Assessing the Readiness and Demand for the Fast-Track Cities Initiative in Türkiye: A Public Policy Perspective

Background: Türkiye is experiencing a rapidly increasing trend in new HIV diagnoses. Despite the global push towards the 95-95-95 targets, the national HIV response remains highly centralized under the Ministry of Health, with minimal involvement from local municipalities. This strict centralization inadvertently exacerbates stigma and restricts access to anonymous testing.

Methods: A cross-sectional online survey was conducted between September 2025 and February 2026. The study cohort consisted of 519 participants: 378 People Living with HIV (PLHIV) and 141 Healthcare Professionals (HCPs) across major and high-mobility Turkish cities (Istanbul, Ankara, Izmir, Bursa, Eskisehir).

Results: A significant "clash of paradigms" was identified. While 47% of HCPs cite the lack of municipal involvement and bureaucracy as the primary barrier, 58% of PLHIV identify stigma in healthcare settings as the greatest obstacle. A massive awareness gap exists regarding the Fast-Track Cities (FTC) initiative (86% among HCPs vs. 28% among PLHIV). Notably, 91% of PLHIV consider municipality-run anonymous testing centers to be more trustworthy and accessible than state hospitals. Furthermore, 79% of PLHIV expect decentralized municipal action to accelerate linkage to care.

Conclusion: There is a strong grassroots demand for localized HIV responses in Türkiye. Integrating Turkish cities into the FTC network, driven by civil society and municipal partnerships, represents a critical step in bypassing institutional stigma and controlling localized HIV epidemics.

Presented as an oral presentation at the Fast-Track Cities 2026 Conference, October 11-13, 2026, Berlin, Germany.