On World AIDS Day, we take time to remember those we’ve lost, to celebrate how far we’ve come, and to renew our commitment to ending the HIV epidemic. Professor Jane Anderson – consultant physician, academic and Co-Chair of Fast-Track Cities London – reflects on the city’s progress over the past year. From peer support integration and expanded HIV testing to stigma reduction and innovative approaches to PrEP access, she highlights the achievements made possible by partnership and community leadership.
A City United by Purpose
World AIDS Day is a time for reflection, remembrance and recommitment. From the earliest and darkest days of the epidemic London and Londoners have mounted powerful, innovative and impactful responses through the commitment and expertise of people living with and affected by HIV, voluntary and community-based organisations, the NHS, academia, local and national government.
London’s Fast Track Cities Initiative brings people and organisations across our City together, harnessing the vast collective knowledge, expertise and power through collaboration and partnership working to achieve our shared ambition of “Getting to Zero”, ending HIV as a public health threat.
Reflecting on 2025
This year has seen real progress in addressing the multifaceted challenges of HIV. The Fast Track Cities Initiative has harnessed the collective knowledge and expertise across our city, emphasising the importance of advocacy, collaboration, cross-boundary leadership, communication and engagement.
1 Peer Support at the Heart of Care
A significant milestone this year has been the integration of peer support in 25 of London’s 26 NHS specialist HIV clinics. Nearly 1,000 people living with HIV have had in-clinic peer mentoring through organisations including Metro, Positive East, and Positively UK. This peer-led support enhances treatment engagement and addresses broader social determinants of health, including mental well-being, housing, and immigration.
Mental health support has been a cornerstone of our initiatives, with people benefiting from counselling and life coaching. Workshops such as “Learning to Live Well with HIV” have empowered participants, fostering meaningful gains in self-esteem, acceptance, and quality of life.
The re-engagement project led by Terrence Higgins Trust has successfully helped reconnect many people with vital HIV services, ensuring they receive the care and support they need to thrive.
2 Tackling Stigma
Reducing HIV-related stigma is a key goal of the Fast Track Cities Initiative. This year, the HIV Confident Charter Mark expanded, providing essential resources for organisations to create an HIV-aware culture. With participation from 13 NHS Trusts and various local authorities, the Charter Mark has developed a suite of tools, including e-learning modules and stigma-reporting mechanisms.
The HIV Ambassadors Programme has also made significant strides, reaching over 3,400 people across 20 London boroughs. The Ambassadors share powerful lived experiences, challenge misconceptions and personalise the conversation around HIV. Their work has resulted in a marked increase in confidence among healthcare professionals discussing HIV, in particular when it comes to HIV testing
3 Championing HIV Care in Primary Settings
Primary care is critical in the response to HIV. The Fast Track GP Champions network has been strengthened, with proactive management initiatives established in southwest London. Collaborations with local HIV charities have facilitated outreach testing, ensuring some of the most vulnerable populations receive appropriate care
The North East London HIV GP Champions pilot has led to a 31% increase in HIV testing, with notable rises in specific boroughs. This increase reflects enhanced access to testing, together with increasing community awareness of the importance of regular health checks.
4 Expanding Access to PrEP
A critical advance in HIV prevention is Pre-Exposure Prophylaxis (PrEP). This highly effective intervention has the potential to significantly reduce new HIV infections. Fast Track Cities London is delighted to partner with The Elton John AIDS Foundation, ViiV Healthcare, and Gilead Sciences to enhance PrEP knowledge and access through two pilot programmes.
Across North East London, the Expanding PrEP Access through Novel Delivery in Northeast London (ExPAND-NEL) pilot is exploring innovative digital approaches to increase awareness and uptake of PrEP. In a second pilot, Brighton, West Sussex, and Liverpool are working together to explore ways to integrate PrEP services into existing care pathways. We are looking forward to seeing early results during the next year.
Looking Ahead: Challenges and Opportunities
We are at a crucial juncture in the HIV response, and whilst celebrating progress, it is essential to recognise the challenges that remain. The gains we have made in prevention, diagnosis, treatment and care are not felt equally by everyone everywhere. The National HIV Action Plan and the NHS ten-year plan will significantly shape our future work, building on what we know works.
Scaling Up Testing
The BBV (blood-borne virus) opt-out testing model – which offers routine HIV testing in A&E settings – has been a success. Expanding it into more healthcare environments could make testing more accessible and routine, leading to earlier diagnoses and timely treatment – before serious HIV-related health challenges occur.
Early diagnosis and treatment also stop onward transmission – a negative test result offers an ideal opportunity for up-to-date prevention advice and intervention.
Maintaining Peer Support
With nearly all of London’s NHS HIV clinics now having peer mentors on site. The challenge lies in sustaining and expanding these models, particularly in underserved areas. Continued investment in training and support for peer mentors will be vital in ensuring that everyone has access to the care they need.
Broadening anti-stigma work
Expanding the HIV Confident Charter into adult social care settings will ensure an inclusive care environment in which people feel safe and supported in accessing services.
Strengthening person-centred whole-system approaches
The latest structural changes in health and care service commissioning and delivery, with an increased emphasis on place-based solutions, bring new opportunities to tailor interventions to communities and develop person-centred care systems.
For this to succeed, collaboration and partnership working, such as London’s Fast Track Cities Initiative, will be essential. The gains made through the HIV response should be seen as a blueprint for person-centred, whole-system, place-based approaches to health and care.
A Call to Action on World AIDS Day
World AIDS Day is both a time of remembrance and a powerful call to action. As we remember and honour those we have lost, let us recommit to a future in which new HIV infections are a rarity, no one dies from HIV, those living with HIV are free from discrimination and can access the care they need to live well. Together, we can build a London where everyone feels valued and supported, paving the way for a healthier future for all.
Professor Jane Anderson is Co-Chair of Fast-Track Cities London, Consultant Physician and Director of the Centre for the Study of Sexual Health and HIV, Homerton University Hospital.
Learn more about the members of the Fast-Track Cities London Leadership Group