BASHH is the largest organisation in the world dedicated to improving the study and practice of diagnosing, treating and managing sexually transmitted infections, HIV and other sexual health problems. The annual BASHH conference was held from the 10th – 12th July at the Examination Halls in Oxford UK.On the afternoon of the 10th of July 200 medical practitioners, nurses, health advisers and scientists gathered for the Gilead Sciences sponsored symposium entitled Because Backbone Matters. Organised by Pharmacom Media, this symposium reviewed how the landscape of HIV treatment has changed almost beyond recognition over the past 30 years. As more and more people are living longer lives with HIV, the importance of quality of life is becoming more and more important. Recently the focus of research and development has focused upon improving the tolerability and long term safety of therapy. Most of these efforts have been focused on the third agent in conventional triple-therapy regimens. However the backbone remains a key foundation of treatment. Recently three new tenofovir alafenamide (TAF)-based regimens provide new backbone options for people living with HIV. The symposium brought together three experts in the management of HIV who talked about the current situation in HIV practice and their experience of using TAF-based regimens in the real world. A number of case studies were presented which illustrated their clinical insights and the potential benefits for the lives of patients. Professor Jane Anderson, a consultant physician, director of the centre for the study of sexual health and HIV at Homerton University Hospital, chaired the symposium. She has 30 years of experience in the treatment of HIV and has a special interest in the treatment and care of women with HIV, of migrant and minority ethnic communities and the psychosocial aspects of HIV care. Dr Laura Waters from University College London presented on the current landscape and treatment of HIV. Dr Andrew de Burgh-Thomas based at the Gloucestershire Royal Hospital spoke about his experience in the early use of TAF-based portfolio. The final presentation was by Dr Arthur Jackson from the Cork and Mercy University Hospital who described his real-world experience of using the TAF-based portfolio in Ireland. The meeting concluded with a question and answer session to cover topics raised by the meeting delegates. The objectives of the meeting were clearly met with the feedback following the meeting showing that 75% of those who attended gained enough information to identify patients who would be clinically appropriate for TAF-based regimens. Additionally 81% gained enough information to understand the value that TAF-based regimens may bring for the longer-term health and outcomes for their patients.