Research and analysis

Annual epidemiological spotlight on HIV in the North West: 2024 data

Updated 11 June 2026

Summary

Changes to the HIV spotlight report

During 2024, UKHSA engaged in a stakeholders’ review on language use for HIV. Consequently, a number of changes have been made to the language used in this report. These include reference to gender identity, sexual orientation and probable route of exposure:

• for gay, bisexual and all men who have sex with men, the abbreviation is gay and bisexual men (instead of GBMSM or sex between men)
• for heterosexual men or men who acquired HIV through sex with women, we abbreviate as heterosexual men (instead of men exposed through sex with women)
• for heterosexual and bisexual women or women who acquired HIV through sex with men, we use heterosexual women (instead of women exposed through sex with men)

In previous Spotlight reports, counts of new HIV diagnoses included people diagnosed with HIV before continuing care in England (referred to as ‘previously diagnosed abroad’). These cases do not reflect HIV acquired in England and most of them are rapidly linked to care shortly after arrival, making the majority extremely unlikely to pass on HIV in England (1). For this report, reflecting changes in national HIV statistics, reference to new HIV diagnoses now only includes diagnoses first made in England.

HIV in the North West

HIV remains an important public health problem in the North West. In 2024 there were 283 new HIV diagnoses (Figure 3).

This is 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 (Table 2).

Key changes in the North West

New diagnoses:

Decreased by 12% between 2023 and 2024 (from 321 to 283 new diagnoses).

Comprised 10% of new diagnoses in England (Figure 3).

This matches national trends.

Shift in transmission route:

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 (Figure 5).

Trends by ethnic group:

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 (Table 1).

Indicators consistent with the previous report

Late diagnoses:

40% of new HIV diagnoses were diagnosed late (defined by a CD4 count of less than 350 cells/mm  at diagnosis) for the period 2022 to 2024 (Figure 17). This is similar for England (42%) (1).

Late diagnoses were higher in heterosexual men (54%) and women (40%) compared to gay and bisexual men (30%) (Figure 18), and in people in the Black African ethnic group (44%) compared to people in the White ethnic group (37%) (Figure 19).

Diagnosed HIV prevalence:

The North West had the second highest regional diagnosed HIV prevalence after London, with 2 per 1,000 people aged 15 to 59 years, compared to 5 per 1,000 aged 15 to 59 years in London (Figure 24). The NW rate is the same as the overall prevalence in England.

One NW local authority had extremely high diagnosed HIV prevalence (>5 per 1,000 population aged 15 to 59 years) in 2024, and 8 had high HIV diagnosed prevalence (2 to 5 per 1,000 population aged 15 to 59 years) (Figure 2 and Figure 30).

New diagnoses

In 2024, 283 North West residents were newly diagnosed with HIV, accounting for 10% of new diagnoses in England. This represents a fall of 12% from 2023 (Figure 3).

The new diagnosis rate for North West residents (4 per 100,000) was below that of England in 2024 (5 per 100,000) (Figure 1).

In 2024, 37% of all new diagnoses in North West residents were in gay and bisexual men (compared to 38% in 2023 and 62% in 2015) (Figure 5). The number of gay and bisexual men resident in the North West newly diagnosed with HIV (106, adjusted for missing information) was 62% lower than in 2015. Of the gay and bisexual men newly diagnosed with HIV 76% were White, and 72% were UK-born.

Heterosexual contact was the largest infection route for new diagnoses in North West residents in 2024 (57%) (Figure 5). Infections in African born persons accounted for 61% of all heterosexually acquired cases in 2024 (n=69), compared to 43% (n=61) in 2015 (Figure 13). Infections in UK-born persons accounted for 27% of all heterosexually acquired cases in 2024 (Figure 14).

Injecting drug use accounted for 3% of new diagnoses in North West residents (Figure 6).

Black Africans represented 37% of all newly diagnosed North West residents in 2024 (compared to 30% in 2023 and 15% in 2015) (Figure 12). A small proportion of new diagnoses in 2024 were in Black Caribbeans (<1%) (Table 1).

The number of new diagnoses was highest in the 25 to 34 year age group in both males and females in 2024 (Figure 7).

Late diagnoses

Reducing late HIV diagnoses is one of the indicators in the Public Health Outcomes Framework and HIV Action Plan Monitoring and Evaluation Framework. People who are diagnosed late have a tenfold risk of mortality within one year of diagnosis compared to those diagnosed promptly and they have increased healthcare costs.

It is of particular concern that a large proportion of North West residents with HIV are diagnosed late (40% from 2022 to 2024, compared to 43% in England), as defined by a CD4 count of less than 350 cells/mm  at diagnosis (Figure 17).

In the North West, heterosexuals were more likely to be diagnosed late (54% of males, 40% of females) than gay and bisexual men (30%) (Figure 18). By ethnic group, Black Africans were more likely to be diagnosed late than the White population (44% and 37% respectively) (Figure 19).

People living with diagnosed HIV

The 11,514 people living with diagnosed HIV in the North West in 2024 was 4% higher than in 2023 and 40% higher than in 2015 (Figure 24). This increase is partly due to the effectiveness of HIV treatment, which has reduced the number of deaths from HIV.

The diagnosed prevalence rate of HIV in the North West in 2024 was 2 per 1,000 residents aged 15 to 59 years (Figure 24). This was equal to the 2 per 1,000 observed in England as a whole (small differences may be hidden by rounding). Nine local authorities in the North West had a diagnosed HIV prevalence in excess of 2 per 1,000 population aged 15 to 59 in 2024, which is the threshold for expanded HIV testing. They were Blackpool (4.1), Bolton (2.1), Bury (2.4), Liverpool (2.5), Manchester (5.5), Rochdale (2.5), Salford (4.9), Tameside (2.2) and Trafford (2.1).

The 2 most common probable routes of exposure for North West residents living with diagnosed HIV in 2024 were sex between men (52%) and heterosexual sex (44%) (Figure 26).

