Thousands of HIV cases diagnosed at A&E amid rollout of opt-out testing
The pioneering programme, which focuses on 88 hospitals across England, has been running since 2022
Last updated 3rd Jul 2026
A pioneering NHS programme in England focusing on opt-out testing in emergency departments has identified nearly 2,000 previously unknown cases of HIV.
Since April 2022, the programme has tested individuals needing blood work in 88 high HIV prevalence areas, also allowing opt-out testing for hepatitis B and C.
The latest NHS figures indicate the initiative is reaching individuals unlikely to be tested through traditional methods, with 93% of diagnoses involving those with no prior record of HIV testing, according to the UK Health Security Agency (UKHSA).
The Economic Impact of Testing
One in 20 people living with HIV in England don’t know they have it, and many others are only diagnosed after the virus has already caused serious damage to their health.
Research by the National Institute for Health and Care Research Health Protection Research Unit at the University of Bristol, published in The Lancet HIV, suggests that early diagnosis is both lifesaving and cost-effective.
The study estimates that for every 802 diagnoses, the programme prevents around 187 HIV-related deaths and 28 new transmissions over 20 years.
Testing Programme Saving Lives
One of the programme's key successes is highlighted through Ayo's story. In his 50s, Ayo was tested during an emergency admission at Manchester Royal Infirmary, revealing his HIV status.
Ayo said: "If I wasn’t in hospital, I wouldn’t have been tested for HIV.
"It wasn’t something I thought would affect me in my fifties, but in the blink of an eye, everything changed."
This comes as it has been confirmed the opt-out testing scheme will continue, with £156 million being invested between April 2026 and March 2029 to emergency departments in 'very high' and 'high' HIV prevalence areas.
Terrence Higgins Trust: 'This news is vital'
The Terrence Higgins Trust - the UK's leading HIV and sexual health charity - has reacted to the news, praising the latest data as 'working and changing lives'.
Katie Clark is their Head of Policy, and told Hits Radio Pride: "This news is vital, as we look in the UK to end new cases of HIV altogether.
"And this all comes as a huge amount has moved on in terms of testing and treatment, so now, if you are diagnosed in a timely way, you can live a normal life and can't pass on the virus to others.
"We're in this fantastic moment where people with HIV can live well, so what's been amazing about this data is that it has confirmed this new approach to testing is finding those people who are out there and living with the virus.
"HIV can be in your system for a long time without you realising, and for some people, they might be presenting doctors with one set of symptoms, but sometimes the dots to something broader aren't always connected.
"For other people, you can live with HIV without it identifying itself, but you can get really quite sick quite quickly - that's why, even if you don't necessarily have any symptoms, it's so useful to still know your status.
This all comes as the government’s HIV Action Plan aims to end new HIV transmissions in England by 2030.
Read more: World AIDS Day: goal to end HIV transmissions by 2030 'within reach'
Katie revealed that the extension of this A&E programme plays a huge role in tracking as many people as possible with the virus.
She explained: "The number of HIV diagnoses overall in the UK has started to plateau, following the introduction of PrEP on the Health Service a few years ago.
"What we're now seeing is a stabilising, and we're hoping the action taken off the back of the government's new strategy is going to mean we'll be able to find the people we need to find.
"There's about 6,000 people in the UK who don't know they're living with HIV, and we need to make sure everyone's accessing the healthcare they need to live long and healthy lives.
"There's certainly a lot more to do, and we're not yet on-track to reach the goal of zero transmissions by 2030, but it's still possible that we could.
"And because we could, we absolutely should."
THT anniversary of his death
The organisation was established back in the 1980s in response to the HIV and AIDS epidemic, and founded by Terry Higgins' close friend Tony Calvert, Martyn Butler, and Terry's partner Rupert Whitaker, along with other friends, following Terry's death at the age of 37 on 4th July 1982.
Terry was among the first known individuals in the UK to have died from AIDS.
What started as a grassroots initiative, with significant support shown during a meeting at Red Lion Square, quickly formalised into an organisation equipped to provide direct services for those impacted by HIV.
Noteworthy is the involvement of Princess Margaret, who became an early patron, marking her as the first member of the British royal family to publicly support a charity centred on AIDS and sexual health.
The organisation, named in memory of Terry Higgins, continues to humanise and address the challenges posed by HIV and AIDS, maintaining its status as a beacon of support for affected individuals.
