NHS A&E opt-out testing has identified about 1,900 previously undiagnosed HIV cases since 2022

NHS England said Thursday that its routine opt-out blood-borne virus testing in emergency departments has identified about 1,900 previously undiagnosed HIV cases since the program began in April 2022, underscoring the growing public-health impact of a scheme designed to catch infections in people who might not otherwise be tested.

Under the model, adults who already need a blood test in A&E are also tested for HIV, hepatitis B and hepatitis C unless they explicitly decline. NHS England said the program is now running in 88 areas of England with the highest rates of HIV, expanding from its initial launch in emergency departments in high-prevalence areas four years ago.

The latest figures matter not just because of the number of diagnoses, but because earlier public-health analysis suggests the program is reaching people often missed by other testing routes. A final evaluation by the UK Health Security Agency, the government body responsible for health protection, found that among people newly diagnosed with HIV through the program, 668 people — or 92.9% — had no record of a prior HIV test in the surveillance dataset.

“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,” said Professor Francesca Swords, NHS national medical director.

The NHS England total should not be confused with the smaller figure reported in the UKHSA evaluation. They cover different periods, different sets of hospitals and different data sources. NHS England’s 1,900 figure is an operational total from the broader rollout since April 2022. By contrast, the UKHSA’s final independent evaluation covered April 1, 2022, to Dec. 31, 2024, and focused on the initial wave of 34 emergency departments.

Within that surveillance-linked dataset, UKHSA recorded 2,781,164 HIV tests and 719 newly diagnosed HIV cases. It said the number needed to test to find one new HIV diagnosis was 1,916.

Separate economic modeling from the University of Bristol, accepted for publication in Lancet HIV on May 1, found the emergency-department testing program was cost-effective. The study estimated an average cost of about 6.31 pounds, or about $8.60, per HIV test and projected that, under its base-case assumptions, the program would avert 187 HIV-related deaths and 28 onward transmissions over 20 years.

“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,” said Dr. Josephine Walker, the University of Bristol researcher who led the study.

The findings come as the government commits longer-term funding to the approach. The HIV Action Plan 2025-2030 includes 156 million pounds for NHS England from April 2026 to March 2029 to continue opt-out emergency-department testing for HIV, hepatitis B and hepatitis C in high- and very-high-prevalence areas.

NHS England said three additional hospitals will begin offering the testing program by April 2027, extending an approach that officials say is helping identify infections earlier and connect patients to treatment sooner.