Ending new HIV transmissions in England by 2030 is within reach thanks to an action plan that will include routine testing at A&Es, the government has said.
The HIV action plan, to be unveiled on World Aids Day on Monday, aims to re-engage the thousands of people who have left HIV care, bringing them back to lifesaving treatment. The £170m package also includes funding for opt-out HIV testing at A&Es during routine blood tests in areas with the highest rates, including London and Manchester.
The prime minister, Keir Starmer, said: “I promised to end HIV transmissions in England and Wales by 2030 and we are making this a reality thanks to our action plan, with a groundbreaking new HIV prevention programme, at-home tests made available through the NHS app and delivering opt-out testing in emergency departments.”
A steady decrease in HIV diagnoses was recorded in England from 2005, but progress faltered during the pandemic, with testing disrupted and an increase in the number of new cases. As a result of new treatments, HIV is now a manageable condition.
There are also as many as one in 10 people living with diagnosed HIV who are not under medical care, according to a National AIDS Trust report published in September. The latest action plan aims to renew efforts to re-engage people with treatment and boost testing to ensure that transmissions continue to be pushed down.
“Today, people living with HIV can enjoy full, healthy lives and can’t pass the virus on to others. That’s remarkable progress,” said Wes Streeting, the health secretary. “But we can go further. Ending new HIV transmissions by 2030 is ambitious and this government is determined to make it happen.”
The Department for Health and Social Care said it would target its support towards the approximately 5,000 people living with HIV who had fallen out of medical care, for reasons including mental health issues, addiction, poverty and fear of judgment. Hospital staff in trusts where the opt-out scheme is in place will receive anti-stigma training, so patients can access care without fear of being judged for their HIV status.
A £5m trial has also been announced that will allow people to order home HIV tests through the NHS app. The new digital service is aiming to offer a discreet route for those anxious about their sexual health to get a test without visiting a clinic.
The plan will also fund formula milk for all babies born to mothers living with HIV, who need it as part of HIV prevention measures.
Prof Susan Hopkins, the chief executive of the UK Health Security Agency, said the latest figures showed progress towards the 2030 target, with about 95% of those living with HIV now knowing they have the virus. “But about 4,700 people remain undiagnosed, including one in three in Black African communities and higher rates of late diagnosis in older age groups,” she said. “People need testing that meets them where they are, in ways that feel safe and accessible.”
Hopkins said the government needed to also improve access to pre-exposure prophylaxis (PrEP), a medication that can reduce the risk of acquiring HIV from sex by about 99%. PrEP is free on the NHS through sexual health clinics, but research has shown that in practice it can be difficult to access.
“We need to make starting PrEP straightforward for anyone who wants it, with particular focus on heterosexual and Black communities who are being failed by current disparities,” Hopkins added.
Richard Angell, the chief executive of the Terrence Higgins Trust, said the funding for opt-out HIV testing would be transformational. “The government has an ambition that is both momentous and historic: that England becomes the first country in the world to end new HIV cases,” he said. “This new plan recognises the scale of the challenge, with the biggest new investment in HIV testing and care in decades.”
