New HIV action plan to end infections by 2030

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It’s Time to End the HIV Epidemic

The government has published a new HIV action plan, backed by over £23 million of funding, to reduce new infections by 80% by 2025.

     The government has bolstered its commitment to achieve zero new HIV infections, AIDS and HIV related deaths in England by 2030 via a new action plan backed by £23 million of funding.

    Current HIV prevention methods are working – with a 35% reduction in new HIV diagnoses in England between 2014 and 2019. This represents one of the biggest decreases worldwide.

      The action plan, which has launched to mark World Aids Day, will:

• prevent new infections by expanding and improving well-proven HIV prevention activities, investing £3.5 million in a National HIV Prevention Programme over 2021 to 2024 and increasing access to PrEP for key groups continues

• scale up HIV testing in high-risk populations where uptake is low to ensure new infections are identified rapidly. This will include expanding opt-out testing in A&E departments backed by an additional £20 million over the next 3 years

• ensure people rapidly receive treatment to stop them transmitting the infection further and increase their chances of living a long, healthy life as well as supporting everyone living with HIV to stay in treatment.

Health and Social Care Secretary, Sajid Javid, said: We will end new HIV infections in England by the end of the decade.

     We’ve made excellent progress already with transmissions continuing to fall across England and we are well on our way towards our ambition of zero HIV transmissions and deaths by 2030.

     The UK is leading the way to stamp out HIV and the new actions we are taking – from scaling up testing to increasing access to PrEP – will help people affected to live longer, healthier lives and eliminate this cruel disease for future generations.

     Health Minister, Maggie Throup, said: Our unwavering commitment to prevention and public health campaigns have helped significantly reduce new HIV infections by tackling stigma and urging more people to get tested, as well as accessing life-saving treatment.

     We’re taking action to make sure we’re firmly on track to meet our target in the next 9 years – doubling down on existing efforts, and adopting new strategies to reach particularly at-risk groups.

    I want to thank Dame Inga Beale, members of the HIV Oversight Group and the Independent HIV Commission for their tireless work in supporting us to develop this plan.

To achieve this, the government will commit to annually updating Parliament on the progress towards the 2030 target to end all new HIV transmissions and a new, national oversight group – the HIV action plan Implementation Steering Group – will be established to closely monitor progress and ensure current actions are on track to meet the 2025 and 2030 targets.

The plan was developed with the help and expertise of the HIV Oversight Group, chaired by Dame Inga Beale.

Professor Stephen Powis, NHS National Medical Director, said: HIV testing, which has been highly successful in England, provides a vital way to reduce transmission and ensure access to life-saving treatment. That’s why the NHS is scaling up testing and investing £20 million over the next 3 years to fund opt-out HIV testing in 16 A&E departments covering areas with the highest prevalence of HIV.

Following our pioneering trial that led the way for new HIV prevention drugs for tens of thousands of people at high risk of HIV infection, we will also be widening access to lifesaving pre-exposure prophylaxis (PrEP) drugs to ensure it’s equally available to all those who need it.

To progress towards the 2030 goal of having no new HIV infections, AIDS and HIV-related deaths in England, this new HIV action plan outlines more detail on the interim target which will be met by 2025:

• to reduce the number of people first diagnosed in England from 2860 in 2019, to under 600 in 2025

• to reduce the number of people diagnosed with AIDS within 3 months of HIV diagnosis from 219 to under 110

• to reduce deaths from HIV/AIDS in England from 230 in 2019 to under 115

Excellent progress has been made to increase diagnoses in key groups – in particular with gay and bisexual men – which has meant new HIV diagnoses in this group fell from a peak of 2,980 in 2014 to 1,890 in 2018, and fell even lower to 1,580 diagnosed in 2019. 

     This is a 47% and 16% drop respectively.

The action plan will set out how to maintain this progress, as well as improve diagnosis for high-risk groups, particularly Black Africans who remain the ethnic group with the highest rate of HIV. This includes nearly £3.5 million of ring-fenced funding to deliver a National HIV Prevention Programme from 2021 to 2024. One of the main objectives of this programme will be to get 20,000 higher risk people to test for HIV in that time.

Additionally, new funding of £20 million will be invested over the next 3 years to roll out opt-out testing in NHS emergency departments within all local authority areas with 5 or more cases of HIV per 1,000 residents. This will make it easier to reach Black African groups as well as heterosexual, gay and bisexual men who might not attend sexual health services regularly and are missing opportunities to test for HIV.

Dr Valerie Delpech, Head of HIV Surveillance at the UK Health Security Agency, said: We have already made great progress in bringing down HIV transmission in England, but there is still a way to go. 

The steepest declines have been in white, gay and bisexual men who live in London. We are committed to preventing HIV in everyone regardless of ethnicity, sexual orientation and location. To end HIV transmission, we need to diagnose people early, start treatment quickly and make sure people stay on that treatment to ensure their virus is not detectable. People with undetectable virus cannot pass it on to sexual partners, even without condoms or PrEP.

    The action plan sets out a clear path to achieve this and we will continue to learn from and share best practice with our partners. Together we will reach our goal of ending HIV transmission by 2030.

Meanwhile, New data shows drop in HIV diagnoses due to fewer tests and less opportunity for transmission.

    The total number of new HIV diagnoses in England decreased by 33% in 2020 according to new data published by the UK Health Security Agency (UKHSA).

     The report shows there were 2,630 new diagnoses in 2020 compared to 3,950 in 2019. The coronavirus (COVID-19) pandemic changed patterns of sexual behaviour, affected HIV testing and limited access to sexual health and HIV services, all of which will have impacted on the number of HIV diagnoses.

      The decline in new HIV diagnoses in England was sharpest in gay and bisexual men, which fell by 41% between 2019 and 2020. The drop in testing was not as pronounced in gay and bisexual men, suggesting that the year-on-year reductions in transmission we have seen in this group have continued.

There is also evidence gay and bisexual men had fewer partners in 2020 and accessing pre-exposure prophylaxis (PrEP) continued. However, the decline in new HIV diagnoses were not seen across all gay and bisexual men, and was steepest in white men, men living in London and younger men.

The 23% reduction in new HIV diagnoses in heterosexuals is likely due to declines in testing; the number of heterosexuals having an HIV test fell by 33% between 2019 and 2020.