HIV and AIDS

Overview of page

• Introduction

• Prevalence

• HIV testing

• Routes of infection

• New diagnosis and late diagnosis

• Treatment and care

• National strategies

• HIV support - local and national services

• References

Introduction

In 2024, there were 103,689 people accessing HIV services in England.¹ HIV care has changed significantly over the past two decades with earlier diagnosis and effective, accessible treatment which allow people to live long, healthy lives without risk of onwards transmission of the virus. England now has the ambition to end HIV transmission by 2030. The HIV Action Plan for England 2025-2030 sets out the country’s plan to achieve this through the priorities of 'Prevent, Test, Treat, Thrive and Collaborate'.²

In 2023, Blackpool became a Fast Track City to commit to collaboration, effective treatment and reducing stigma to end the HIV epidemic.³ Knowledge of local diagnosed HIV prevalence and identification of local risk groups can be used to help direct resources for HIV prevention and treatment.

The 2026 Sexual Health Joint Strategic Needs Assessment for Blackpool presents a picture of all sexual health needs and service provision for sexual health in Blackpool and supports the development of the Sexual Health Strategy and Action Plan for Blackpool. This information on HIV in Blackpool should be read in conjunction with the wider joint strategic needs assessment. The numbers related to HIV diagnoses particularly at local authority level can be small and fluctuate year on year, it is therefore important to review trends of data captured across multiple years to understand an accurate picture. Blackpool Council commissions sexual health services and works alongside service providers to ensure the best care and outcomes for the residents of Blackpool regarding sexual health. The sexual health services report to the Blackpool Health and Wellbeing Board and Bsafe. 

England’s picture:

• The overall prevalence of HIV in England was 2.4 per 1,000 people aged 15 to 59 in 2024.

• Nationally the UNAIDS 95-95-95 targets are being met

• It is estimated that 95% of all adults living with HIV in England were diagnosed

• 95% of adults diagnosed were receiving treatment

• 98% of adults on treatment were virally suppressed

• 87% of adults living with HIV in England are estimated to have suppressed viral loads meaning they cannot transmit the virus.¹

Free and effective anti-HIV treatment also known as antiretroviral therapy (ART), alongside expanded testing, partner notification, access to pre-exposure prophylaxis (PrEP), condom use and other forms of prevention have transformed HIV care in the UK. This has meant that HIV has changed from a historically terminal diagnosis to a chronic and manageable condition. People living with HIV in England that are diagnosed promptly and adhere to treatment can expect a near-normal life expectancy.⁴

Risk factors for HIV infection include higher risk sexual behaviours (such as unprotected sex, multiple sexual partners, and chemsex); belonging to specific population groups including men who have unprotected sex with men, trans women who have sex with men, people who inject drugs, sex workers, Black Africans, and those in prisons; exposure through sexual partners living with HIV; and additional factors such as previous STIs, occupational exposure, unsafe medical procedures and sexual assault.⁵

Despite progress to end HIV transmission and HIV-related and AIDS deaths, there continues to be inequalities in relation to HIV prevention, care and treatment.2 Stigma and structural inequalities encompassing poverty, racism, sexism, contribute to late testing and decisions to not seek treatment following a HIV diagnosis. Inequalities exist and are widening across age, ethnicity, gender identity and route of exposure. Addressing healthcare inequalities is a core part of the new national HIV Action Plan.²

The high prevalence and incidence of HIV in Blackpool shows a continued effort is needed for HIV testing and the importance of high quality services to support people living with HIV. Targeted prevention and wider testing should further identify people who may be living with undiagnosed HIV and reduce late diagnosis. This would also include sexual health promotion with a focus on HIV, with the main outcome being reducing new infections amongst heterosexual people.

The National Institute for Health and Care Excellence (NICE) recommend annual testing to people in groups or communities with a high rate of HIV, and more frequently if they are at high risk of exposure (as noted above) and targeted HIV testing can be considered.⁶ Gay, bisexual men, and men who have sex with men (GBMSM) are advised to have an HIV and STI screen at least annually, and every three months if having condomlesss sex with new or casual partners. 

