“Opt-out” HIV testing in A&E departments is to be ramped up in a bid to find undiagnosed cases of the virus, officials have said.
It is thought that more than 4,000 people in England are living with the virus but are not aware.
After a successful pilot project, health officials are increasing testing of blood samples in areas where there is higher prevalence of HIV in a bid to spot people with the condition.
Testing everyone having a blood test in Emergency Departments for HIV works. It helps diagnose people who wouldn’t have been reached via any other testing route and who have often been missed before.— Richard Angell, Terrence Higgins Trust
The pilot project saw 34 A&Es in hotspot areas test blood taken in routine A&E care for bloodborne viruses – including HIV and hepatitis B and C.
Since April 2022, some 4,000 people with one of these viruses has been identified through the scheme after more than 1.4 million samples were tested.
As well as spotting new cases, the project has also been found useful to spot people who have disengaged with HIV care.
Now the Department of Health and Social Care has announced more funding to expend the scheme, which is still operating as a research project, in 46 more emergency departments across England.
Officials hope the £20 million National Institute for Health and Care Research (NIHR) project will help the Government achieve its ambition to end new cases of HIV in England by 2030.
Health and Social Care Secretary Victoria Atkins said: “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 people’s health and wellbeing, saves lives and money. ”
Professor Kevin Fenton, the Government’s chief adviser on HIV, added: “The opt-out testing programme will boost our progress to identify the estimated 4500 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.
NHS England’s national medical director, Professor Sir Stephen Powis, said: “Without this NHS testing programme, these people may have gone undiagnosed for years, but they now have access to the latest and most effective lifesaving medication, helping to prevent long term health issues and reducing the chances of unknown transmission to others.”
Commenting, Richard Angell, chief executive of Terrence Higgins Trust, said: “Today’s announcement is the testing turbo boost that’s needed if we are to end new HIV cases by 2030.
“It’s hugely significant that an additional two 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 wouldn’t have been reached via any other testing route and who have often been missed before.
“It also saves the NHS millions, relieves pressure on the health service and helps to address inequalities with those diagnosed in A&E more likely to be of black ethnicity, women and older people.”
Anne Aslett, chief executive of the Elton John Aids Foundation, added: “Results from the last 18 months demonstrate how incredibly important this approach is to ensure no one is left behind.
“Today’s 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.”
Deborah Gold, chief executive of National Aids Trust, added: “This decision, which will more than double HIV testing capacity in England, means that more people will be diagnosed with HIV faster, and will be able to access lifesaving treatment which will also stop the virus being passed on.
“Routine HIV testing in emergency departments is especially good at finding people who would otherwise not receive a test, most often from marginalised communities who are being left behind in our progress on HIV.
“With HIV diagnoses rising among women, and stubbornly high levels of late diagnosis among women and people from Black African communities, this announcement could not be more timely in making sure we don’t miss vital opportunities to diagnose someone who needs access to HIV care.”
Sir Keir Starmer, leader of the Labour Party, said: “The tireless work of campaigners, survivors, scientists, medical staff and others has meant that, for the first time, we can say that the end of the HIV/Aids epidemic is on the horizon. We now have a world where HIV positive people can live freely and love freely, something so many people were once too scared even to dream.
“The incredible progress made so far, resulting in the expansion of the NHS opt-out blood-borne virus testing programme, should be widely celebrated.”
