The HIV Action Plan 2025 to 2030 seeks to minimise the number of people living with HIV without accessing treatment
Increasing uptake to treatment is a vital part of the HIV Action Plan’s core goal to reduce new HIV infections and cut AIDS-related deaths. Comprehensive, timely HIV treatment not only improves health outcomes, but prevents transmission.
The action plan points to ‘clear’ progress in linking people to timely treatment once they are diagnosed. Of the 2,838 adults diagnosed with HIV in England in 2023, 82% were linked to specialist HIV care within two weeks, compared to 71% in 2019.
However, the plan acknowledges ongoing challenges around reaching all demographics. ‘Not all people living with HIV are able to maintain adherence to their treatment – particularly people experiencing personal, financial, housing, immigration, or mental health difficulties, with a disproportionate impact on Black African communities and women,’ it says.
In 2023, an estimated 15,800 to 18,900 people were living with transmissible levels of the virus – equating to between 15% and 18% of those living with HIV in England. This population includes people living with undiagnosed HIV, as well as those who have been diagnosed but are not receiving treatment.
To cut that number, the DHSC is investing in a retention and re-engagement initiative and looking at providing treatment in more accessible settings.
Key takeaways for ICBs
- ICBs could play a role in allocating the £9m funding for the national retention and re-engagement project
- Community settings offer an opportunity to expand treatment uptake
Retention and re-engagement
To reach people who have lapsed in their treatment, the government is investing £9m in a national retention and re-engagement initiative from April 2026 to March 2029. The project is seen as a vital part of efforts to boost treatment rates.
As part of the initiative, NHS England will ‘amplify existing work within local services’, while partnering with voluntary and community organisations and industry to increase the number of patients re-engaged in their care. ‘This will support individual care and clinical outcomes, as well as preventing new infections,’ the plan says.
The push is welcomed by BHIVA chair Tristan Barber, who points to the varying reasons for people falling out of treatment. ‘Sometimes people have moved, some are taking time to adjust to their diagnosis, and some struggle with their treatment,’ he says. ‘Being able to re-engage those people into care is really important if we are to meet our goals around cutting transmission.’
The Elton John AIDS Foundation CEO Anne Aslett also points to ‘stigma and mental health’ as the major drivers of disengagement, alongside ‘poverty, food insecurity and substance use’.
As the full details emerge, ICBs could play a crucial role in delivering the initiative. ‘We’re not quite clear yet how this £9m funding is going to be spent, but there may well be a role for ICBs in that,’ points out Katie Clark, head of policy at the Terrence Higgins Trust.
Ms Clark highlights work by South East London ICB as an example. In 2022, it launched the South East London ICS HIV Re-engagement Project to support people to re-engage with their HIV care and re-start taking antiretroviral medicines.
Three NHS Foundation Trusts offered ‘tailored support to address competing needs that often pushed patients out of care, including unemployment, alcohol misuse, mental health issues, and substance use’. As a result, 333 people living with HIV reconnected with treatment between April 2022 and March 2025, South East London ICB reports. Of those, 84% were re-engaged via proactive outreach.
Still, 20 patients experienced ‘repeated disengagement’ which shows ‘re-engagement activity needs to be ongoing and consistent’, the ICB says.
Both South East London and South West London have launched a new HIV re-engagement programme funded through Fast Track Cities in 2026. The goal is to address some of the areas of unmet need. For example, this includes deploying a dedicated chemsex worker – who specialises in counselling around sexual activity under the influence of drugs – from LGBT+ charity Antidote.
Community care
Providing care in accessible settings was identified as a vital part of boosting treatment rates. In the HIV Action Plan, the DHSC pledged to work with clinics, voluntary and community organisations and primary care providers to offer ‘flexible, person-centred re-entry pathways’.
Specialist centres in hospitals remain the preferred option for the majority of people living with HIV, says BHIVA’s Mr Barber. However, he believes it is important to offer choice.
‘There is a proportion of people who find a specialist service in itself stigmatising,’ he says. ‘So the role for ICBs is seeing where people can be seen at the right time.’ The North Central London HIV GP Champions pilot uncovered ‘a small but significant minority’ who would prefer to have consultations at their GP surgery, Mr Barber adds.
The importance of providing care across a range of settings is reiterated by the Derby and Derbyshire ICB, Lincolnshire ICB, and Nottingham and Nottinghamshire ICB cluster, which works closely with the public health team at Lincolnshire County Council.
‘Local authorities and health partners need to work closely to ensure that people living with HIV are well supported both in the community and when attending hospital,’ the cluster spokesperson says. ‘A priority is improving the coordination of care for people living with HIV, who often experience co-morbidities and co-infections.’
This report has been initiated and funded by MSD. MSD has had no input into the content of this non-promotional report.
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