In 2024, 40% of those living with diagnosed HIV in the North West were aged between 35 and 49 years, and 47% were aged 50 years and over (up from 28% in 2015) (Figure 27). Males represented 71% of North West residents living with diagnosed HIV in 2024 and females represented 29%.

In 2024, 61% of North West residents living with diagnosed HIV were White and 28% were Black Africans. However, due to the relative sizes of the White and Black African populations the rate per 1,000 population aged 15 to 59 years was much higher in Black Africans (25 per 1,000) than in the White population (1 per 1,000) (Figure 28).

HIV testing

A total of 106,145 people were tested in specialist sexual health services (SHSs) in the North West in 2024, an increase of 69% since 2020 and an increase of 20% since 2023 (Table 2). The HIV testing rate (per 100,000 population) at all SHSs in the North West was 2,189, which compares to 2,843 across England (Figure 33). HIV testing rates in all SHSs (specialist and non-specialist services) in the North West is higher in men (2,086) than women (2,062).

PrEP

In 2024, 9% of HIV-negative North West residents accessing SHSs in England were defined as having a PrEP need, among whom 73% initiated or continued PrEP. Of those with PrEP need, 86% had this need identified at a clinical consultation. Among gay and bisexual men, the group with greatest need, these proportions were: 67%, 76% and 87% (Figure 34). Consistent use of PrEP can be an efficacious and effective intervention to prevent HIV acquisition. Despite PrEP being routinely available through specialist SHS, awareness, accessibility and uptake of primary prevention initiatives is variable for different population groups. Addressing this disparity is key to HIV prevention.

HIV in England

The HIV Action Plan for England, 2025 to 2030 was published on 1 December 2025. It sets UNAIDS 2025 ambitions to reduce HIV transmission (measured by new HIV diagnoses) and AIDS-related deaths by 90% between 2010 and 2030. New diagnoses among White gay and bisexual men are on track to reach the ambition, however further work is needed over the next 5 years for other population groups such as ethnic minorities gay and bisexual men, Black African and other ethnic minorities heterosexual populations. This is why HIV Official Statistics this year highlight progress along the HIV pathway for 5 population groups.

The number of people first diagnosed with HIV in England decreased by 2% in 2024 (2,838 in 2023 to 2,773) (2). Gay and bisexual men accounted for almost 30% of new HIV diagnoses (810 of 2,773), with heterosexual men 23% (634) and heterosexual women 27% (749). Within and between these population groups, there remains evidence of considerable inequalities (2). Further provision of services that are culturally competent and accessible to diverse populations is needed.

The number of new HIV diagnoses in England decreased by 6% (859 to 810) in 2024 for gay and bisexual men (2). However, this reduction was not seen consistently among all ethnic groups. While a reduction of 6% was observed among White gay and bisexual men (488 to 461), new HIV diagnoses increased among Black (15%, 80 to 92) and Asian (6%, 101 to 107) gay and bisexual men. Nearly half (48%, 386 of 810) of the gay and bisexual men newly diagnosed in England in 2024 were born abroad.

For heterosexuals, the number of new HIV diagnoses were similar in 2024 compared to 2023 (1,371 to 1,383), although numbers increased for heterosexual men (by 3%, 615 to 634) and decreased marginally for heterosexual women (by 1%, 755 to 749) (2). As with gay and bisexual men, for heterosexuals, there was considerable variation between ethnic groups. Notably, new HIV diagnoses among Black African heterosexual men increased by 15% (231 to 265) but decreased by 5% among Black African heterosexual women (441 to 418). Of the heterosexual men newly diagnosed in 2024, 27% (170 of 634) were known to be born in the UK and 68% (431 of 634) abroad. Among women, 15% (116 of 749) were known to be born in the UK and 77% (580 of 749) abroad.

Overall, the number of people tested for HIV in sexual health services (SHSs) in England was 3% higher in 2024 than 2023 but has not fully recovered to pre-pandemic (2019) levels for all groups. Whereas testing increased markedly within specialist SHSs (9%), non-specialist online testing declined by 4% in 2024. The proportion of people tested through online consultations at all SHSs (compared to face-to-face) fell by 3%, continuing a year-on-year reduction in this proportion since a peak in 2021. There was a 7% decrease in the HIV testing rate in all SHSs in people aged 15 to 24 years. This compares to a continued increase in the HIV testing rate in all other age groups.

Testing increases were observed across gender and sexual orientation groups (gay and bisexual men, 2%; heterosexual men, 5%; heterosexual woman, 2%). Consistently increased testing for gay and bisexual men, coupled with an overall decline in HIV test positivity (0.3% in 2020 to 0.2% in 2024) suggests that there may be a reduction in transmission in this community. HIV test positivity in heterosexual men and women has remained similar in 2023 and 2024 (0.05% to 0.06%, and 0.08% to 0.08%, respectively). The programme of emergency departments (ED) opt-out testing for bloodborne viruses continues to be a successful approach for HIV diagnoses, contributing to 8% of all new HIV diagnoses in 2024.

The number of people diagnosed with HIV before continuing care in England fell markedly in 2024 (3,363 to 2,525) with a corresponding 15% drop in all HIV diagnoses (6,201 to 5,298). The reduction in the number of people diagnosed before continuing care in England was most pronounced in heterosexual women (33%), compared to reductions in heterosexual men (11%) and gay and bisexual men (21%). The decline in the number of people diagnosed before continuing care in England in 2024 varied by ethnic group. The largest proportionate reductions in numbers (compared to 2023) were seen in people of Black Other (30%; 79 to 55), Black African (28%; 2,196 to 1,587), Asian (25%; 228 to 172), Other or Mixed (25%; 288 to 216) and White (22%; 326 to 253) ethnicities.

The number of people receiving HIV pre-exposure prophylaxis (PrEP) via SHSs has been increasing on an annual basis since 2020, increasing by 7.7% between 2023 and 2024 (111,123 in 2024 vs. 103,138 in 2023). However, inequalities in access remain. While the overall number of gay and bisexual men with unmet HIV PrEP need was highest, there is proportionally greater unidentified and unmet PrEP need among heterosexual men and women.

