Department Of Health
- A new 20 million National Institute for Health and Care Research (NIHR) project will support the governments ambition to end new transmissions of HIV within England by 2030 and get people into the right care
- Undiagnosed HIV, hepatitis B and C will be picked up in new testing programme in 46 more emergency departments in 32 high HIV prevalence areas of England
- Expansion comes after success of schemes in extremely high prevalence areas of HIV, identifying almost 4,000 people with a bloodborne virus (BBV) since April 2022
A new research project to evaluate an expansion of the hugely successful HIV opt-out testing programme to new sites across England, has today been announced (29 November 2023). Given the success of the existing testing programme, this new initiative is expected to save, and improve the quality of, thousands of lives.
Backed by 20 million of NIHR funding, the research will evaluate the testing programme in 46 new sites across England. Expansion of the programme could identify a significant proportion of the estimated 4,500 people living with undiagnosed HIV - preventing new transmissions and saving more lives through testing peoples blood already being taken in emergency departments for bloodborne viruses (BBVs), including HIV and hepatitis B and C.
Last year, as part of the governments world leading HIV action plan for England, NHS England launched the BBVs opt-out testing programme, with funding available for 34 emergency departments in areas with the highest prevalence of HIV. Todays announcement will mean the programme will be expanded as part of a research evaluation in all 46 emergency departments covering 32 areas with high prevalence of HIV.
It will support the UKs progress in being a world leader in the fight against HIV - and in meeting its goal to end new transmissions of HIV within England by 2030.
Health and Social Care Secretary, Victoria Atkins, said:
Less than 3 decades ago, HIV could be a death sentence. It was often - and wrongly - considered a source of shame, and diagnoses were hidden from friends, family and society. But today, thanks to effective treatments, it is possible to live a long and healthy life with HIV.?
As well as promoting prevention for all, the more people we can diagnose, the more chance we have of ending new transmissions of the virus and the stigma wrongly attached to it.
This programme, which improves peoples health and wellbeing, saves lives and money.
The evaluation of the expansion of opt-out testing will help reach the governments bold ambitions of reducing new HIV transmissions by 80% in 2025 and ending new transmissions by 2030, according to an update on the?HIV action plan for England.
The existing programme in extremely high prevalence areas has been shown to be highly effective in identifying HIV in people unaware they had the virus and re-engaging those who are not in HIV care. The programme provides linkage to medication, a treatment and care pathway which enables people to live long and healthy lives, where the virus is undetectable.?
During the first 18 months of the BBVs opt-out testing programme, 33 emergency departments conducted 1,401,866 HIV tests, 960,328 hepatitis C virus (HCV) tests and 730,137 hepatitis B virus (HBV) tests significantly increasing the number of bloodborne virus tests conducted in England each year.
It has identified:
- 934 people living with HIV or people disengaged from HIV care
- 2,206 people living with HBV and 388 disengaged from HBV care
- 867?people living with HCV and 186 disengaged from HCV care
Professor Kevin Fenton, government chief adviser on HIV and chair of the HIV Action Plan Implementation Steering Group, said:
We know HIV is most commonly unknowingly spread by people who dont know their status.Knowledge is power in preventing HIV transmission and accessing life-saving care.
The core ambitions of our world-renowned HIV action plan are to intensify HIV prevention, expand HIV testing, strengthen linkage to and retention in high quality HIV care, and tackle HIV stigma and discrimination. We will not give up this fight until there are no new HIV transmissions in England.
The opt-out testing programme will boost our progress to identify the estimated 4,500 people who could be living with undiagnosed HIV and help us ensure we meet our 2030 ambition, with the possibility to save thousands of lives in the process.
Outside of BBVs opt-out testing, progress is also being made. There are fewer people living with undiagnosed HIV and, as a result of effective treatments, it is possible to live a long and healthy life with HIV. Most people with HIV diagnoses are receiving world class treatment, making it undetectable.
There is much to celebrate, ahead of World Aids Day (1 December), on the governments progress towards its action plan ambitions, with fewer than 4,500 people living with undiagnosed HIV - the lowest its ever been since recording begun - and extremely high levels of antiretroviral treatment, used to treat HIV, and viral suppression.
In 2022, England once again achieved the UN AIDS 95-95-95 target nationally: 95% of people living with HIV being diagnosed, 98% of those diagnosed being on treatment and 98% of those on treatment having an undetectable viral load - meaning the levels of HIV are so low that the virus cannot be passed on.
In a speech this evening at the All Party Parliamentary Group on HIV and AIDS event, Health and Social Care Secretary Victoria Atkins thanked the ongoing dedication from NHS staff, HIV charities, the UK Health Security Agency (UKHSA), local government and professional bodies and campaigners, which have worked tirelessly to support the government in achieving its goal to end new transmissions.
People with reactive or positive tests results are linked to care and offered information and support through community organisations.
The opt-out strategy for BBVs testing is important to address health inequalities by reaching groups, such as those from ethnic minorities or women, who are less likely to attend sexual health services and may be disproportionately affected both by higher rates of some BBVs and stigma associated with BBVs testing or diagnosis.
Opt-out testing additionally provides a valuable opportunity to re-engage with people who have previously been diagnosed with a BBV but who are not accessing treatment or care.
Anne Aslett, CEO of the Elton John AIDS Foundation, said:
The Elton John AIDS Foundation launched the first HIV Social Impact Bond in 2018 because too many vulnerable people were being left behind. Together with our partners, we identified opt-out testing in emergency departments as an effective and cost-saving way of ensuring people living with HIV get the treatment they needed.
We warmly welcomed the governments decision to expand this successful method of HIV diagnosis to 33 sites in April last year and results from the last 18 months demonstrate how incredibly important this approach is to ensure no one is left behind. Todays announcement to further expand opt-out testing to 46 additional emergency departments is another fantastic and very significant step towards meeting the goal of ending new HIV transmissions by 2030 and above all else will save lives.
Richard Angell, Chief Executive of Terrence Higgins Trust, said:
Todays announcement is the testing turbo boost thats needed if we are to end new HIV cases by 2030. Its hugely significant that an additional 2 million HIV tests will be carried out in A&Es over the next year thanks to a temporary but wholesale expansion of opt-out HIV testing to 46 additional hospitals. With this landmark investment, opt-out HIV testing in A&Es will account for more than half of all tests in England. This major ramping up of testing is absolutely crucial to find the 4,400 people still living with undiagnosed HIV.
The evidence is crystal clear: testing everyone having a blood test in emergency departments for HIV works. It helps diagnose people who wouldnt have been reached via any other testing route and who have often been missed before. It also saves the NHS millions, relieves