World AIDS Day: How Routine Testing Is Changing Lives, From Experts at NWLP

Every year, International HIV Day gives us an opportunity to raise awareness, challenge stigma, and highlight the progress being made in HIV prevention and care. Today, HIV is no longer the illness it once was. With effective treatment and early diagnosis, people living with HIV can expect long, healthy lives. And thanks to innovative public health initiatives in England, including work taking place every day in North West London Pathology, we’re moving closer to the goal of ending new HIV transmissions by 2030.

HIV Today: Treatable, Manageable, and Undetectable

HIV (human immunodeficiency virus) affects the immune system, making it harder for the body to fight infections. But with a daily pill, most people with HIV remain healthy and active. When treatment works effectively, the virus becomes undetectable in the bloodstream, which means it cannot be passed on to anyone else. This is known as U = U (Undetectable = Untransmittable), one of the most significant public health breakthroughs of our time.

The Importance of Early Diagnosis

In 2024, 103,689 people accessed HIV care in England, a 4% increase from 2023. However, late diagnosis is still a major concern. When HIV is detected late, individuals may already have weakened immune systems, putting them at greater risk of serious illness. In fact, people diagnosed late face an eightfold increase in the risk of death compared to those diagnosed early.

This is why routine and accessible testing is essential, and why the UK government has committed to the UNAIDS goal of achieving zero HIV transmissions by 2030.

Opt-Out Testing: A Simple Idea Making a Big Difference

As part of the HIV Action Plan launched in December 2021, England introduced a blood-borne virus (BBV) opt-out testing initiative in April 2022. The idea is simple: if someone has routine blood tests while attending A&E in certain high-prevalence areas, they are automatically tested for HIV, hepatitis B, and hepatitis C unless they choose not to.

This helps identify infections earlier and reach people who may never visit sexual health clinics.

Nationally, for the period 1 April 2022 through December 2024:

• 1,377,299 people tested for HIV through the programme
• 8,624 people tested positive (either new or previously known HIV) – ~ 0.63% positivity.
• Of those positives, 719 were newly diagnosed HIV cases – ~ 0.052% of those tested

These are individuals who might otherwise have gone undiagnosed.

NWLP’s Role in Protecting Community Health

In North West London, North West London Pathology (NWLP) plays a key role in delivering this programme. A dedicated A&E blood-borne virus screening (BBVED) pathway was implemented in April 2022, allowing HIV tests to be integrated seamlessly into standard emergency department blood work using following workflow.

• All BBVED samples are screened for HIV in blood science laboratories (serology) at the site of origin.
• Any reactive sample is sent to Immunology & Immunity (I&I) Lab at Charing cross hospital for further confirmatory testing.
• Confirmed cases are quickly referred to specialist HIV outpatient clinics for treatment and ongoing monitoring.

Since April 2022 till November 2025, in all A&E sites at NWLP:

• 437,026 were tested for HIV
• 3527 (0.807%) tested positive

Each of these diagnoses represents an opportunity for early treatment, better health, and reduced transmission.

Why This Matters on International HIV Day

• Reducing stigma: Routine testing makes HIV screening normal — just another part of healthcare.
• Saving lives: Early diagnosis leads to earlier treatment and better long-term outcomes.
• Promoting equity: Testing reaches people who may not access specialist or sexual health clinics.
• Strengthening communities: NWLP’s work helps keep our communities safer, healthier, and more informed.