The latest data published by the UK Health Security Agency (UKHSA) that new HIV diagnoses in England fell by nearly a third between 2019 and 2021 (from 2,986 to 2,023).
Transmission of the virus among gay, bisexual and men who have sex with men (GBMSM) continued to fall and the estimated number of GBMSM living with HIV who are unaware of their infection decreased between 2019 and 2021.
However, progress towards ending HIV transmission has slowed during the coronavirus (COVID-19) pandemic, and diagnoses among heterosexual people rose slightly in 2021, despite lower levels of HIV testing. This means HIV transmission and undiagnosed HIV infection in this group has not fallen.
In 2021, there were an estimated 4,400 people unaware of their HIV infection, equivalent to 5% of all people estimated to be living with HIV in England (95,900). This figure has fallen from 2019 (5,600). An estimated 1,500 GBMSM were living with an undiagnosed HIV infection compared with 1,100 heterosexual men and 1,500 heterosexual women.
Increased testing is vital for reducing the number of people unaware of their HIV infection. The COVID-19 pandemic has had an impact on HIV testing behaviours, with reductions in testing seen for other infectious diseases throughout the pandemic.
Across all sexual health services (SHSs), 1,053,169 people received an HIV test, a 20% reduction from testing reported in 2019 (1,319,915). While testing showed a partial recovery toward pre-pandemic levels in 2021, this has mainly been driven by an increase in testing by GBMSM compared to 2019. Testing in heterosexual men and women remains lower than 2019 and similar to 2020.
UKHSA’s HIV Action Plan monitoring and evaluation framework report continues to highlight the importance of equitable access to and uptake of frequent HIV testing, to HIV pre-exposure prophylaxis (PrEP), and also to post-exposure prophylaxis (PEP) to maintain individuals’ HIV negative status and end HIV transmission by 2030.