Prevalence 

In 2023, Blackpool became a Fast Track City to commit to collaboration, effective treatment and reducing stigma to end the HIV epidemic.⁸ Knowledge of local diagnosed HIV prevalence and identification of local risk groups can be used to help direct resources for HIV prevention and treatment.

In 2024, there were 463 Blackpool residents aged 15+ that accessed HIV care.⁹ Among those living with diagnosed HIV in Blackpool in 2023, 91% were White, 4% Black African and 6% of other ethnic origin.¹⁰  

The wider Blackpool population is 94.7% White, 0.5% Black and 4.8% belonging to other ethnic groups, although Black and other ethnic minority groups are slightly over-represented among people living with HIV than in the local population overall.¹¹

Blackpool is the only authority in Lancashire that is a high prevalence area (2 to 5 per 1,000 population), this means it is above the threshold (2 per 1,000) where HIV testing is recommended for new registrations in general practice, medical admission and opt-out testing on attendance in emergency departments.

 The diagnosed HIV prevalence rate was 4.1 per 1,000 population aged 15-59 years, compared to 2.4 per 1,000 in England (figure 1). Blackpool’s prevalence rate has decreased four percentage points since 2023 and by 16 percentage point in the five years since 2019.⁹

Figure 1: HIV prevalence (aged 15-59), 2011 - 2024

The map shows the prevalence rates across Blackpool, showing the highest rates are concentrated in the town centre, which also mirrors the pattern of deprivation in Blackpool.¹²

Figure 2: HIV prevalence by ward, 2024 (2023 ward boundaries)

Figure 3 shows that Blackpool has the third highest diagnosed HIV prevalence rates in the North West and is one of nine local authorities with a rate in excess of 2 per 1,000 population (high or very high >5), which is the threshold for expanded HIV testing.¹³ 

Figure 3: diagnosed HIV prevalence per 1,000 (15-59 years) by NW local authority, 2024

HIV testing and routes of infection

HIV testing is integral to the treatment and management of HIV. Knowledge of HIV status improves quality of life, increases survival rates and reduces the risk of onward HIV transmission. HIV testing rates are measured from people who accessed sexual health services in the past year.

The testing rate is calculated using the total number of tests taken in a year, among residents in England; therefore, an increased rate will be seen if the frequency with which individuals test increases.¹⁴

In Blackpool the HIV testing rate was 3,122 per 100,000, significantly higher than England (2,843). Blackpool had consistently higher testing rates than both the North West and England between 2015 and 2019 (figure 4) until 2020-22, with testing falling below the England rate. In Blackpool testing has increased since 2022 and is now back to pre-pandemic levels.

Figure 4: HIV testing rate per 100,000 in Blackpool, the North West and England

For a more detailed breakdown of testing by sexual orientation please see table 1 below. The data are from 2023 and cannot be compared with 2024 testing data. Please also note the caveat with the data.

Current testing services

The National Institute for Health and Care Excellence (NICE) recommends expanding access to HIV testing and to offer tests in different settings to increase the uptake of tests among people who may have undiagnosed HIV. This is based on local prevalence and encompasses testing through specialist sexual health services, in primary, secondary and emergency care, community settings and through self-sampling and rapid point-of-care tests. 

HIV screening in accident and emergency departments

In November 2020 (during the COVID-19 pandemic), Blackpool Teaching Hospital introduced routine screening of HIV in the emergency department (ED), supported by the HIV team. Prior to screening in the ED, and since 2013, HIV screening was offered in the acute medical unit (AMU). Blackpool’s Emergency Department recorded 43,556 HIV tests in 2024, with eight new HIV positive diagnoses that may have otherwise remained undetected.¹⁵ 

Testing in the community

Testing in non-medical settings such as community HIV testing and self-sampling for HIV offers wider opportunities for people to access a HIV test. The Harm Reduction Service in Blackpool (Renaissance) offers point-of-care testing within the Blackpool locality, with a focus on men who have sex with men. 