Despite a 2% decrease in the number of adults being diagnosed late between 2023 and 2024 (950 to 928), 42% (928 of 2,196) of the new HIV diagnoses were made at a late stage in England in 2024. Reductions in the number of late HIV diagnoses fell most among gay and bisexual men (11%) compared with heterosexual women (4%) and heterosexual men (1%). The percentage of new diagnoses that were late for all 3 groups remained similar to 2023 (45% to 46%, 53% to 52%, 31% to 30% for heterosexual women, heterosexual men, and gay and bisexual men, respectively). In 2024, half of adult Black African heterosexuals newly diagnosed with HIV were diagnosed late (285 of 572; 50%). People diagnosed late with HIV in England in 2023 were 10 times more likely to die within a year of their diagnosis, compared to those diagnosed promptly.

Provisional estimates are that 95% of all adults living with HIV in England are diagnosed, with 99% of diagnosed adults receiving treatment, and 98% of adults on treatment having suppressed viral loads.

HIV prevention messages

Using condoms consistently and correctly protects against HIV and other STIs such as chlamydia, gonorrhoea and syphilis. They can also be used to prevent unplanned pregnancy.

HIV testing is central to HIV prevention since it provides access to PrEP and health advice for people testing HIV negative, while a positive result leads to essential HIV care and treatment, supporting a long healthy life whilst preventing onwards transmission. Everyone should have an STI screen, including an HIV test, on at least an annual basis, if having condomless sex with new or casual partners. Gay and bisexual men should have tests for HIV and STIs annually, or every 3 months if having condomless sex with new or casual partners.

HIV PrEP is available for free from specialist SHSs and can be used to reduce an individual’s risk of acquiring HIV. Consistent use of PrEP can be an efficacious and effective intervention to prevent HIV acquisition. Despite PrEP being routinely available through specialist SHSs, awareness, accessibility and uptake of primary prevention initiatives such as HIV PrEP is variable for different population groups.

HIV post-exposure prophylaxis (PEP) can be used to reduce the risk of acquiring HIV following some sexual exposures. PEP is available for free from specialist SHSs and most emergency departments. Symptoms due to HIV may not appear for many years, and people who are unaware of living with HIV may not feel themselves to be a risk to others. Prevention messages should reinforce that anyone can acquire HIV regardless of age, gender, ethnicity, sexuality or religion, and it is important to challenge assumptions about who is at risk of acquiring HIV.

People living with diagnosed HIV who are on treatment and have an undetectable viral load are unable to pass on the virus to others during sex, even without PrEP or condoms. This is known as Undetectable = Untransmittable or U=U.

Stigma, anxiety and depression experienced by people with HIV affect their ability to seek healthcare, engage in treatment and remain in care. Reducing stigma in healthcare services will encourage people from seeking the healthcare services they need.

Specialist SHSs are free and confidential. They offer testing and treatment for HIV and STIs, condoms, vaccination, HIV PrEP and PEP. Clinic-based services are commissioned by local authorities for residents of all areas in England and online self-sampling for HIV and STIs is widely available. Information and advice about sexual health including how to access services is available at NHS.UK and from the national sexual health helpline on 0300 123 7123.

Local and regional prevention strategies

HIV prevention strategies at a local and regional level should consider inclusion of all actions published recently in the HIV Action Plan for England (HIVAP). Below are some examples of how this could be done, focusing on each of the 5 HIVAP priorities:

Prevent

Ensure localities are aware that there is central funding for formula milk (and related sterilised equipment) for the infants of women living with HIV.

Drive forward HIV service improvements and innovation with a focus on reducing inequalities in HIV testing, access to HIV PrEP and PEP.

Collate evidence and best practice of HIV PrEP provision pilot studies.

Test

Implement and monitor BHIVA, British Association for Sexual Health and HIV (BASHH) and British Infection Association (BIA) Adult HIV testing guidelines 2020, including opt-out in SHSs and reduce inequalities in HIV testing.

Continue ED opt-out testing in very high and high prevalence HIV areas.

Work with GP practices to promote HIV testing into routine primary care pathways.

Scale up partner notification activities.

Understand the drivers of late diagnosis in order to better focus interventions.

Treat

Share learnings from UKHSA audits with local networks and encourage provision of peer support and psychological support within HIV treatment services.

Ensure commissioning arrangements are in place with local providers for HIV peer support provision.

Ensure local SHSs and HIV services engage with and learn from retention in care reviews to strengthen pathways.

Thrive

Ensure services provide a holistic approach to HIV care for women, signposting to other services, such as partner violence services and menopause clinics, when needed.

Improve the quality of life for people living with HIV, including promotion of U=U, particularly for older adults and people with complex health and care needs, by commissioning integrated, person-centred support services that address physical, mental and social wellbeing.

Collaborate

Share culturally competent education and awareness of new technologies as they become available to enhance national messaging.

Apply and promote the HIV Low Prevalence Toolkit to guide local planning, commissioning and evaluation and strengthen outreach, primary care partnerships and service visibility to ensure equitable access to prevention, treatment and care in low prevalence areas.

Charts, tables and maps

Figure 1. Rate of new HIV diagnoses per 100,000 population (all ages) by UKHSA region of residence, 2024

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

The North West had the fifth lowest rate of new HIV diagnoses at 3.7 per 100,000 population for all ages in 2024. London had the highest rate at 10.8 per 100,000. The rate of new HIV diagnoses across England was 4.7 per 100,000 (Figure 1).

Figure 2. Rate of new HIV diagnoses per 100,000 population (all ages) by upper tier local authority of residence, North West residents, 2024

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: HIV diagnosed prevalence (rate per 1,000 aged 15 to 59 years as per NICE testing guidelines). Lower diagnosed prevalence less than 2, high diagnosed prevalence 2 to 5, Extremely high diagnosed prevalence more than 5.

