A photograph of the exterior of the Manchester NHS Foundation Trust building

Over 200, 000 tests have been done locally since 2021 as part of a national NHS England initiative to routinely test people, on an opt-out basis, within areas where the prevalence of HIV is highest. National opt-out testing is set to be expanded.

People aged 16 and over are now tested for HIV in four Greater Manchester NHS emergency departments (EDs), when receiving a blood test. This is part of a national NHS England initiative to routinely test people, on an opt-out basis, within areas where HIV is highest. The programme is part of wider work to achieve the local and national aim of reaching zero new transmissions of HIV by 2030.

Nationally, routine opt-out HIV testing in emergency departments is making a substantial contribution to HIV testing in England. In the first 12 months of the programme, the number of tests delivered was equivalent to more than half of all tests delivered in GP, sexual health, drug, and prison services combined.

Manchester University NHS Foundation Trust implemented routine HIV testing at Manchester Royal Infirmary (MRI) in December 2021, Wythenshawe Hospital in March 2022, and North Manchester General Hospital in September 2022. Salford Care Organisation, part of the Northern Care Alliance NHS Foundation Trust also began testing in October 2023. The combined efforts have delivered over 200,000 HIV tests since December 2021 and successfully identified people living with undiagnosed HIV in Greater Manchester.

To date, over 70 people have been newly diagnosed with HIV through ED testing across Manchester and Salford – enabling the majority of those diagnosed to go on to access care, effective treatment, and community support. Routine testing has also identified 248 new diagnoses of Hepatitis C.

In Greater Manchester, more than 6,000 people are thought to be living with HIV and receiving care, with a further estimated 5% unaware of this (Office of Health Improvement and Disparities, 2022). With 39% of diagnoses taking place at a late stage, routine testing is key for early identification and to reduce the impact on health, including onward transmission and premature death.

The programme has been well-received by staff, patients and people living with HIV. It is particularly successful with people who may not otherwise engage with services. Thanks to routine testing, nearly 40% of people previously diagnosed with HIV in Manchester and Salford, have continued with care and support after a previous lapse.

A person living with HIV, if diagnosed early and with the right treatment, can expect a normal life expectancy. On effective treatment and with undetectable viral load, the virus cannot be passed on to others. Routine HIV testing in emergency departments is critical to help Greater Manchester reach their aim of zero new HIV transmissions and zero stigma by 2030.

Paul Dennett, Deputy Mayor of Greater Manchester and Chair of the Greater Manchester Integrated Care Partnership said:

“Routine testing in four of our Greater Manchester emergency departments has proven vital to help reach more people living with HIV, who remain undiagnosed, and those who may not ordinarily access sexual health screening. We know that late diagnosis significantly impacts people who are disproportionately affected by HIV, such as people from ethnic minority backgrounds, migrant women and men, and people struggling with social and economic challenges as well as unequal access to health care.

“This work forms part of a wider partnership programme across Greater Manchester and internationally, within a movement of 200 cities, all striving to get to zero new cases of HIV, zero preventable deaths, zero stigma and discrimination; and a better quality of life for people living with HIV. Greater Manchester is well on the way to reaching this goal due to joint efforts of voluntary sector partners, local government, and the NHS.

“The next phase of the opt out testing announced today is very welcome news and will expand this testing to a number of other Greater Manchester emergency departments.”

Dr Orla McQuillan, Consultant Genitourinary Medicine, MFT, said:

“Emergency department opt-out testing has very quickly become the source of most new HIV diagnoses at Manchester Royal Infirmary and Wythenshawe Hospital in 2022, detecting more cases than any other testing method. It is a crucial step towards preventing new transmissions of HIV to enable us to achieve getting to zero new infections.”

Newly diagnosed patient, Male, age 50, said:

“I attended the emergency department for a completely unrelated reason. I was initially upset about being tested as I felt my control had been taken away from me. After being diagnosed and speaking with the doctors, I learnt that HIV is a long-term, manageable condition and with treatment does not reduce life expectancy. I now feel very grateful I have been diagnosed as I don’t think it’s something I would have been tested for otherwise.”

For help and support, please visit The Pash Partnership: Home | PaSH (gmpash.org.uk).

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