England Meets HIV Targets, But Inequalities Persist - EMJ

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England Meets HIV Targets, But Inequalities Persist

England has once again achieved the UNAIDS 95-95-95 HIV targets, but a new report from the UK Health Security Agency warns that major inequalities in testing, prevention, and diagnosis continue to affect some communities.

Progress Continues Nationwide

According to the latest HIV Action Plan monitoring report, 95% of people living with HIV in England have now been diagnosed, 95% of those diagnosed are receiving treatment, and 98% of people on treatment have undetectable viral loads.

Overall HIV diagnoses also continue to decline, supporting England’s ambition to dramatically reduce new cases and AIDS-related deaths by 2030.

Disparities in Testing and Prevention

Despite this progress, the report highlights persistent disparities in access to HIV prevention and care.

More than 1.3 million people were tested for HIV through sexual health services in 2024, but testing uptake remained lowest among Black African heterosexual and bisexual women, at 78%, compared with more than 95% among gay and bisexual men.

Significant inequalities were also seen in uptake of pre-exposure prophylaxis (PrEP), the medication used to prevent HIV infection. While PrEP use among gay and bisexual men with identified need is approaching 80%, uptake among Black African heterosexuals remains below 40%.

Late Diagnosis Remains a Major Concern

Around 42% of people diagnosed with HIV in 2024 were diagnosed late, increasing the risk of poorer health outcomes and onward transmission.

The burden was especially pronounced in Black African communities, with late diagnosis affecting 57% of Black African heterosexual men and 45% of Black African heterosexual women.

Experts say stigma, fear of discrimination, and unequal access to healthcare continue to play a major role.

Stigma Still Impacts Lives

Nearly half of people living with HIV reported experiencing stigma, with the highest levels reported among Black African heterosexual men and other ethnic minority heterosexual groups.

Dr Tamara Đjuretić described the overall decline in diagnoses as encouraging, but stressed that progress remains uneven.

She noted that stigma continues to prevent some people from accessing testing and prevention services, despite HIV tests and PrEP being available free of charge through the NHS.

Looking Ahead

The report reinforces that while England remains on track overall, eliminating HIV transmission by 2030 will require more targeted interventions for underserved communities.

Public health experts continue to emphasise that regular testing, condom use, and wider access to PrEP remain among the most effective tools for preventing HIV transmission, alongside early treatment for those diagnosed.

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