Equity and inclusion aren’t aspirations bolted onto the side of HIV care. They are the work.
As part of the re-engagement strand of the Getting to Zero programme, Terrence Higgins Trust and voluntary sector partners have been working with HIV clinics across London, using a peer navigator to reconnect people who have disengaged from HIV care, or who were attending so inconsistently that they were at risk of doing so.
Working alongside Guy’s and St Thomas’, King’s College, Lewisham and Greenwich, St George’s, North Middlesex and Hillingdon hospitals, and in partnership with community organisations including 4M Network, Food Chain and the Africa Advocacy Foundation, the programme focuses on helping people return to and stay in care.
Of 97 people referred into the programme, 76 were inconsistently engaged and considered at high risk. So far, 29 have successfully re-established regular clinical care.
The demographics of that group should prompt reflection. 58% were women. The largest single ethnic group was Black African; Caribbean and White British communities were also represented. It’s an important story about who HIV is affecting in London today.
These are not the demographics that tend to dominate the public conversation about HIV. That gap, between the perceptions of HIV and the lived reality of who is navigating it in London today, matters enormously. It shapes who gets tested, who asks for help, and who feels that HIV services are for them.
This programme works precisely because it doesn’t assume. Outreach is peer-led, flexible and non-judgemental, meeting people where they are in their actual lives. Food deliveries. Peer support. Connections to mental health, benefits and immigration advice.
It demonstrates that re-engaging someone in clinical care means addressing everything that led to disengagement in the first place – and requires a service model that sees the whole person.
“I loved the grocery service and enjoyed all the food that was sent. My friend commented on how I was now eating healthier foods. I have been buying more fruit and vegetables.”
That’s a quote from someone reached through the programme’s food support. It’s a powerful reminder that the route back into care can start somewhere unexpected and that meeting practical needs is an act of inclusion in itself.
The number of people referred to services is modest. 18 people were connected to 4M Network for peer support and groupwork. 10 were referred to the Africa Advocacy Foundation for advice and mental health services. 25 were linked to Food Chain. The impact on those individuals is not.
There are many barriers to engagement. 21 people remained completely unreachable despite multiple, varied outreach attempts. A clear reminder that re-engagement is hard, and that the challenges people face are real and persistent. That honest acknowledgment sits alongside the progress, because both are part of the picture.
What this work highlights is that “Getting to Zero” is more complex than simply getting more people tested or onto treatment, important as that is. It’s about making sure that care and support, and the community around it, is genuinely open and accessible to the people who need it most and understands their lived experience and challenges. It means thinking outside the box and going to where people are.
More than ever, it means partnership across NHS services, voluntary organisations and community groups.
* Facts and stats are from April 2024 to December 2025
Learn more
Visit Our Work – Getting to Zero page.