And this weekend, on the anniversary of his death, the organisation is urging as many people as possible to come together and remember him.
Katie Clark said: "This weekend, we are remembering Terry.
"We are calling on our supporters to 'do it for Terry', however way they want, as we do every year, to come together, mark that moment, and mark how far we have come in this epidemic.
"It's a moment for us to reflect on the person who we do all this work in honour of."
You can find out more about the man on the Terrence Higgins Trust website.
'Knowing your HIV status is as important as checking your blood pressure'
Recent research continues to validate the campaign's potential, showcasing its worth both economically and in public health outcomes.
These findings strengthen support for the programme’s continuation, partnered with efforts for wider rollout across GP practices, while NHS leaders expand the initiative to further hospitals by 2027.
Professor Francesca Swords, NHS national medical director, said: “Knowing your HIV status is as important as checking your blood pressure; and this pioneering NHS programme is helping hundreds of people get a diagnosis – often before they have any symptoms at all – to access life-saving treatment.
“The NHS is committed to improving early detection of HIV and other blood borne viruses, and by helping more people get a diagnosis, this initiative is helping reduce the chance of people unknowingly passing it on to others.
“The rollout of this testing in A&Es is an excellent example of how the NHS is making every contact with patients count to support them to stay well and access treatment they may need, helping to save lives while making the best use of our resources.”
Dr Josephine Walker, lead author at the University of Bristol & NIHR Health Protection Research Unit in Evaluation and Behavioural Science, said: “At around £6 per HIV test, and even though a large number of tests are required to identify one undiagnosed person living with HIV, the programme is good value for money for the NHS. Importantly it has led to linkage to treatment to improve the health and lifespan of many people who were previously living with undiagnosed HIV.”
Dr Tamara Djuretic, Consultant Epidemiologist and Head of HIV Section at the UK Health Security Agency, said: “NHS opt-out testing in emergency departments is helping to reach people who don’t realise they’re living with HIV or other blood-borne viruses. Many of these people might not have been tested otherwise.
“This new research underscores the programme’s long-term value – earlier detection of HIV not only improves individual health outcomes and saves lives but also supports wider public health HIV prevention efforts.”
The three additional EDs taking part in the programme means it will be available in nearly all areas of England.
Which hospitals have received funding for opt-out HIV testing?
The list of hospitals to have received funding - in addition to those in London, Brighton, Greater Manchester and Blackpool, included:
- Berkshire and Northampshire: Royal Berkshire Hospital
- Black Country and Shropshire: New Cross Hospital (Wolverhampton)
- Bucks Beds and Herts: Luton and Dunstable Hospital; Milton Keynes University Hospital; Wexham Park Hospital; Bedford Hospital
- Cambridgeshire: Hinchingbrooke Hospital
- City Hospital
- Coventry and Warwickshire: University Hospital Coventry
- East Mids: Leicester Royal Infirmary; Queen’s Medical Centre; Royal Derby Hospital; Burton Hospital
- Essex: Southend University Hospital and Mid Essex Hospital; Basildon University Hospital
- Kent: Medway Maritime Hospital
- Northamptonshire: Northampton General Hospital; Kettering General Hospital
- North East: Royal Victoria Infirmary
- North West: Royal Liverpool University Hospital; University Hospital Aintree; Royal Oldham Hospital; Fairfield General Hospital; Tameside General Hospital; Royal Bolton Hospital
- PSR: Peterborough City Hospital
- South Coast and Dorset: Southampton General Hospital; Royal Bournemouth Hospital; Poole Hospital; Queen Alexandra Hospital; Conquest Hospital
- South Yorkshire: Northern General Hospital
- Surrey and East Hampshire: Frimley Park Hospital
- Sussex: Eastbourne District General Hospital
- West of England: Bristol Royal Infirmary; Weston General Hospital; Southmead Hospital
- West Mids: Sandwell General Hospital; Queen Elizabeth Hospital; Good Hope Hospital; Heartlands Hospital; Walsall Manor Hospital; Royal Stoke University Hospital; County Hospital
- West Yorks: Leeds General Infirmary; St James’s University Hospital
You can find out more about the above on the Terrence Higgins Trust website.
You can check out more information about HIV and AIDS on the NHS website.