In 2022, 33 UK Hospitals started a groundbreaking trial, offering an opt out service for HIV. Hepatitis B & C testing for all patients who attended their casualty departments.

The crucial reason for this, is that 42% of HIV cases are diagnosed late. That means that the patient has lost some ability to manage their disease early, and there has also been the potential risk of spread to other patients.

In the world of healthcare, we use the analogy that it is harder to pull people out of the river rather than stopping them falling into the river in the first place. This is a clear example of where having an opt out system means we are catching people before they fall into the river.

HIV has a huge amount of stigma associated with it, when we identify patients with HIV before they develop problems, meaning we can help those patients live, long, healthy lives, hopefully dispelling the outdated views of HIV

When HIV is diagnosed later in the course of the disease, patients may have suffered for years with ill health without realising the cause, experiencing recurrent skin issues, bowel problems, frequent infections, sore throats, mouth ulcers and potentially even nerve damage. As a result of this opportunistic testing, an early diagnosis can mean that patients can be treated straight away, and with the latest generation of medications suppress the virus so that it is undetectable in the body. Obviously viral suppression is of huge personal importance to the patient, but also means that person cannot pass on the virus other people.

When the projects were initially announced there was the question as to how many people would accept testing, thankfully, that concern has not been found to be warranted, with some departments, reporting a 97% testing rate. To clarify, that is 97% of people have been happy to be opportunistically tested for HIV, hepatitis B, and C

In absolute numbers, the trial has identified 934 new cases of HIV. Initially this might seem like a comparatively small number, overall, but given it is thought that there are 4500 people living with HIV in the UK undiagnosed, to potentially have identified over 20% of those individuals in a little over 18 months can only to be seen as a massive win for the NHS, for public health, HIV campaigners but most crucially, those patients who are getting help early.