Note 3: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

Note 4: Colour coding of bars does not relate to new diagnosis but to the data in the diagnosed prevalence section later.

Figure 2 is a bar chart displaying the rate of new HIV diagnoses in 2024 per 100,000 population by upper tier local authorities in the North West. Manchester, Salford, and Liverpool had the highest rates of new HIV diagnoses in the North West at 9, 6, and 6 diagnoses per 100,000, respectively. Knowsley, Rochdale and Stockport had the lowest rate of new HIV diagnoses at 1 diagnosis per 100,000. The rate of new HIV diagnoses across the North West was 3.7 per 100,000 in 2024.

The bars are coloured according to the diagnosed HIV prevalence in the upper tier local authority of residence. The areas with the highest rates of new HIV diagnoses also had extremely high or high diagnosed HIV prevalence. Tameside, Rochdale, Trafford, and Bury are high diagnosed HIV prevalence areas, yet the number of new diagnoses in these areas in 2024 was low compared to other areas in the North West region.

Figure 3. New HIV diagnoses and deaths, the North West, 2015 to 2024 [note 3]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission. Numbers may rise as we receive more reports and more information. This will impact on interpretation of trends in more recent years. New HIV diagnoses are shown by UK region of residence at diagnosis. Deaths are shown by UK region of death which in some instances may not be the same as UK region of residence at diagnosis. Region of death may not be known for all deaths, particularly for those in the most recent years. Numbers for these years should be interpreted as minimum numbers (deaths reported and allocated to a region of death to date) and not as a trend.

Note 2: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

Note 3: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 3 is a line chart displaying 2 trend lines: the number of new HIV diagnoses and deaths from 2015 to 2024. In 2024, 283 HIV diagnoses were recorded, 22.8% lower when compared to 2023. Between 2015 and 2024, there was an initial declining trend in diagnoses between 2015 and 2020 from 449 to 231 diagnoses. Diagnoses have slightly increased over the years between 2020 and 2024. The number of HIV deaths decreased from 101 in 2022 to 76 in 2023, a decrease of 25%.

Figure 4. New HIV diagnoses by whether a person had been diagnosed with HIV before continuing care in England, the North West, 2020 to 2024 [note 2]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 4 is a bar chart displaying the number of new HIV diagnoses in the North West by whether a person had been previously diagnosed with HIV before continuing care in England, between 2020 and 2024. In 2024, there were 273 individuals with new HIV diagnoses before continuing care in England, which represents a decrease when compared to 2023, when there were 317 new HIV diagnoses previously made abroad.

Figure 5. New HIV diagnoses by probable route of exposure (adjusted for missing route information), North West residents, 2015 to 2024 [note 3]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

Note 3: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 5 is a line chart displaying trend lines of the number of new HIV diagnoses by probable route of infection over the past 10 years (2015 to 2024) in the North West. Three probable routes of infection are shown: sex between men, sex between men and women, and other infection routes. Overall, sex between men was the probable route of infection for the largest number of cases between 2015 and 2022, however, in 2023 and 2024 the largest number of new HIV diagnoses were probably transmitted through sex between men and women. There was a sharp increase in diagnoses attributed to sex between men and women in 2023, followed by a slight decrease in 2024, with 160 new HIV diagnoses. There was a small decrease in new diagnoses attributed to sex between men overall in 2024, with 106 new HIV diagnoses.

The number of new HIV diagnoses with other probable infection routes has remained consistently low.

Figure 6. New HIV diagnoses detailed ‘other’ route of exposure (not adjusted for missing information), North West residents, 2015 to 2024 [note 3]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

Note 3: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 6 is a line chart displaying trend lines of the number of new HIV diagnoses by probable route of infection over the past 10 years (2015 to 2024) in the North West. The routes of infection included in this chart are those grouped into the ‘other infection routes’ category in Figure 5. Three probable routes of infection are shown: intravenous drug use, mother-to-child, and other. The numbers of new HIV diagnoses across these 3 probable routes of infection are very small, therefore, caution is encouraged when interpreting trends from this figure as small changes in the number of diagnoses can appear dramatic. New diagnoses attributed to mother-to-child transmission have been increasing between 2021 and 2024 from 2 to 8. New HIV diagnoses related to intravenous drug use slightly decreased from 8 to 6 in 2023 and 2024, respectively.

Figure 7. Number of new HIV diagnoses by age group and gender, North West residents, 2024

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infections and transmission.

Note 2: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

Figure 7 is a type of bar chart called an age-sex pyramid displaying the number of new HIV diagnoses in the North West in 2024 by age group and gender (male vs. female). Six age groups are displayed: under 15, 15 to 24, 25 to 34, 35 to 44, 45 to 54, and 55 and over. Within each age group, consistently fewer new HIV diagnoses are seen in women in comparison to men, with the exception of under 15s, with 2 new diagnoses in females and in males. The largest number of new HIV diagnoses in men are in the 25-to-34-year-old and 35-to-44-year-old age groups (62 and 48 diagnoses, respectively). Among women, the largest number of new HIV diagnoses are in the 25-to-34-year-old age group (30 diagnoses).

Figure 8. Number of new HIV diagnoses by age group and gender, split by whether first diagnosed in the UK or abroad, North West residents, 2024

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note: The number of new diagnoses will depend on accessibility of testing as well as infections and transmission.

Figure 8 is 2 age-sex pyramid bar charts comparing the number of new HIV diagnoses among North West residents by age group and sex in people first diagnosed in the UK to people previously diagnosed abroad. Five age groups are displayed: under 15, 15 to 24, 25 to 34, 35 to 44, 45 to 54, and older than 55 years.

With the exception of under 15 and 35 to 44 year olds first diagnosed abroad, more new HIV diagnosis are observed amongst males when compared to females. In both first diagnosed in the UK and previously diagnosed abroad groups, the majority of new diagnoses are aged 25 to 34 and 35 to 44 years. New diagnoses are more evenly distributed by sex in people previously diagnosed abroad compared to people first diagnosed in the UK.