HIV home self-sampling enables people across Blackpool to order tests online. Tests are mailed to people's address of choice, with self-taken blood samples returned to the provider's laboratory. Confirmatory testing is undertaken by local clinical services for all reactive tests. Home self-sampling is also available for a wide range of STIs.

Routes of infection

HIV is a blood-borne virus and without adequate treatment is most commonly transmitted through sexual contact. It can also be passed from mother to child during pregnancy or birth (vertical transmission), although this is very rare in England. Unsafe injection practices for people who inject drugs, and infection via contaminated blood products and needlestick injuries are also rarer routes of infection.¹⁶

The most prevalent route is now from heterosexual contact (men and women). There has been a decline in new HIV diagnoses among gay and bisexual men and men who have sex with men (GBMSM). This is a reflection of a combination of HIV prevention approaches in the UK, including condom provision, pre-exposure prophylaxis (PrEP), post exposure prophylaxis (PeP), expanded HIV testing and prompt initiation of treatment. 

Figure 5 shows the transmission routes among all people living with diagnosed HIV in Blackpool and England (2023). In 2023, sex between men remained the most common route of transmission among Blackpool residents, comprising 77% of cases, compared with 17% attributed to sex between men and women. This contrasts to the national figures, where the largest proportion of people living with HIV acquired infection through sex between men and women (50%). The 2019 data shows the exposure groups in Blackpool have remained relatively unchanged.¹⁷

Figure 5: transmission routes among those diagnosed with HIV, Blackpool and England (2023)

Figure 6 shows trends for the North West of exposure routes, overall, sex between men was the probable route of infection for the largest number of cases between 2015 and 2018 but steadily declined over this period and reached a level similar to that for sex between men and women by 2019. New diagnoses attributed to both transmission routes remained similar and stable until 2022. There was a sharp increase in diagnoses attributed to sex between men and women in 2023, followed by a small decline to 160 new HIV diagnoses. There was a slight rise in new diagnoses attributed to sex between men overall in 2023, followed by a small decline in 2024.

Figure 6: HIV infection in the North West, 2015 to 2024

New diagnosis and late diagnosis

New diagnosis

A new HIV diagnosis may be months or years after someone has become infected. Understanding diagnosis provides a timely insight into levels of onward transmission, which may allow for targeted efforts to reduce this. Although the majority of HIV diagnoses are made in sexual health services, HIV testing has been introduced in a variety of different medical services and non-medical settings, including the expansion of self-sampling/self-testing.⁹

 In Blackpool in 2024 the rate of new diagnoses was 6.2 (per 100,000), similar to England (4.7) and significantly higher than the North West (3.7). Although rates are still high, this is a 26% decrease since 2023 and a 27% decrease in the five years since 2019. The new HIV diagnosis rate refers to diagnoses first made in England and excludes people diagnosed elsewhere before continuing care in England. Figure 7 below shows the trend.

Figure 7: trend in new HIV diagnoses, Blackpool, North West and England, 2015 to 2024

Looking at new diagnoses in the North West, Blackpool has one of the highest rates per 100,000 of the population. It is the fourth highest among local authorities in the North West, behind Manchester, Salford and Liverpool in 2024 (figure 8). Routes and trends of diagnosis by demographics have changed over the past decade as seen in figure 8.

Figure 8: new HIV diagnoses rate per 100,000 (newly diagnosed in England) for NW local authorities, 20242

Source: UKHSA (2025) Annual epidemiological spotlight on HIV in the North West: 2024 data. (HIV and AIDS Reporting System)

In the North West in 2024:

• there were 283 new HIV diagnoses - a 22% decrease compared to 2023 (321 cases) and a 22% increase compared to 2020 (231 cases). Nationally new diagnoses decreased by 4% compared to 2023 (1).
• HIV testing at all (specialist and non-specialist) sexual health services (SHSs) in the North West was 18% higher than in 2023 and 72% higher than 2020.
• fifty-seven percent (160 out of 283) of new diagnoses in 2024 were attributed to sex between men and women, a continued marked change (that started in 2023) from previous years, where a similar or higher proportion were among gay and bisexual men.
• the White ethnic group has consistently had the highest number of new diagnoses since 2015, accounting for 49% of new diagnoses. However, since 2020 diagnoses among the Black African ethnic group have been rising, making up 37% of new diagnoses.

