London signs up to the HIV Fast-Track Cities initiative

On 10 January, I joined HIV clinicians, representatives from London Councils and other charitable HIV organisations to witness London’s Mayor, Sadiq Khan, signing his city up to the Fast-Track Cities initiative. The pledge commits London to a major push to reduce the rate of new HIV infections and eliminate stigma in London – aiming to bring an end to new HIV infections, AIDS deaths and HIV stigma in the capital by 2030.

Although London comes late to the Fast-Track Cities initiative, which already has more than 200 pledges, NAM aidsmap’s home city is already in the top leagues for HIV diagnoses and treatment. In 2016, for the first time, London met or exceeded all the UN's 90-90-90 targets, with 90% of people living with HIV in the capital diagnosed, 97% of these on treatment, and 97% of these achieving viral suppression (undetectable). London is only the third city to achieve this target so far – joining Amsterdam and Melbourne.

By hitting or exceeding the UN targets, almost 85% of people living with HIV in London now have an undetectable viral load, which means that they no longer pose a transmission risk to their sexual partners. This, alongside condom use and some people sourcing pre-exposure prophylaxis (PrEP) for themselves, resulted in last year’s steep reduction in HIV diagnoses.



Social attitudes that suggest that having a particular illness or being in a particular situation is something to be ashamed of. Stigma can be questioned and challenged.


In HIV, refers to the act of telling another person that you have HIV. Many people find this term stigmatising as it suggests information which is normally kept secret. The terms ‘telling’ or ‘sharing’ are more neutral.

virological suppression

Halting of the function or replication of a virus. In HIV, optimal viral suppression is measured as the reduction of viral load (HIV RNA) to undetectable levels and is the goal of antiretroviral therapy.

90-90-90 target

A target set by the Joint United Nations Programme on HIV/AIDS (UNAIDS) for 90% of people with HIV to be diagnosed, 90% of diagnosed people to be taking treatment, and 90% of people on treatment to have an undetectable viral load. 

The gains that we have made are not guaranteed. Cuts to sexual health services mean that many people struggle to get appointments, potentially leading to later diagnosis and access to treatment. The stigma that people with HIV face remains considerable, which serves to discourage testing and disclosure of HIV status, as well as having a profound impact on the confidence and emotional health of many people living with the virus.

The Fast-Track Cities programme seeks to galvanise HIV prevention and anti-stigma actions in cities across the world. Fast-Track Cities work together, sharing best practices in testing, treatment and prevention initiatives and in tackling stigma and discrimination.

The goals set out in the Fast-Track Cities initiative, zero new HIV infections, zero AIDS-related deaths and zero stigma, are ambitious. However, it is only by being ambitious that we will truly be able to support all of those who live with the virus and honour those that we have lost; it is only by being ambitious that we will end this epidemic. By signing up to Fast-Track, London commits to being ambitious about ending HIV.