Figure 9. Number of new HIV diagnoses by age group and probable route of exposure, male North West residents aged 15 to 64 years, 2024

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

Figure 9 is an age-sex pyramid bar chart showing the number of new HIV diagnoses among male North West residents by age group and probable route of infection. Probable route of infection is divided into 2 groups: sex between men and all other exposures. Five age groups are displayed: 15 to 24, 25 to 34, 35 to 44, 45 to 54, and 55 to 64 years.

Within age groups 15 to 24, 25 to 34, and 55 to 64, the number of new HIV diagnoses where the probable route of infection is sex between men is higher than all other exposures. Among men aged 35 to 44, and 45 to 54, the number of new HIV diagnoses where the probable route of infection was sex between men is lower than all other exposures. The largest number of new HIV diagnoses is found among men aged 25 to 34 with a probable exposure of sex between men.

Figure 10. Number of new HIV diagnoses in gay and bisexual men by age group and year of first UK HIV diagnosis, North West residents aged 15 to 64 years, 2015 to 2024 [note 3]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

Note 3: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 10 is a line chart displaying trend lines of the number of new HIV diagnoses probably acquired through sex between men by age group in the North West over the past 10 years (2015 to 2024). Five age groups are displayed: 15 to 24, 25 to 34, 35 to 44, 45 to 54, and 55 to 64

Overall, the number of HIV diagnoses where the probable route of infection is sex between men has decreased across all age groups since 2015. This decrease appears to have plateaued since 2020 for all age groups with the exception of the 35 to44 year olds, where the number of new HIV diagnoses increased in 2021. The highest number of new HIV diagnoses has consistently been among those aged 25 to 34 (with the exception of the increase among 35 to 44 year olds in 2021), while the lowest has been among those aged 55 to 64, with the exception of 2024, where the 45 to 54 year old group presents the lowest number of new HIV diagnosis.

Figure 11. Number of new HIV diagnoses with a probable route of exposure through heterosexual sex by age group (in years) and year of first HIV diagnosis, North West residents aged 15 to 64 years, 2015 to 2024 [note 3]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

Note 3: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 11 is a line chart displaying trend lines of the number of new HIV diagnoses probably acquired through heterosexual sex by age group in the North West over the past 10 years (2015 to 2024). Five age groups are displayed: 15 to 24, 25 to 34, 35 to 44, 45 to 54, and 55 to 64.

The number of new diagnoses in 2024 was very similar to that of 2015 for the 25 to 34 and 35 to 44 year old groups (with 42 and 46 new diagnosis respectively). New diagnoses in the 35 to 44 age group increased steeply in 2023 to the highest level in the previous 10 years, while the trend for age groups 15 to 24 and 55 to 64 has overall remained stable. The highest number of new HIV diagnoses has mostly been among those aged 35 to 44 while the lowest has primarily been among those aged 15 to 24.

Figure 12. Number of new HIV diagnoses by ethnic group (adjusted for missing ethnic group information), North West residents, 2015 to 2024 [note 3]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

Note 3: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 12 is a line chart displaying trend lines of the number of new HIV diagnoses by ethnic group in the North West over the past 10 years (2015 to 2024). Ethnicity is divided into 3 groups: White, Black African, and all other ethnic groups. The number of new HIV diagnoses among White people has generally trended downwards since 2015. The number of new HIV diagnoses among people of Black African ethnicity decreased slightly from 2015 to 2020 but shows an increasing trend since then, recording the highest number of new HIV diagnoses in 2024 (105). The number of new HIV diagnoses in the ‘all other ethnic groups’ category remained relatively stable and low between 2015 and 2024. The highest number of new HIV diagnoses has consistently been among people who are White.

Figure 13. Number of new HIV diagnoses by world region of birth (adjusted for missing world region of birth information), North West residents, 2015 to 2024 [note 3]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: Due to a change in the definition of new HIV diagnoses, this figure no longer includes data for persons previously diagnosed abroad and differs from that included in previous reports.

Note 3: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 13 is a line chart displaying trend lines of the number of new HIV diagnoses by world region of birth for North West residents over the 10 year period 2015 to 2024. World region of birth is broken into 3 categories: UK, Africa, and all other countries. Among people born in the UK, new HIV diagnoses have generally trended downwards since 2015, going from 321 new HIV diagnoses in 2015 to 127 diagnoses in 2024. The number of new HIV diagnoses among people born in Africa remained stable until 2023, when a sharp increase in the number of new HIV diagnoses was observed (48 in 2022, 116 in 2023). The number of new HIV diagnoses among people born in countries outside of the UK and Africa has remained stable over the past 10 years.

Table 1. Number of new HIV diagnoses by ethnic group and whether born abroad, North West residents, 2020 to 2024 [note 3]

Ethnic group	UK-born	Born abroad	Unknown country of birth
White	588	100	12
Black African	14	272	12
Black Caribbean	8	3	1
Other	39	140	9
Unknown	14	42	91

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).

Note 1: Table 1 shows that the relationship between ethnic group and whether a person newly diagnosed with HIV was born abroad. Data is for the 5-year period 2020 to 2024. Those with a prior diagnosis abroad are excluded. To make it clear that there are differences in completeness of ascertainment of country of birth for different ethnic groups, numbers in this table are not adjusted for missing information.

Note 2: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 3: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Table 1 displays the number of new HIV diagnoses among North West residents over the 5-year period 2020 to 2024 by ethnic group, and whether born in the UK or abroad. Amongst those born in the UK, White people represented the highest number of new HIV diagnoses, with 588 new diagnoses between 2020 and 2024. Amongst people born abroad, Black African people had the highest number of new HIV diagnoses, with 272 diagnoses between 2020 and 2024.

Figure 14. New HIV diagnoses in gay and bisexual men by whether born abroad, North West residents, 2015 to 2024 [note 2]

Source: UKHSA, HANDD.

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission. Those with a prior diagnosis abroad are excluded.

