HIV Action Plan for England: £170m to reduce new diagnoses and re-engage people in care

1 December 2025. Related: Special reports, Treatment access, HIV prevention and transmission, Activism & advocacy.

Simon Collins, HIV i-Base

On 1 December 2025, the Department of Health and Social Care published a new HIV Action Plan for England supported by £170 million funding to cover the next three years. [1]

Achieving increased funding – significantly more that the previous plan five years ago – is the result of successful engagement with the HIV sector, but the focus is predominantly on prevention and many details about the 2030 targets remain unclear.

A separate government webpage on the plan includes an introduction that endorses the Supreme Court’s ruling on a new definition of ‘biological sex’. Although none of the following details suggest changes that will reduce the quality of HIV care for people who are transgender or non-binary, this community concern will need to be carefully followed. Essential data and monitoring for these populations will also continue. [2]

The programme is focussed on five areas – prevention, testing, rapid ART, reducing stigma and new partnerships.

New £170 million funding

Of the £170 million, roughly 90% is for HIV prevention with just over 10% allocated to re-engaging the 5% of people living with HIV who are disconnected from care.

None of this budget however is allocated to reducing HIV-related stigma, although this is a key goal.

The following new initiatives are included.

£4.8 million to develop and support more equitable access to HIV prevention resources, including PrEP. This includes information services and a new policy to provide free access to formula milk and sterilising equipment.
£108 million to deliver opt-out HIV testing in emergency services including A&E, including up to £9.8 million to support community programmes to reconnect people living with HIV who have disconnected from care.
£48 million to continue opt-out testing for hepatitis B and C in A&E services.
£5 million to support open-access HIV home testing via the NHS app.
£9 million for a new initiative to try to re-engage the approximately 5% of people living with HIV, who for various complex reasons, have become disconnected from care.
An unbudgeted plan to reduce HIV-related stigma. This includes training NHS staff and to ensure new programmes account for the needs of women living with HIV.
An unbudgeted goal to support new and continued collaborations across sexual and reproductive health services. Although not specified in detail, this also includes supporting organisations involved in global health.

HIV targets for 2030

The definitions for ending AIDS by 2030 include three UNAIDS targets, which seem very difficult, if not impossible to achieve.

Reducing new HIV infections by 90% from 2010 levels – and a continued 5% decline per year after 2030. Although it is not clear, this target appears to use new diagnoses as a marker for new infections.
Reducing HIV-related deaths by 90% from 2010 levels.
Ensuring that the HIV response through 2030 and beyond is sustainable.

Ensuring equity

To ensure that progress is equitable, the Action Plan will be monitored in five key populations that are disproportionately affected by HIV in the UK.

Ethnic minority gay, bisexual and other men who have sex with men (GBMSM), which includes GBMSM of Black African ethnicity, Black Caribbean ethnicity, Black other ethnicity, Asian ethnicity and other ethnicity or mixed ethnic background.
White GBMSM.
Black African heterosexual men.
Black African heterosexual women.
Ethnic minority heterosexual adults, which includes heterosexual adults of Black Caribbean ethnicity, Black other ethnicity, Asian ethnicity and other ethnicity or mixed ethnic background.

Other than gay and bisexual men, there are no references to the other four UNAIDS key populations:

Sex workers
People who inject drugs
Transgender people
Prisoners

comment

This new plan is reported in detail online, and the increased resources to launch important new programmes are clearly good news. Pilot programmes for opt-out testing have been highly effective, and were responsible for more than 8% of new diagnoses last year.

The majority of funding (~£150 million) is for HIV prevention, although the £18.8 million to re-engage people living with HIV who are currently disconnected from care is important and strongly welcomed. It is unclear why the goals to reduce stigma and to strengthen collaborations have not been included within the new funding.

The 2030 targets for reducing new diagnoses and HIV-related mortality should perhaps be re-thought though as they do not seem achievable given the very limited changes over the last 15 years. This would involve reducing new HIV diagnoses to less than 700 per year by 2030 and yet there has been little change over the past 15 years. There were 6660 new diagnoses in 2010 (an estimated 3640 acquired in the UK and 3020 acquired abroad) and 5568 new diagnoses in 2024 (an estimated 3043 acquired in the UK and 2525 acquired abroad).

For mortality, this would involve reducing annual deaths to less than 70; 680 people living with HIV died in 2010 and 643 people died in 2024. Even if only 10% of deaths are strictly defined as being HIV-related, it is difficult to see how reducing this annual number from 64 to 6 would be achievable, especially as we are an ageing population.

Defining achievable targets is important, as this is how the effectiveness of the overall five-year programme will be measured each year.

The previous HIV Action Plan published in 2021 only referred to £23.5 million in new funding. This plan included a goal to reduce HIV transmissions by 80% and HIV-related deaths by 50% between 2019 and 2025. Although neither of these targets were achieved, progress was made. [3]

References

Gov.uk. HIV Action Plan for England 2025 to 2030. (1 December 2025).
https://www.gov.uk/government/publications/hiv-action-plan-for-england-2025-to-2030/hiv-action-plan-for-england-2025-to-2030
Gov.uk. HIV Action Plan for England, 2025 to 2030: equality impact assessment. (1 December 2025).
https://www.gov.uk/government/publications/hiv-action-plan-for-england-2025-to-2030/hiv-action-plan-for-england-2025-to-2030-equality-impact-assessment
Gov.uk. Towards Zero: the HIV Action Plan for England – 2022 to 2025. (1 December 2021).
https://www.gov.uk/government/publications/towards-zero-the-hiv-action-plan-for-england-2022-to-2025