HIV diagnoses in England decreased by 35% in 2020

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 35% in 2020 according to new data published today 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 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.

In 2020, the UNAIDS 95-95-95 targets were met across the UK for the first time with 95% of all people diagnosed, 99% of those in care on treatment and 97% of those on treatment virally suppressed, meaning that 91% of all people living with HIV in care were virally suppressed in England and the UK.

However, the total number of people with diagnosed HIV infection who accessed HIV services in 2020 was lower than in 2019. An estimated 97,740 people were living with HIV in England in 2020 and of these, an estimated 4,660 were unaware of their infection.

Detecting HIV early allows effective treatment to start sooner and people diagnosed can expect to have a normal life expectancy. In addition, people living with HIV who are treated and maintain an undetectable level of virus cannot pass HIV even if having sex without condoms or PrEP, known as Undetectable = Untransmissible (U=U).

Tests are free and available through GP surgeries, local hospitals and sexual health clinics, as well as by using a self-testing kit.

The overall risk of dying with HIV infection now remains low. There were 620 deaths among people with HIV. Of the 99 COVID-19 deaths that occurred in people with HIV during the first wave, almost all occurred in people with co-morbidities associated with COVID-19. It is likely that the vaccine programme and social distancing measures reduced the risk of severe COVID-19 infection among people with HIV.

The annual report demonstrates the importance of testing as part of a combination prevention approach – as set out in HIV Action Plan (2022 to 2025) for England, also published today. Designed to meet a commitment to end HIV transmission and AIDS, to decrease the number of HIV-related deaths and to end HIV-related stigma by 2030, it sets out a combination approach focussed on prevent, test, treat and retain. A monitoring and evaluation framework will be published in 2022.