Note 2: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 14 is a line chart displaying trend lines of the number of new HIV diagnoses in the North West among gay and bisexual men by whether they were born abroad, in the UK, or where country of birth is unknown over a 10-year period (2015 to 2024). The number of new HIV diagnoses in gay and bisexual men were born in the UK decreased between 2015 and 2024, going from 227 in 2015 to 60 in 2024. The trend for number of new HIV diagnoses in gay and bisexual men born abroad and of unknown country of birth has remained stable over the past 10 years.

Figure 15. New HIV diagnoses in heterosexuals by whether born abroad, North West residents, 2015 to 2024 [note 2]

Source: UKHSA, HANDD.

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission. Those with a prior diagnosis abroad are excluded.

Note 2: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 15 is a line chart displaying trend lines of the number of new HIV diagnoses in heterosexuals for North West residents by whether they were born abroad, over the past 10 years (2015 to 2024). The number of new HIV diagnoses in heterosexuals born in the UK has decreased between 2015 and 2024, going from 63 in 2015 to 31 in 2024. Following a steady downward trend in the number of new HIV diagnoses in heterosexuals born abroad between 2015 and 2020, there has been an increasing trend between 2020 and 2023 (with 98 new HIV diagnosis), and slight decrease in 2024 (with 83 new HIV diagnosis). The trend for number of new HIV diagnoses in heterosexuals of unknown country of birth has been increasing since 2015, from 1 in 2015 to 19 in 2024.

Figure 16. People diagnosed with HIV before continuing care in England by probable route of exposure, North West residents, 2015 to 2024 [note 2]

Source: UKHSA, HANDD.

Note 1: The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note 2: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2024.

Figure 16 is a line chart displaying trend lines of the number of people diagnosed with HIV before continued care in England by probable route of exposure, among North West residents in the past 10 years (2015 to 2024). Four probable routes of exposure are shown: heterosexual women, heterosexual men, gay and bisexual men, and people who inject drugs. There is an increasing trend since 2015 in the number of new HIV diagnosis among heterosexual women and men previously diagnosed abroad, going from 17 and 12 new HIV diagnoses in 2015 to 100 and 66 in 2024, respectively. The trend has also been increasing since 2020 for gay and bisexual men, with 50 new diagnoses in 2024 compared to 31 in 2020. The number of new diagnoses among people who inject drugs first diagnosed abroad has remained consistently low in the past 10 years.

Figure 17. Percentage of new HIV diagnoses, by local authority of residence, that were diagnosed late, North West, aged 15 years and over, 2022 to 2024 [note 2]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD), HIV and AIDS Reporting System (HARS).

Note 1: The number contained within each bar indicates the number of cases.

Note 2: Only includes new diagnoses in those aged 15 years or older with no prior diagnosis abroad and for which a CD4 count was reported within 91 days of diagnosis; late diagnosis defined as CD4 count <350  cells/mm³. The underlying population will impact on the proportion diagnosed late, for example gay and bisexual men are less likely to be diagnosed late.

Figure 17 is a bar chart displaying the percentage of new HIV diagnoses that were diagnosed late by upper-tier local authority for the period 2022 to 2024. It shows that the highest percentage of late HIV diagnoses were in Knowsley and Blackburn with Darwen (80% and 60%, respectively), followed by Halton (55%), and Sefton (50%). The upper-tier local authorities with the lowest percentage of late diagnoses were Westmorland and Furness (10%), Bury (20%), and Tameside (25%). Across the entire North West, 40% of new HIV diagnoses were diagnosed late from 2022 to 2024.

Figure 18. Percentage and number of new HIV diagnoses by probable route of exposure that were diagnosed late, North West residents, aged 15 years and over, 2022 to 2024 [note]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD), HIV and AIDS Reporting System (HARS).

Note: Only includes new diagnoses in those aged 15 years or older with no prior diagnosis abroad and for which a CD4 count was reported within 91 days of diagnosis; late diagnosis defined as CD4 count <350  cells/mm³. Proportions are only shown for the gay and bisexual men, heterosexual men, heterosexual women, and injecting drug use exposure groups and are withheld for any of these categories if they contain fewer than 5 late diagnoses.

Figure 18 is a bar chart displaying the percentage of new HIV diagnoses that were diagnosed late by probable route of infection in the North West from 2022 to 2024. Four probable routes of infection are shown: gay and bisexual men, heterosexual men, heterosexual women and injecting drug use. It shows that the percentage of new HIV diagnoses that were diagnosed late is higher among those where the probable route of infection was heterosexual men (54%), in comparison to those where the probable route of infection is gay and bisexual men (30%). The difference in the proportion of late diagnoses was statistically significant between heterosexual men and gay and bisexual men.

Figure 19. Percentage and number of new HIV diagnoses by ethnic group that were diagnosed late, North West residents, aged 15 years and over, 2022 to 2024 [note]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD), HIV and AIDS Reporting System (HARS).

Note: Only includes new diagnoses in those aged 15 years or older with no prior diagnosis abroad and for which a CD4 count was reported within 91 days of diagnosis; late diagnosis defined as CD4 count <350  cells/mm³. Proportions are only shown for the White, Black African and Black Caribbean ethnic groups and are withheld for any of these ethnic group categories if they contain fewer than 5 late diagnoses. IPB means Indian/Pakistani/Bangladeshi.

Figure 19 is a bar chart displaying the percentage of new HIV diagnoses that were diagnosed late by ethnic group in the North West for the period 2022 to 2024. Three categories of ethnic group are displayed: White, Black African and Black Caribbean. It shows that the percentage of late new HIV diagnoses was higher among people who are Black African (44%) in comparison to people who are White (37%) or Black Caribbean. However, these differences are not statistically significant, and the number of new diagnoses in the Black Caribbean group is less than 5.

Figure 20. Percentage of new HIV diagnoses that were diagnosed late by probable route of exposure and year of first UK HIV diagnosis, North West residents, aged 15 years and over, 2015 to 2024 [note]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD), HIV and AIDS Reporting System (HARS).

