The HIV epidemic has changed beyond recognition. The UK government has made an ambitious pledge to end new HIV transmissions in England by the year 2030, and become the first country in the world to achieve a milestone that would have been unimaginable at the peak of the epidemic.1 Recently, the government’s commitment to achieving this goal was reaffirmed in the 10 Year Health Plan.2
Yet new data shows we are further off-track to end the HIV epidemic by 2030 than previously believed. The modelling – developed by Aquarius Population Health and commissioned by Gilead Sciences – is the first to map new transmissions across the whole population; not just among gay, bisexual, and other men who have sex with men.3 The modelling explores three possible scenarios based on how the number of new HIV transmissions (acquired in the UK) are projected to change as HIV interventions are scaled up, including prevention, testing and timely treatment.
Starting from a baseline of 947 new transmissions in 2024, in the current scenario there will still be 924 new transmissions in the year 2030 if nothing about the government’s response to HIV were to change, the modelling suggests. In fact, new transmissions will begin to increase after the year 2030. In the moderate scenario with somewhat upscaled HIV interventions, this number falls to 750 new transmissions. In the optimal scenario, with significantly upscaled interventions, we can reach 411 new transmissions and get much closer to our goal.
The data tells a clear story about how the HIV epidemic is changing. Gay, bisexual and other men who have sex with men have been most significantly and disproportionately impacted by HIV, but we have seen a significant drop in new diagnoses among this group over time.4 New diagnoses are now rising most steeply among heterosexual men and women.5 Our modelling predicts that three quarters of new transmissions could be among heterosexual men and women in 50 years.3
Widening inequalities in HIV are putting the 2030 goal at risk. Gilead has recently spotlighted the experiences of women affected by HIV across England, who for too long have been systematically excluded and ignored.6 As the nature of the HIV epidemic evolves, we cannot simply do more of the same. The government believes that we will end new HIV transmissions by 2030,2 and the whole HIV community stands behind this ambition. We hope that this new data can allow us to refocus our efforts and do things differently to get us back on track to 2030.
“By sharing this new modelling, Gilead hopes to inspire the government to act decisively, now,” said Peter Wickersham, Vice President and General Manager, UK and Ireland, of Gilead Sciences. “The data shows that there is still much work to be done. We need the same ambition, but new ideas as well.”
We have the learnings. The effectiveness of the HIV response among gay, bisexual and other men who have sex with men shows us that the impossible is possible. But we cannot get complacent with a one-size-fits-all approach. The changing nature of the epidemic and widening inequalities requires a new strategy to target different groups.
We also have the momentum. In recent years, the emergency department opt-out blood-borne virus testing programme across England has helped to identify over one thousand people living with HIV who may not otherwise have been diagnosed.7 Building on this momentum and being willing to try new approaches will be vital.
Finally, we have the mechanism. The government has promised to publish a new HIV Action Plan this year to take us to 2030. This new HIV Action Plan must set out plans to upscale effective HIV interventions, in alignment with the government’s wider shifts for the NHS: for example, widening access to the prevention tool Pre-exposure Prophylaxis in local communities; establishing a new national programme to re-engage people in care; and rolling out digital innovations to support self-management. These interventions need to be implemented in parallel to be effective.8
“Without investing in new approaches to HIV prevention and care, we will miss the opportunity to end new HIV infections in England by 2030,” commented Anne Aslett, CEO of the Elton John AIDS Foundation. “Put simply, many more people need to be using Pre-exposure Prophylaxis. A new digital prevention strategy that guarantees everyone in England online access to at-home HIV tests and postal delivery of Pre-exposure Prophylaxis would help drive down new infections, especially among harder-to-reach groups,” she added. “The government should also provide Pre-exposure Prophylaxis outside of sexual health clinics, such as in women’s health hubs and community health centres to engage the communities overlooked by the current system.”
The next five years could change the course of the HIV epidemic forever and show the world what is possible. With bold leadership and increased focus as well as investment, the UK government can ensure we don’t just slow down transmissions, but end the epidemic altogether. Let’s get back on track and within touching distance of 2030.
Document reference: UKI-UNB-1616
References:
1. Terrence Higgins Trust. “‘We cannot fail’ – Health Secretary Wes Streeting speaks to his commitment to ending new HIV cases at Labour Party conference”. 2024. https://www.tht.org.uk/news/we-cannot-fail-health-secretary-wes-streeting-speaks-his-commitment-ending-new-hiv-cases
2. UK government. “Fit for the Future: 10 Year Health Plan for England”. 2025. https://assets.publishing.service.gov.uk/media/6866387fe6557c544c74db7a/fit-for-the-future-10-year-health-plan-for-england.pdf
3. Aquarius Population Health and Gilead Sciences. “How can the UK achieve HIV transmission elimination? Modelling the impact of current HIV prevention efforts on progress towards the 2030 elimination goal”. 2025. https://aquariusph.com/reports/how-can-england-achieve-hiv-transmission-elimination-modelling-the-impact-of-current-hiv-prevention-efforts-on-progress-towards-the-2030-elimination-goal/
4. Terrence Higgins Trust. “Heterosexual HIV diagnoses overtake those in gay men for first time in a decade”. 2022. https://www.tht.org.uk/news/heterosexual-hiv-diagnoses-overtake-those-gay-men-first-time-decade
5. UK government. “Rise in HIV diagnoses steepest among heterosexual men and women”. 2024. https://www.gov.uk/government/news/rise-in-hiv-diagnoses-steepest-among-heterosexual-men-and-women
6. Gilead Sciences and the Sophia Forum. “Systematically excluded and ignored: Addressing inequalities for women in the HIV response”. 2025. https://sophiaforum.net/wp-content/uploads/2025/06/Sophia-Forum-and-Gilead-Women-and-HIV-report.pdf
7. NHS England. “NHS expands HIV opt-out testing to 30 more A&Es”. 2025. https://www.england.nhs.uk/2025/02/nhs-expands-hiv-opt-out-testing/
8. Chang LW, et al. “Combination implementation for HIV prevention: moving from evidence to population-level impact”. 2013. Lancet Infectious Diseases. https://www.sciencedirect.com/science/article/pii/S1473309912702736?via%3Dihub
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