way of spreading HIV. It’s a wake-up call for health systems and governments, the speed with which you can end up with a massive spike of infection because of the efficiency of transmission.' This underscores the urgent need for preventative measures and increased awareness.
To put the situation in Fiji into perspective, in 2014, the country had fewer than 500 people living with HIV. By 2024, that number had surged to approximately 5,900. In that same year, the nation recorded 1,583 new cases, a 13-fold increase compared to its typical five-year average. Shockingly, about half of all newly infected patients admitted to sharing needles.
Kalesi Volatabu, executive director of Drug Free Fiji, shared a harrowing firsthand account with the BBC: 'I saw the needle with the blood, it was right there in front of me. This young woman, she'd already had the shot and she's taking out the blood, and then you've got other girls, other adults, already lining up to be hit with this thing. It's not just needles they're sharing, they're sharing the blood.' Her words paint a vivid picture of the desperation and disregard for safety that fuels this practice.
It's estimated that around 33.5% of drug users in the US share needles, which, needless to say, also carries a significant risk of HIV transmission. Experts emphasize that viruses like HIV and Hepatitis can cling to needles used by infected individuals and then be easily transferred to others.
While overall HIV rates in the US have generally decreased since 2017, disruptions in healthcare access due to the COVID-19 pandemic in 2020 likely led to missed diagnoses and a slight increase in new cases. According to the CDC, there were 39,201 new HIV diagnoses in the US and its territories in 2023, an increase from 37,721 in 2022. Of those 2023 cases, the newest CDC report shows 518 diagnoses were associated with intravenous drug use.
It's crucial to remember that HIV is no longer an automatic death sentence. Effective medications are available that can significantly slow the virus's replication, enabling infected individuals to live full and normal lives. But prevention is always better than cure.
The earliest recorded instances of 'bluetoothing' date back to around 2010 in Tanzania, where it quickly spread from urban centers to suburban areas. In Zanzibar, a popular tourist destination within Tanzania, HIV rates were found to be up to 30 times higher than those on the mainland, highlighting the devastating impact of this practice. 'Bluetoothing' has also been documented in Lesotho, a small nation bordering South Africa, and even in Pakistan, where individuals have been found selling used, blood-infused syringes.
Given the potential for 'bluetoothing' to undermine progress in combating HIV and other bloodborne diseases, what steps should be taken to prevent its spread? Should harm reduction strategies be prioritized, or should the focus be on stricter drug enforcement and rehabilitation programs? And perhaps the most uncomfortable question of all: does society bear some responsibility for creating the conditions that drive individuals to such desperate measures? Share your thoughts in the comments below.
