England is on track to have diagnosed 95% of people living with HIV by 2025, beating a goal set by Unaids, according to a new study.
Experts from the University of Cambridge and Public Health England (PHE) said the country is in a strong position to eliminate HIV transmission by 2030.
Unaids has set a global target for 95% of people living with HIV to know their HIV status by 2030.
In a study published in The Lancet Public Health journal, the PHE and Cambridge researchers said the number of people living with diagnosed HIV aged 15 to 74 in England increased from 83,500 in 2013 to 92,800 in 2019.
The proportion diagnosed steadily increased from 86% to 94% during the same time period, with the number of undiagnosed infections halving from 11,600 to 5,900.
In addition, 98% of those living with diagnosed HIV were on treatment, and 97% of these were virally suppressed where the amount of HIV in the blood drops to undetectable levels.
“Similar steep declines were estimated in all subgroups of gay, bisexual, and other men who have sex with men and in most subgroups of Black African heterosexuals,” the study said.
“The pace of reduction was less pronounced for heterosexuals in other ethnic groups and people who inject drugs, particularly outside London; however undiagnosed prevalence in these groups has remained very low.”
The researchers concluded: “The Unaids target of diagnosing 90% of people living with HIV by 2020 was reached by 2016 in England, with the country on track to achieve the new target of 95% diagnosed by 2025.
“Reductions in transmission and undiagnosed prevalence have corresponded to large scale-up of testing in key populations and early diagnosis and treatment.
“Additional and intensified prevention measures are required to eliminate transmission of HIV among the communities that have experienced slower declines than other subgroups, despite having very low prevalences of HIV.”
Professor Daniela De Angelis, from the Medical Research Council’s Biostatistics Unit at Cambridge and the study’s senior author, said: “Overall, we see a positive picture for the HIV epidemic in England, with a dramatic fall in the number of people living with undiagnosed HIV.
“We estimate we are already several years ahead of the Unaids 2020 goals and are on target to reach 95% diagnosed by 2025 and to eliminate HIV infections by 2030.”
Dr Valerie Delpech, head of the HIV Team at Public Health England said: “This research is good news and shows that combination prevention, and in particular HIV testing and early treatment, is working in England.
“The increasing use of pre-exposure prophylaxis among persons at higher risk of HIV has further amplified our response to end HIV transmission.
“Nevertheless, further reducing the number of people who remain undiagnosed with HIV infection will become very challenging in the coming years.
“This is particularly the case for heterosexuals who may not consider themselves at risk of HIV.
“The priority must be to ensure that all sexual health clinic attendees are offered and encouraged to accept a HIV test, regardless of ethnicity, rather than the 73% that currently do test.
“If we can increase the number of clinic attendees unaware of their HIV status who get tested and diagnosed, as well as improve partner notification, the prospect of eliminating HIV transmission becomes increasingly likely.”
The research was funded by the Medical Research Council and Public Health England.
Earlier this week, the Elton John Aids Foundation, National Aids Trust and Terrence Higgins Trust urged ministers to ensure funding is provided to end HIV transmission in England during next month’s Spending Review.
Without the Government allocating the necessary resources, the chance to end new cases of HIV by 2030 could slip from grasp, the charities said.
They said more funds need to be ploughed into HIV prevention, testing and support for people living with HIV.
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