Note: Only includes new diagnoses in those aged 15 years or older with no prior diagnosis abroad and for which a CD4 count was reported within 91 days of diagnosis; late diagnosis defined as CD4 count <350  cells/mm³.

Figure 20 is a line chart displaying trend lines of the percentage of new HIV diagnoses that were diagnosed late by probable route of infection in the North West for the 10-year period 2015 to 2024. Three categories of probable route of infection are displayed: gay and bisexual men, heterosexual sex and other exposure route. The percentage of new HIV diagnoses that were diagnosed late where heterosexual sex was the probable route of infection decreased (44% in 2015, 12% in 2024). The percentage of late new HIV diagnoses with a probable route of infection of gay and bisexual men has remained similar since 2015, going from 23% in 2015 to 24% in 2024. The percentage of new late HIV diagnoses among those with other probable infection routes has fluctuated greatly due to the small overall number of people in that category.

Figure 21. Percentage of new HIV diagnoses that were diagnosed late in gay and bisexual men and heterosexuals by whether born abroad, North West residents, aged 15 years and over, 2022 to 2024 [note]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD), HIV and AIDS Reporting System (HARS).

Note: Only includes new diagnoses in those aged 15 years or older with no prior diagnosis abroad and for which a CD4 count was reported within 91 days of diagnosis; late diagnosis defined as CD4 count <350  cells/mm³.

Figure 21 is a bar chart displaying the percentage of new HIV diagnoses that were diagnosed late in gay and bisexual men and heterosexuals by whether born abroad, among North West residents aged 15 and over, for the period 2022 to 2024. Among gay and bisexual men, 32% of those born in the UK were diagnosed late, compared to 25% of those born abroad. Among heterosexuals born abroad, 51% of new diagnoses were diagnosed late, compared to 40% for UK-born.

Figure 22. Age distribution of new HIV diagnoses that were diagnosed late by year of first HIV diagnosis, North West residents, aged 15 years and over, 2015 to 2024 [note]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD), HIV and AIDS Reporting System (HARS).

Note: Only includes new diagnoses in those aged 15 years or older with no prior diagnosis abroad and for which a CD4 count was reported within 91 days of diagnosis; late diagnosis defined as CD4 count <350  cells/mm³.

Figure 22 is a bar chart displaying trends of the percentage of late new HIV diagnoses by age group in the North West from 2015 to 2024. Five age groups are displayed: 15 to 24, 25 to 34, 35 to 44, 45 to 54, and 55 and older.

The 45 to 54 and 35 to 44 year old groups show a decreasing trend in the percentage of new diagnoses that were late between 2023 and 2024, with the age group 35 to 44 showing the biggest percentual decrease over this period.

Figure 23. Percentage of all new diagnoses that were late by age by year of first HIV diagnosis, North West residents, aged 15 years and over, 2015 to 2024 [note]

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD), HIV and AIDS Reporting System (HARS).

Note: Only includes new diagnoses in those aged 15 years or older with no prior diagnosis abroad and for which a CD4 count was reported within 91 days of diagnosis; late diagnosis defined as CD4 count <350  cells/mm³.

Figure 23 is a bar chart displaying trends of the percentage of late new HIV diagnoses for each age group in the North West from 2015 to 2024. Five age groups are displayed: 15 to 24, 25 to 34, 35 to 44, 45 to 54, and 55 and older.

The proportion of new diagnoses which were diagnosed late increases with increasing age. In the 15 to 24 and 55+ age groups, a decreasing trend in the percentage of new diagnoses that were diagnosed late was observed between 2020 and 2024. In the 35 to 44 and 45 to 54 age groups, the proportion of late new diagnoses decreased in 2024 compared to 2023.

Figure 24. Diagnosed HIV prevalence per 1,000 residents aged 15 to 59 years by UKHSA region, 2024

Source: UKHSA, HIV and AIDS Reporting System (HARS).

Figure 24 is a bar chart displaying the prevalence of diagnosed HIV in 2024 among people aged 15 to 59 by UKHSA region. It shows that the prevalence of HIV in the North West in 2024 was the second highest in England at 2.1 diagnoses per 1,000 residents aged 15 to 59.

The highest prevalence was found in London (5.0 diagnoses per 1,000 residents aged 15 to 59) while the lowest was found in the South West and North East (1.4 and 1.3 diagnoses per 1,000 residents aged 15 to 59, respectively).

Figure 25. Number of residents living with diagnosed HIV (all ages) and accessing care, the North West, 2015 to 2024

Source: UKHSA, HIV and AIDS Reporting System (HARS).

Figure 25 is a line chart displaying the trend in the number of North West residents living with diagnosed HIV and accessing care from 2015 to 2024. The number of people living with HIV and accessing care has steadily increased since 2015 reaching 11,514 persons in 2024.

Figure 26. Number of residents living with diagnosed HIV and accessing care by probable route of exposure (adjusted for missing route information), the North West, 2024

Source: UKHSA, HIV and AIDS Reporting System (HARS).

Figure 26 is a bar chart displaying the number of North West residents living with diagnosed HIV and accessing care in 2024 broken down by probable route of transmission. Five categories of probable route of transmission are shown: gay and bisexual men, heterosexual sex, vertical transmission, injecting drug use, and blood or healthcare worker. It shows that gay and bisexual men (5,933 diagnoses) and heterosexual sex (5,106 diagnoses) were the probable route of transmission for 52% and 44% of people living with diagnosed HIV respectively, more vertical transmission (213 diagnoses), injecting drug use (143 diagnoses), and blood/healthcare worker (119 diagnoses) combined (4%).

Figure 27. Percentage of all residents with diagnosed HIV who are accessing care, by age group contribution, the North West, 2015 and 2024

Source: UKHSA, HIV and AIDS Reporting System (HARS).

Figure 27 is a bar chart displaying the age distribution of North West residents with diagnosed HIV who accessed care in 2015 and 2024. Five age groups are displayed: younger than 15, 15 to 24, 25 to 34, 35 to 49, and 50 and older.

