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. 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 people’s blood already being taken in emergency departments for bloodborne viruses (BBVs), including HIV and hepatitis B and C.
Last year, as part of the government’s 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. Today’s 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 UK’s 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.’
The evaluation of the expansion of opt-out testing will help reach the government’s 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
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.
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.