Late diagnoses

Late diagnosis is the most important predictor of HIV-related morbidity and short-term mortality and is used as an indicator to understand progress of successful HIV prevention, local testing efforts and trends towards earlier diagnoses.⁹ It is defined as having a CD4 count  under 350 within 91 days (three months) of a person’s first HIV diagnosis and excludes people previously diagnosed before continuing care in England.

People who experienced a late HIV diagnosis in 2023 in England were 10 times more likely to die within the first year following diagnosis, compared to people who were diagnosed promptly.¹⁷

The reduction of late HIV diagnoses is a key action in the National HIV Action Plan and this indicator allows monitoring to target equitable progress by improving the proportion of HIV infections diagnosed promptly between different groups.

In Blackpool between 2022 and 2024, 42.9% of HIV diagnoses were made at a late stage of infection (CD4<350 within 91 days of diagnosis), similar to 43.3% in England. From 2012-14 to 2022-24, the proportion of late diagnoses in Blackpool has fluctuated both above and below regional and national trends (figure 9).

Figure 9: HIV late diagnosis rate per 100,000, Blackpool, North West and England

 

Across 2022-24, 40.9% of HIV diagnoses among GBMSM in Blackpool were diagnosed late, compared with 36.2% nationally. Among heterosexual men in Blackpool 50.0% of diagnoses were late, while no late diagnoses were recorded among women, although this should be interpreted with caution due to the very small number of diagnoses in women.⁹ 

Nationally and across the North West during 2022-24, late diagnosis was most common among heterosexual men (54.3% in England), heterosexual women (47.2% in England) and people whose exposure was associated with injecting drug use. The North West breakdown can be seen in figure 10 below. Older age and certain ethnic groups are also associated with disproportionately higher numbers of late HIV diagnoses.¹³

Figure 10: late diagnosis in the North West, 2022-24

Treatment and care

Following a HIV diagnosis, people can access free antiretroviral therapy (ART). ART is an effective treatment which following prompt HIV diagnosis and access to treatment improves outcomes, quality of life and allows undetectable levels of the virus. This prevents onwards transmission (even for condomless sex). An undetectable viral load = untransmissable.    

In 2024, in Blackpool, out of all people (aged 15+) accessing HIV services, 99.8% were prescribed ART. Prompt access to treatment is measured by those newly diagnosed with HIV who started ART within 91 days of diagnosis. In Blackpool this was 97.6% compared to 81.2% in England. The percentage of adults in Blackpool accessing HIV care who were virally suppressed (undetectable viral load) was 96.3%, similar to England (97.5%).

95-95-95 targets

From 2021, United Nations member states adopted targets for: 95% of people living with HIV to be aware of their HIV status; 95% of these to be on treatment; and 95% on treatment to have a suppressed viral load. For Blackpool, proportions have remained overall similar or higher than the UN targets.

Figure 11: late HIV diagnosis in the North West 2022-24

Pre-exposure prophylaxis (PrEP) is a medication taken by HIV-negative individuals before they have sex to stop them acquiring HIV. PrEP need assesses the proportion of all HIV-negative people accessing specialist sexual health services who are at higher risk of HIV and would benefit from using PrEP, it includes both those whose needs are met (on PrEP) and unmet.¹⁸

In 2024, 9% of HIV-negative attendees at sexual health services in Blackpool were identified as having a PrEP need (10.6% in England) and of these 75.4% initiated or continued PrEP, similar to England (76.1%).⁹

