The Government has said new HIV transmissions could be eradicated in England by 2030 thanks to increased testing.
The Department of Health and Social Care (DHSC) said new transmissions of the virus fell by almost a third between 2019 and 2021.
Statistics published by the UK Health Security Agency (UKHSA) in December 2022 estimated that 4,400 people were living with undiagnosed HIV in England in 2021, down from 5,600 in 2019.
The number of people using sexual health services due to their partner receiving a positive diagnosis fell from 1,558 to 820.
The news is part of an update on the HIV Action Plan for England, which was launched four years ago.
A report released on Wednesday by NHS England said testing for HIV and hepatitis in a number of A&E departments had helped to identify almost 2,000 new cases of the diseases and to provide better care for 470 people who had a confirmed case that was untreated.
As part of the opt-out testing programme, people who need to have their blood taken in A&E can offer an additional sample to be screened for HIV and hepatitis B and C.
NHS England has invested £20 million in expanding the scheme into areas where cases are more prevalent, including London, Manchester, Brighton, Salford and Blackpool.
Its £3.5 million National HIV Prevention Programme is also helping to raise awareness of HIV and other sexually transmitted infections.
Professor Kevin Fenton, the Government’s chief adviser on HIV and chairman of the HIV Action Plan Implementation Steering Group, said: “It’s positive to see new HIV diagnoses continue to fall, but our work is not done – late HIV diagnoses remain high in England which sadly increases the risk of death.
“Improving quality of life for people living with HIV and addressing stigma is a key objective in our HIV Action Plan and we will continue working with UKHSA and key delivery partners to understand, measure and address stigma in all its forms.”
Health minister Neil O’Brien said the news was “hugely encouraging”, adding: “Since the HIV Action Plan was launched in 2019, we have been working hard to reduce new infections by tackling stigma and urging more people to get tested, as well as helping people to access potentially life-saving treatment.
“Regardless of sexual orientation, people should get tested regularly for HIV, so we can drive down infections further.”
Deborah Gold, chief executive of National Aids Trust, said the organisation is “delighted with the encouraging findings” which must be built on.
She added: “The report has highlighted the need to fully utilise the tools we have to end HIV in England. We know that opt-out testing works and the time to expand the programme to more hospital emergency departments across the country is now.”
The Association of Directors of Public Health (ADPH) said there is more to be done, and the goal of eradicating transmission could be “at risk”.
The comments came after data from the UKHSA showed cases of gonorrhoea had reached record levels while infectious syphilis diagnoses were at their highest since 1948.
The ADPH said there is an “increased likelihood” that people with other STIs could contract HIV, which could have a “worrying impact” on progress in reducing HIV transmission.
Professor Jim McManus, ADPH president and director of public health for Hertfordshire, added: “There is enormous pressure on sexual health teams, and this increase in demand – on both their time and resources – has sadly not been met with increased funding.
“Directors of public health and their teams are committed to meeting the 2030 target. However, we need to improve access to (HIV drug) PrEP, testing and treatment in order to reduce HIV transmission rates even further and improve the quality of life of people living with HIV.”
Richard Angell, chief executive of sexual health charity Terrence Higgins Trust, said ending new HIV cases in England by 2030 was “possible, but not yet probable” and that opportunities were being missed “at every stage”.
He added: “We know what works. The new data today show that nearly 2,000 people have been newly diagnosed with HIV, hepatitis B and hepatitis C in hospital A&E departments in London, Manchester, Brighton and Blackpool as a result of the £20 million investment from the HIV Action Plan.
“This highly successful Government programme pays for itself many times over in savings to the NHS in care costs. That’s extraordinary, but people living with undiagnosed HIV are more than twice as likely to live outside of London. We have to expand this remarkable programme to the 42 A&Es in areas with a high HIV prevalence across the country – as the national guidelines say.”
Mr Angell also said that more people should be given faster access to the drug PrEP, which reduces the chances of contracting HIV sexually or intravenously, and called for more investment in HIV clinics to treat those diagnosed with the disease but not receiving treatment.
He said: “We have seen remarkable progress on HIV in the last 40 years. Now ending new cases within this decade is within reach, but when you come close to the finish line you have to speed up and not slow down. Today’s report is a clear reminder of that.”