These are not just individual or community-level issues; they are the result of wider systemic racism and inequalities that have shaped health outcomes for generations. Tackling these injustices is not only a moral imperative but a public health necessity.

This assessment brings together epidemiological data, community surveys, and lived experiences to inform our future work and ensure our interventions are truly effective.

Below are some of our key findings:

• 51% of new HIV diagnoses in Black heritage individuals between 2018 to 2023
  were made at a late stage.
• 26% of survey respondents had not tested for HIV in over a year.
• 76% had never used PrEP, with low awareness of local services offering it.
• 66% preferred receiving HIV information from healthcare professionals.
• Only 37% of respondents were aware of U=U; the fact that if the level of HIV in
  someone’s blood is undetectable, it can’t be passed on.

The assessment revealed that many Black Londoners fear judgment or ostracisation when seeking sexual health services, with cultural and religious beliefs often reinforcing shame and secrecy.

Access to services is further limited by factors such as clinic hours, childcare responsibilities, work commitments, and digital exclusion.

When discussing HIV prevention messaging, people told us they want campaigns and messages that reflect diverse identities and avoids stereotypes.

While over half of survey respondents reported good knowledge of HIV prevention, awareness of newer methods like PrEP (the once-a-day pill that can prevent HIV) and Undetectable =Untransmittable (when a person living with HIV is on effective treatment can’t pass the virus on) remains low.

PrEP awareness and uptake are particularly low among Black African and Caribbean communities. Late diagnoses are still far too common, and regular testing rates are not where they need to be. A late HIV diagnosis is a particular concern because it means that a person is diagnosed after the virus has already started to damage their immune system. This can lead to more serious health complications and increases the risk of passing HIV on to others. The scale of impact in the Black African community in particular is notable; in 2023, National AIDS Trust reported a 40% increase in late diagnosis for Black African people.

The assessment also highlighted the distinct challenges faced by Black women and Black men.

Black women often encounter cultural and social barriers, including stigma, misogyny, and stereotypes that link HIV to promiscuity.

These factors can make it difficult for women to access sexual health services or negotiate condom use with partners. Experiences of intimate partner violence were identified as further increasing women’s vulnerability.

For Black men, traditional ideas of masculinity and perceptions of risk can discourage engagement with sexual health services. Many men do not perceive themselves as at risk for HIV, and societal expectations around masculinity can make it harder to seek testing or prevention support.

Addressing these gendered experiences is essential for creating effective, inclusive HIV prevention strategies.

Community members also spoke about the importance of trusted spaces and people. There was a strong call for HIV education in schools to dispel myths and normalise discussion from an early age, and for outreach and mobile services to reach those facing practical barriers to attending clinics. Peer-led initiatives were highly valued, but participants emphasised the importance of respecting confidentiality.

Tackling Racism and Inequality as a Public Health Issue

The findings of this assessment make it clear that racism and inequality are not abstract concepts—they are lived realities that directly shape health outcomes. Structural racism manifests in the form of unequal access to services, lack of culturally competent care, and persistent stigma. These factors combine to create barriers that prevent Black communities from accessing the HIV prevention and care they need and
deserve. Addressing these issues is central to the mission of the LHPP. By embedding anti-racism into our strategies, investing in culturally competent services, and ensuring that Black voices are at the heart of decision-making, we can begin to dismantle the systemic barriers that drive health inequalities.

Recommendations for Change

Based on the report recommendations, my team and I are currently developing a new HIV prevention programme targeting Londoners of Black heritage.

The London HIV Prevention Programme is committed to taking forward the recommendations that HIV prevention programmes must be co-produced with Black communities and Black voices and lived experience must be central.

The new programme, due to be launched in early 2026, will include culturally appropriate and tailored HIV prevention training for community representatives and healthcare professionals, co-designed culturally competent campaigns, targeted outreach across a range of settings, and building relationships with Black businesses, faith and community leaders to foster collaboration for community based events.

A shining example of innovative outreach is our recent ‘Tips & Test’ nail pop-up at Peckham Palms, where we empowered Black women to get tested for HIV in a lively, welcoming setting designed to break down barriers and spark vital conversations.

This free London nail bar is raising awareness about HIV | Dazed

The report recommends the implementation of an anti-racism action plan and assessment framework. The LHPP will work with the PHTRI programme to explore taking this action forward.

Moving Forward: A Call to Action

Ending new HIV transmissions by 2030 is possible—but only if we centre Black voices, address systemic racism, and invest in sustained, community-led change. As Lead Commissioner, I am committed to working alongside Black heritage communities, local authorities, and voluntary sector partners to build trust, reduce stigma, and reshape service delivery for lasting health equity.

Now is the time for action. We must listen to the voices of those most affected, challenge the structures that perpetuate inequality, and invest in solutions that are bold, inclusive, and rooted in community leadership. Every Londoner deserves the opportunity to live free from the fear of HIV and the burden of stigma. Together, we can create a future where health equity is not just an aspiration, but a reality. Let’s move
from assessment to action—together, let’s make history.

Marc Thompson, Lead Commissioner, London HIV Prevention Programme