Ending new HIV cases in Scotland by 2030 ‘at risk’ without new investment, says Public Health Scotland

27 August 2025 — A new report outlining progress made on the Scottish Government’s HIV Transmission Elimination Delivery Plan has been published by Public Health Scotland. Marking the half-way point of the Plan, which runs until 2026, today’s report highlights successes and learnings to date and lays out an updated set of ‘pillar interventions’ to reduce new HIV transmissions.

The report concludes that ‘the decision to be made in Scotland in 2025 is whether there is collective commitment to make the additional investment in these pillars (with associated costs) or risk not achieving HIV transmission elimination by 2030.’

In recognition of this, Public Health Scotland has proposed new actions to drive progress towards ending new HIV transmissions. These include:

• The roll-out of opt-out HIV testing in emergency departments in NHS boards with the highest prevalence of HIV and the consideration of further expansion, following the Programme for Government commitment earlier this year.
• A national roll-out of an online PrEP service, building on the ongoing ePrEP clinic underway in NHS Greater Glasgow and Clyde.
• The implementation of the Positive Voices survey of people living with HIV across all services in Scotland. Action to re-engage people not accessing life-saving HIV care is ‘to be developed’.

Richard Angell OBE, Chief Executive of Terrence Higgins Trust, said:

‘It is refreshing that this report is frank about the scale of the challenge ahead. While the HIV Transmission Elimination Delivery Plan has driven significant steps forward, without new investment in HIV prevention, our chance to end new HIV cases in Scotland by 2030 is at risk. That this has been recognised by public health leaders – and they have identified actions to address it – is encouraging.

‘Scotland could be the first country in the world to achieve the historic feat of ending new transmissions of HIV, but it is not a given. We urgently need to see the roll-out of emergency department opt-out HIV testing in Glasgow and Edinburgh; the delivery of a national online HIV and STI testing service; and meaningful investment in HIV support services to tackle disengagement from care and ensure everyone living with HIV in Scotland has the support they need to live well and access vital treatment and care. It’s time to seize this historic opportunity’

The HIV Transmission Elimination Delivery Plan was published in March 2024, setting out a framework for ending HIV transmissions in Scotland by 2030. Achievements to date include the delivery of the national HIV stigma campaign by Terrence Higgins Trust and partners, the piloting of an online PrEP clinic in Glasgow and pilots of emergency department opt-out HIV testing in three Scottish NHS boards.

Despite this, gaps remain in our response to the HIV epidemic. There are an estimated 500 people living with undiagnosed HIV in Scotland and 1,115 people are diagnosed with HIV but are not accessing life-saving treatment and care. HIV testing rates fell by 19% between 2019 and 2023 and the HIV prevention drug, PrEP, is not reaching everyone who could benefit from it.

In partnership with Waverley Care, earlier this summer we published: Progress towards ending HIV transmission in Scotland: Assessing the HIV Transmission Elimination Delivery Plan. In our own assessment of progress to date, we identified areas where urgent action is needed to succeed in ending new HIV transmissions in Scotland by 2030. We called on the Scottish Government to:

1. Deliver on the commitment to roll out opt-out HIV testing in A&Es in NHS Lothian and NHS Greater Glasgow and Clyde. This commitment must be funded, with ring-fenced investment for wrap-around support for those newly diagnosed with HIV or who are re-engaged in care.
2. Enable PrEP access outside of sexual health clinics, including through community pharmacies.
3. Fund a National HIV Testing Week to increase testing uptake and tackle HIV stigma.
4. Invest in HIV support services and develop a national programme to re-engage the growing number of people lost to HIV care, who now represent nearly 20% of Scotland’s HIV-positive population.
5. Commit multi-year funding to build upon the success of the anti-stigma campaign and improve HIV awareness in the health and social care sectors.