Towards Equity Report
Our report on reimagining HIV prevention for London’s Black Heritage communities
Report Top Lines
While progress has been made in increasing HIV testing and awareness across London, significant disparities persist —particularly for Black African and Caribbean communities. These groups continue to experience higher rates of new HIV diagnoses, late diagnoses, and lower uptake of key prevention tools like PrEP.
These disparities are not simply the result of individual behaviours. They are shaped by deeper, systemic issues: structural inequalities, cultural stigma, and racism within healthcare systems.
This needs assessment highlights the urgent need to centre Black voices, leadership, and lived experiences in the design and delivery of HIV services.
Key findings show that:
- Structural racism and stigma hinder engagement with HIV prevention
- Black African and Caribbean individuals experience higher rates of late HIV diagnosis, which can lead to worse health outcomes
- Community-led, culturally tailored interventions are essential to improving outcomes
Ending new HIV transmissions by 2030 will require long-term investment, trust-building, and inclusive public health strategies that reflect the realities of Black communities.
Report Recommendations
To address disparities and improve HIV prevention uptake, the report outlines the following priority actions:
- Implement an anti-racism strategy with a clear action plan, assessment framework, and annual progress reporting
- Provide culturally appropriate and tailored HIV prevention training for community reps and healthcare professionals
- Pilot and evaluate innovative interventions to increase uptake of HIV prevention tools, including PrEP and HIV testing
- Embed anti-racism and accessibility into HIV service policies and commissioning
- Secure dedicated funding for creative, community-led projects that tackle stigma and improve communication
Our Response
Responding to the report’s finding, the LHPP is funding community-based outreach for Londoners with Black Heritage. From January to April 2026, this outreach was run by One Voice Network under the Skin Like Mine programme. You can read the interim campaign report, published in June 2026, via the link below.
We are delighted to report that the One Voice Network has subsequently been selected to run a one year outreach programme. Made up of seven experienced London organisations, the Skin Like Mine programme will promote regular HIV testing and prevention as part of routine self-care, using trusted community partners to reach populations that are underserved by traditional services. The partnership has extensive reach across London and a strong track record of delivering effective, culturally competent public health programmes, and we’re excited to support this innovative programme.
Key Stats
- 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
- 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
WHAT PEOPLE SAID
Outreach service providers noted the how social determinants of health and deprivation hinder peoples’ ability to access care. This highlights the importance of centering health promotion within a holistic package of support. Both service providers and members of the public noted the need for cultural competence in healthcare; for providers to understand, respect, and effectively respond to the cultural and linguistic needs of patients from diverse backgrounds.
Key Findings
Several cross-cutting themes emerged from the assessment:
- Stigma and low self-perceived risk remain major barriers. Many individuals do not see themselves as at risk, despite evidence to the contrary. This disconnect limits engagement with testing and prevention services.
- Cultural competence and anti-racism must be embedded across all levels of service design and delivery. This includes training for healthcare professionals, culturally tailored messaging, and dismantling systemic barriers that perpetuate health inequities.
- Community involvement and co-production are essential. Services and campaigns co-designed with Black heritage communities are more trusted, relevant, and effective. Yet nearly a third of London boroughs reported no co-production in their HIV prevention strategies.
- Access and proximity to services continue to shape engagement. While many Black Londoners live within 2–4km of a sexual health clinic, practical barriers like travel time, childcare, and work commitments limit access. Outreach and mobile services—especially in trusted community spaces—are vital to closing this gap.
- Digital inclusion and literacy must be considered in the design of online services. Digital platforms offer convenience and privacy and should be widely promoted, but the needs of those with limited digital access or confidence must not be neglected.
- Gendered experiences highlight the need for tailored interventions that address power dynamics, relationship norms, and gender-based stigma. These factors influence how individuals engage with HIV prevention and must be acknowledged in service design.
- Faith, community leadership, and peer-led models offer powerful avenues for engagement. However, they must be approached with sensitivity, appropriate training, and long-term investment—particularly when working with voluntary and community organisations (VCOs).
Spotlight on: Black Women
- Cultural stigma that can incorrectly link HIV to promiscuity
- Difficulty negotiating condom use with male partners
- Prevalence of intimate partner violence, which can increase HIV risk
- Greater likelihood of testing during antenatal care, but less engagement outside of it
- Empowerment, education, and safe spaces are essential to support Black women in making informed sexual health decisions
Spotlight on: Black Men
Men with Black heritage often experience:
- Societal pressure around masculinity that discourages engagement with sexual health services
- Low self-perceived risk of HIV, despite behaviours that can increase vulnerability
- Preference for discreet testing options, such as home kits or mobile units over clinics
The report noted that framing HIV prevention as a responsibility to family and community can help shift perceptions and increase uptake.
What's Next?
The London HIV Prevention Programme and Do It London are committed to enacting the recommendations from the report, and supporting inclusive, community-led HIV prevention strategies.
The Lead Commissioner (left) is currently developing a new HIV prevention programme targeting Londoners of Black heritage.
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, codesigned 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.
Bringing Prevention to Communities
Do It London joined forces with Wicked nail artist Shea Osei and partner notification app Zults to bring to “Tips & Tests” to life.
This initiative used the 20-30 minute window provided by someone getting their nails done to talk about HIV testing, prevention and stigma.
With a particular focus on holding conversations with Black women, Tips & Tests focussed on taking HIV prevention out of the clinic and into a place women already treat as part of their self-care ritual: a nail salon.
The initiative has been well-received by clients and the media, with coverage on ITV News, print media and across social media.
Acknowledgements
This report was written by Dr Torquil Pyper, Alex Wicking and Dr Cecilia Pyper of the Public Health Action Support Team (PHAST). Its review and editorial support was undertaken by Oluwakemi Agunbiade, Senior Policy and Research Officer at National AIDS Trust.
The London HIV Prevention Programme and PHAST would like to extend sincere thanks to all of the professionals who contributed their time and effort to support this report.
Thank you to Florence Eshalomi MP, Member of Parliament for Vauxhall and Camerwell Green and Co Chair of the All Party Parliamentary Group on HIV, AIDS & Sexual Health for supporting this work and providing the foreword for the report.
Finally, we wish to thank the London residents who took part and shared their experiences and perspectives. Your contributions are central to this work and are deeply valued.