Although a greater number of GBMSM have unmet need, proportionally higher unmet and unidentified need is found among heterosexual men and women and ethnic minorities.²  

The routine commissioning of PrEP began in 2020 in England, with specialist sexual health services responsible for its delivery.¹⁹ This indicator assesses the proportion of individuals with a PrEP need that start or continue PrEP at specialist sexual health services. It forms part of the national monitoring framework to support the goal to end new HIV transmissions in England by 2030.² Higher coverage may indicate that more need is being met, while lower coverage could suggests gaps in access or uptake and the results will inform PrEP service delivery and help reduce inequalities.

National strategies

• A Framework for Sexual Health Improvement in England (2013) sets out the Government's ambitions for good sexual health and provides evidence, interventions and actions to improve sexual health outcomes. A commitment from the Government for a new sexual and reproductive health framework for England has been made.⁷

• The joint NICE and UKHSA guideline [NG60] HIV testing: increasing uptake among people who may have undiagnosed HIV (updated September 2025) covers how to increase the uptake of HIV testing in primary and secondary care, specialist sexual health services and the community. It describes how to plan and deliver services that are tailored to the local prevalence of HIV, promote awareness of HIV testing and increase opportunities to offer testing to people who may have undiagnosed HIV.

• HIV Action Plan for England, 2025 to 2030 sets out England’s commitment to end new HIV transmission. It has been developed by the Department of Health and Social Care (DHSC), in partnership with UKHSA and NHS England and has five strategic priorities to achieve clear goals and will measure progress through focus on five populations disproportionately affected by HIV. It will be delivered through local and regional HIV Action Plans and by services commissioned by local authorities and integrated care boards.

HIV support – local and national services

• Revolution – Renaissance
• HIV Services: Blackpool Teaching Hospitals
• Homepage | Terrence Higgins Trust

References

[1] UK Health Security Agency (UKHSA) (2026) HIV testing, PrEP, new HIV diagnoses and care outcomes for people accessing HIV services: 2025 report

[2]UKHSA (2025) HIV Action Plan for England, 2025 to 2030 - GOV.UK

[3] Blackpool Council (2023) Blackpool to join a network of towns and cities around the world committed to beating HIV

[4] Lancet (2023) Life expectancy after 2015 of adults with HIV on long-term antiretroviral therapy in Europe and North America: a collaborative analysis of cohort studies - The Lancet HIV

[5] National Institute for Health and Care Excellence (NICE) (2025) Risk factors | HIV infection and AIDS | CKS | NICE

[6] NICE (2025) When to offer HIV testing | Diagnosis | HIV infection and AIDS | CKS | NICE

[7] BASHH (2026) BASHH welcomes the Government’s commitment to a sexual and reproductive health framework for England | BASHH

[8] Blackpool Council (2023) Blackpool to join a network of towns and cities around the world committed to beating HIV

[9] UKHSA (2026), Summary profile of local authority sexual health, SPLASH Blackpool 2026-02-05

[10] UKHSA (2026), GUMCAD, HIV and STI Portal, SPLASH Supplement

[11] UKHSA (2026), Summary profile of local authority sexual health, SPLASH Blackpool 2026-02-05

[12] Blackpool Council (2026), Blackpool Deprivation JSNA

[13] UKHSA (2025) Annual epidemiological spotlight on HIV in the North West: 2024 data. (HIV and AIDS Reporting System)

[14] OHID (2026), HIV testing rate per 100,000, Fingertips | Department of Health and Social Care

[15] Blackpool Teaching Hospitals data (2026)

[16] Terrence Higgins Trust (2024), How HIV is transmitted | Terrence Higgins Trust

[17] UKHSA (2026), GUMCAD, HIV and STI Portal, 2019 and 2023 data

[18] OHID (2026) Determining PrEP need Definition, Fingertips | Department of Health and Social Care

[19] UKHSA (2022) Routine commissioning of HIV Pre-Exposure Prophylaxis (PrEP) in England

[20]