London is now an HIV Fast-Track City Author: Matthew Hodson, Executive Director, NAM On 10th January, HIV clinicians, representatives from London Councils and charitable HIV organisations gathered to witness London’s Mayor, Sadiq Khan, signing London up to the Fact Track City 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 City initiative, which already has more than 200 pledges, our 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 PrEP for themselves, resulted in last year’s steep reduction in HIV diagnoses. The gains that we have made are not guaranteed to continue. Cuts to sexual health services mean that many 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 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 and 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 honour all those that we have loved and lost; it is only by being ambitious that we will end this epidemic. London is seizing the moment. This is the time for us to conquer HIV.