The federal government has announced a six-year $48 million program to support Pacific neighbours in managing and containing increasing infection rates related to the virus.
It will boost technical assistance, disease surveillance and co-investment in national public health responses, as rising rates of HIV and co-infections like tuberculosis beleaguer Pacific health systems, societies and economies.
Infections in Fiji have increased tenfold over the past decade, including a huge spike in 2024, according to the World Health Organisation.
More than 3000 new transmissions are expected this year after the nation officially declared an outbreak in January.
Injecting drug use has been identified as a major factor, with potential spillover of infections to other Pacific nations.
In June, Papua New Guinea declared HIV a national crisis following rising infections among women of reproductive age and children.
At a time when humanitarian crises are burgeoning, traditional development partners are dramatically reducing aid levels, Foreign Minister Penny Wong told the World AIDS Day Breakfast.
The full impact of these cuts is only starting to be felt, but Senator Wong warned there will be consequences for the region.
"This is an investment not only in the health and stability of our neighbours, but it is an investment in the stability of our region, which is good for our country," she said on Thursday.
"So even as others step back, Australia will play our part, and we should always do that, and that includes on HIV."
The investment for Pacific nations has been commended as "life-saving" by Australia's peak body for HIV response, Health Equity Matters.
"Australia has a responsibility as close friends and neighbours to support the response, which will emphasise harm reduction and integrate tuberculosis assessments," chief executive Dash Heath-Paynter said.
The outbreak will overwhelm health systems across the Pacific without comprehensive harm reduction programs, Pacific Friends of Global Health chair Brendan Crabb said.
"Stigma and under-reporting mean the actual scale of this outbreak may be even worse than official figures suggest," said Professor Crabb, who leads research and public health group the Burnet Institute.
"This is a robust response to an outbreak that threatens not just Fiji but the entire Pacific region."
The announcement builds on the government's $3.9 million to help implement Fiji's HIV outbreak response, and a three-year $266 million commitment to the Global Fund to Fight AIDS, tuberculosis and malaria.
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