Time to read
This Black History Month, we are sharing a conversation between our Chief Executive, Robbie Currie, and Marc Thompson, a leading voice in the HIV response.
Marc has been at the forefront of HIV prevention and advocacy for over three decades. He currently manages London’s HIV prevention programme, commissioned across all 32 boroughs, and leads Lambeth’s response to HIV – in a borough with the highest prevalence in the country. Alongside this, he has long been a champion for Black gay men and other communities whose needs are too often overlooked.
Marc joins Robbie to reflect on the HIV response past and present, the structural inequalities that persist, and what this year’s Black History Month theme – Standing Firm in Power and Pride – means for their work.
Seeing the gaps
Marc: I first got involved in the early 1990s after my own diagnosis. Back then, as a Black gay man, it was obvious that mainstream HIV organisations weren’t speaking to us. The posters and campaigns didn’t look like me or talk to my community. What I always say is that it wasn’t what I did that led me to HIV, it was what wasn’t available to me. I didn’t know about prevention, or how to access services, because nothing was designed with people like me in mind.
“It wasn’t what I did that led me to HIV, it was what wasn’t available to me.” – Marc
Robbie: That really resonates. When I first volunteered in the sector in the late 80s, HIV services were mainly hospices, because people were dying. With treatment advances in the 90s, the focus shifted. But even as prevention developed, structural inequalities weren’t acknowledged. Intersectionality wasn’t even a term we used. I think it’s really important to recognise the structural racism that existed in the UK: that was the landscape that we operated in. Only more recently have we begun to talk openly about how systemic racism shaped – and continues to shape – access to care, prevention, and treatment. We can see this when we look at a whole number of different indicators, in the research we carry out.
Inequalities then and now
Marc: Yes, even now, inequities persist. Black communities still have lower uptake of PrEP and are disproportionately represented in late diagnoses. That tells me the system still isn’t designed with us in mind.
Robbie: I’d agree. Research from National AIDS Trust shows that people of colour often feel unheard in healthcare. Stigma and discrimination are still very tangible, and austerity, with cuts to health and social care, has only widened those gaps, not just for HIV, but for a whole range of health conditions. In many respects, inequalities have worsened, even as our understanding of them has deepened.
“In many respects, inequalities have worsened, even as our understanding of them has deepened.” – Robbie
Marc: At the same time, I’m proud of the sector. Thirty years ago, it would have been easy to dismiss communities like mine, and sometimes it felt like that’s exactly what was happening. But over the years, the HIV sector has worked hard to acknowledge inequality and take steps to address it. We’re not where we need to be, but we’ve evolved.
Complexity and structural barriers
Robbie: Something I’ve learned is how complex these issues really are. When we talk about Black communities, it’s often bundled into one category. But there’s enormous diversity – from country of origin to faith, to cultural norms, to gender roles. And all of that intersects with sexuality and class. Unless we drill into those differences, we risk oversimplifying.
And we can’t avoid naming structural racism as part of the picture. From healthcare systems that minimise Black women’s pain, to underinvestment in culturally competent services, these inequities are not accidental. They’re part of a wider history, and we have to accept responsibility for changing that.
Marc: Exactly. And changing it requires more than consultation. It’s about meaningful co-production. Communities need to be part of the entire process of shaping services, including research, commissioning, design and delivery and evaluation: not just asked for feedback at the end. But that takes resources and investment – not just money, but time, training, and real commitment. Too often, that’s missing.
“It’s about meaningful co-production – communities shaping services from the start, not as an afterthought.” – Marc
Standing firm in power
Marc: So this year’s Black History Month theme is: Standing Firm in Power and Pride. For me, it’s about how we use the influence we have, and how we pass it on. Too much of the leadership in our sector is still white and disconnected from the communities most affected by HIV. If we’re serious about being driven by lived experience, we need to share power and build succession.
Robbie: I think about that a lot. As a white gay man in leadership, I have to ask myself: what power am I prepared to give up? How do I create space for others? Pride, for me, is about visibility and solidarity. And that means not only standing firm ourselves but ensuring others have the chance to stand tall too.
Pride in community leadership
Marc: I’m proud of the resilience and leadership Black communities have shown, particularly Black women living with HIV. Many of them face sexism, racism, and the challenges of migration, yet they’ve put their bodies, time, and energy into driving change. They didn’t have to – they could simply have focused on their own lives – but they chose to stand up for others.
Robbie: Absolutely. Throughout HIV’s history, people living with HIV have been at the forefront of change – demanding treatment, prevention, and justice. That mantra of “nothing about us without us” is still vital. During Black History Month, we should recognise that power and be proud of what has been achieved, while also recommitting to what still needs to be done.
“Throughout HIV’s history, people living with HIV have been at the forefront of change.” – Robbie
Looking forward
Robbie: The work isn’t done. Inequities remain, and in some areas they’re growing. But as leaders, we have a responsibility to create space, support succession, and keep challenging inequality wherever we see it. Standing Firm in Power and Pride is not just a slogan – it’s a call to action for all of us in the sector.
Marc: And I’d add this: communities have always been the heart of the HIV response. From the very beginning, it’s been people living with HIV who’ve led the fight for change. That hasn’t stopped – and it won’t stop now. I believe in the strength of our communities, and I believe we can keep moving forward, together, standing firm in power and pride.
Read the One Voice Network and National AIDS Trust’s Unheard Voices report
