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Introduction: The urban planning between France and Geneva leads us to target the local HIV epidemic dynamics in its cross-border dimension. We aim to assess its importance while taking into account cross-border movements. Purpose of research: This study aims to describe the HIV epidemic on a cross-border scale by comparing data with two other areas known for their HIV incidence, Lyon and Zurich, using epidemiological data available in France and Switzerland. Results: Available data demonstrate that the Geneva cross-border region HIV epidemics are similar in magnitude to those of the Lyon metropolitan area and Zurich canton. In addition, describing the target groups attending two NGO’s services allows us to understand the dynamics of cross–border mobility as well as target groups’ health needs. Conclusion: The study shows that policy makers and experts need to focus on the cross-border dimension of the HIV epidemic dynamics in order to provide adequate responses around Geneva. We advocate for a sustained cross-border dialogue: to re-think the fight against HIV in the region, to take into account real life experiences, to make public policies and programs evolve on a cross-border basis, and to base our policies on a common set of good practices.