Frequently Asked Questions

What is Fast-Track Cities?

On 10 January 2018 London signed the Paris Declaration on Fast-Track Cities Ending the AIDS Epidemic. Fast-Track Cities is a global initiative to end the HIV epidemic by 2030.

London aims to end new HIV infections, stop preventable HIV deaths and eliminate the discrimination and stigma associated with HIV.

By signing up to this initiative the Mayor of London has committed to work with London Councils, NHS England, the Office for Health Improvement and Disparities (OHID), and London’s HIV community to:

  • Build on the amazing work London has done to reach and exceed the United Nations’ adjusted AIDS targets of 95:95:95 – 95 per cent of people living with HIV knowing their status, 95 per cent of people living with HIV on treatment and 95 per cent of people on treatment with suppressed viral loads
  • End new transmission of HIV by 2030
  • End HIV-related stigma and discrimination by 2030
  • Stop preventable deaths from HIV-related causes
  • Work to improve the health, quality of life and well-being of people living with HIV across the capital
Why is this initiative important?

HIV remains an important ongoing public health and equalities concern.

  • There is an estimated 39,600 people living with HIV in London (41% of the England total), of whom 1,600 (4%) undiagnosed and 8,118 (21%) may have transmissible levels of HIV (UKHSA, 2021).
  • The diagnosed prevalence rate of HIV in London in 2017 was 5.7 per 1,000 residents aged 15-59 years. This was two and a half times the rate of the rest of England as a whole. All (33) Local Authorities in London had a diagnosed HIV prevalence rate in excess of 2 per 1,000 population aged 15-59 years in 2017 (PHE, 2017).
  • In 2021, 36% of new diagnoses were likely transmitted were in men and women through heterosexual contact, while 34% were in men who have sex with men (UKHSA, 2022).
How is London doing?

London has exceeded the United Nations’ targets of 90:90:90 and the more challenging ambitions of 95-95-95, with 2020 figures now confirmed at 96-98-97:

  • 96 per cent of people living with HIV infection diagnosed
  • 98 per cent of people diagnosed receiving treatment
  • 97 per cent of people receiving treatment being virally suppressed

Nevertheless, HIV remains an important problem in London, with the infection impacting on Londoners more than any other part of the UK.

If London is already doing well, why do we need to do more work?

For many Londoners HIV remains a stigmatising condition that negatively impacts on quality of life. According to a 2022 survey by the Terrence Higgins Trust, 74% of people living with HIV reported experiencing stigma or discrimination due to their HIV status. In addition, over half of people (62%) experienced stigma within a relationship and one in three from their own friends (33%) (

Not only is it important to make sure people living with HIV can live their lives without discrimination, but the fear of stigma can stop people getting tested. This leads to more late diagnoses, which negatively impacts the quality of life of those living with the condition.

Late diagnosed infection rates in London remain unacceptably high (45%) and with considerable geographical variability across the city (UKHSA, 2022). Currently, there are differences in the rate of late diagnoses across London and among different demographic groups, with disproportionately high rates among Black and ethnic minority (BAME) communities in poorer areas of the city.

The number of people living with HIV in London is growing, effective treatments mean that more people are now living longer with HIV. This, coupled with ongoing new infections, means that the number of people living with HIV in London has never been higher; and many people have complex health and care needs.

Improving the health, quality of life and well-being of people living with HIV requires significant additional work. Quality of life for people with HIV is below that of the general population, mental health problems are more frequent, and HIV associated stigma continues to blight the lives of many people with HIV.

Delivering effective models of care for HIV in the longer term is becoming increasingly important and is so far poorly understood. Therefore, we are working with our clinical colleagues, people living with HIV and the HIV sector to develop a vision for HIV care for the future. Find out more about this work in Evolving HIV care.

Signing up to the Fast-Track Cities initiative will bring together all those already working to tackle HIV across the capital. More joint working will help to ensure that communities affected by HIV can access the prevention, testing, treatment and support they need.

How will Londoners benefit from the Fast-Track Cities initiative?

The Fast-Track Cities initiative has brought together all the organisations and communities with roles to play around HIV to agree a joint action plan, the Roadmap to zero.

The roadmap recognises and complements all the work on HIV that is already happening in London and where it might be useful to link programmes and projects up to share good practice.

London will also join the global network of cities, all working to a common purpose. This will be a major opportunity to share expertise and learning to accelerate progress locally and globally. Having a shared vision and strategy for London may also help to galvanise additional funding to support additional HIV efforts.

Who is most at risk of HIV in London?

There is an estimated 39,600 people living with HIV in London (41% of the England total), of whom 1,600 (4%) undiagnosed and 8,118 (21%) may have transmissible levels of HIV (UKHSA, 2021).

People identifying as men over 35 make up the majority (61%) of people accessing HIV care in London in 2021. In total, across age groups are more than double the number of men (71%) receiving HIV treatment than people who identify as women (29%).  41% of people receiving treatment are white, while 31% are of Black African heritage (UKHSA, 2021).

In newly identified HIV cases in 2021, for the first time since UKHSA recorded, the most common probable means of exposure was through heterosexual contact for both men and women, making up 36% of new cases. Sex between men was the second most common exposure category (34%) (UKHSA, 2021).

Injecting drug use accounted for only a small proportion (<1%) of new diagnoses in London (UKHSA, 2021).

The number of people newly diagnosed with HIV was highest in the 35-44 year age groups in men and the 25-34 year age groups in women in 2021 (UKHSA, 2021).

Worryingly, there is still a large proportion – 39 per cent – of Londoners being diagnosed late with HIV, a 10% increase since 2019. People who are diagnosed late have a tenfold risk of mortality within one year of diagnosis, compared to those diagnosed promptly. In London, heterosexuals were more likely to be diagnosed late.

How is the Fast-Track Cities initiative supported and funded?

Transformation Partners in Health and Care acts as the host and provides the support to deliver the Fast-Track Cities initiative. The International Association of Providers of AIDS Care (IAPAC) provides technical and logistical support to all cities that join the initiative and works closely with London to provide development support.

NHS England (London) has provided funding to deliver on the priorities in the strategic roadmap. This funding is in addition to, and not to replace or duplicate, statutory funding that supports existing HIV services and programmes.

London Councils have also extended funding for the London HIV Prevention Programme. This was to secure the continuation of the ‘Do It London’ campaign, free condom distribution, an outreach and rapid testing service for men who have sex with men, and online sexual health outreach and advice.