It shows that among people aged less than 50 years, the proportion living with diagnosed HIV and accessing care decreased in 2024, compared to 2015, whereas in those aged 50 years and above, it increased (from 28% to 47%, respectively).

Figure 28. Diagnosed HIV prevalence per 1,000 residents by ethnic group (all ages), the North West, 2024

Source: UKHSA, HIV and AIDS Reporting System (HARS).

Figure 28 is a bar chart displaying the prevalence of diagnosed HIV in the North West in 2024 by ethnic group. Six categories of ethnic group are shown: Black African, Black Caribbean, Black other/unspecified, Other/mixed, White, and Asian. The chart shows that diagnosed HIV prevalence is significantly higher among people who are Black African (24.9 diagnoses per 1,000 residents) in comparison to all other ethnic groups.

Figure 29. Diagnosed HIV prevalence per 1,000 population by Index of Multiple Deprivation decile, the North West, 2024

Source: UKHSA, HIV and AIDS Reporting System (HARS).

Figure 29 is a bar chart displaying the prevalence of HIV diagnoses per 1,000 North West residents in 2024 by index of multiple deprivation (IMD) decile (1 being the most deprived, 10 being the least deprived). It shows that the rate of HIV diagnoses consistently increases with increasing deprivation, going from 0.6 diagnoses per 1,000 residents in IMD 10 to 2.6 diagnoses per 1000 residents in IMD 1.

Figure 30. Diagnosed HIV prevalence per 1,000 residents aged 15 to 59 years by local authority, the North West, 2024

Source: UKHSA, HIV and AIDS Reporting System (HARS).

Figure 30 is a bar chart displaying diagnosed HIV prevalence per 1,000 residents aged 15 to 59 years in 2024 by North West local authority. It shows that diagnosed HIV prevalence per 1,000 residents was extremely high in Manchester (>5 per 1,000 population aged 15 to 59) and was high (2 to 5 per 1,000 population aged 15 to 59) in 9 other local authorities (Salford, Blackpool, Liverpool, Rochdale, Bury, Tameside, Bolton, Trafford and Oldham). In the other local authorities, diagnosed HIV prevalence was classed as low (<2 per 1,000 population aged 15 to 59). Across the North West, the prevalence of diagnosed HIV in 2024 was 2.1 per 1,000 residents.

Figure 31. Diagnosed HIV prevalence per 1,000 residents aged 15 to 59 years by local authority, the North West, 2024

Source: UKHSA, HIV and AIDS Reporting System (HARS).

Figure 31 is a map displaying diagnosed HIV prevalence per 1,000 residents aged 15 to 59 years in 2024 by North West local authority. It displays the same information as Figure 30.

Figure 32. Diagnosed HIV prevalence per 1,000 residents (all ages) by middle super outer area of residence the North West, 2024

Source: UKHSA, HIV and AIDS Reporting System (HARS).

Figure 32 is a map displaying the diagnosed HIV prevalence per 1,000 residents in 2024 by middle super output area.

Figure 33. HIV testing rate per 100,000 by population group, North West residents, 2020 to 2024 [note 2]

Source: UKHSA, GUMCAD.

Note 1: The proportion of eligible attendees at specialist sexual health services (SHS) who accepted a HIV test. An eligible attendee is defined as a patient attending specialist SHS at least once during a calendar year. Patients known to be HIV positive, or for whom a HIV test was not appropriate, or for whom the attendance was related to Sexual and Reproductive Health (SRH) care only, are excluded.

Note 2: ONS mid-2023 population estimates have been used to calculate HIV testing rates.

Figure 33 is a line chart displaying trend lines of the HIV testing rate per 100,000 by sex among North West residents between 2020 and 2024.Trends for the whole population, males, and females are displayed. Annual testing rates were virtually the same in males and females between 2020 and 2024. The testing rate has steadily increased since the COVID-19 pandemic in 2020.

Table 2. People tested for HIV by population group, North West residents attending all SHSs, 2020 to 2024

Gender/sexual orientation	2020	2021	2022	2023	2024	% change 2020 to 2024	% change 2023 to 2024
Heterosexual men	21,810	24,832	26,472	31,700	38,018	74%	20%
Gay and bisexual men	13,352	19,963	18,216	17,926	22,619	69%	26%
All men	37,906	47,619	46,588	51,708	63,535	68%	23%
Hetero/bisexual women	37,872	49,475	48,781	55,941	66,780	76%	19%
All women	42,550	54,238	51,473	59,110	71,213	67%	20%
Total	83,003	109,956	111,663	120,570	142,684	72%	18%

Source: UKHSA, GUMCAD.

Note: The totals for ‘All men’ and ‘All women’ include people tested from sexual orientation categories not shown in the table above.

Table 2 displays the number of people tested for HIV in the North West by population group and year (2020 to 2024). Six population groups are shown: heterosexual men, gay and bisexual men, all men, heterosexual and bisexual women, all women, and all genders. The percentage change in the number of people tested for HIV in each population group is shown for 2020 to 2024 and 2023 to 2024.

Between 2023 and 2024, there was an increase in testing across all population groups; the largest increase was seen in gay and bisexual men (26%). Testing was also higher in 2024 compared to 2020 for all groups, with the largest increase seen in heterosexual and bisexual women (76%).

Figure 34. HIV pre-exposure prophylaxis (PrEP) need and initiation or continuation in residents attending specialist sexual health services (SHSs), the North West, 2024

Source: UKHSA, GUMCAD.

Note: Figure 34 is a column chart showing information about PrEP need and use by gender and sexual orientation in 2024. The first column represents the percentage of North West residents attending specialist SHSs who were determined to be in need of PrEP based on clinical and other information. The second column shows the percentage of those in need of PrEP whose PrEP need was identified by the service, and the third column shows the percentage of those in need of PrEP for whom PrEP was initiated or continued. These 2 final columns for each group must be looked at in relation to the first column.

Figure 34 is a bar chart displaying the percentage of HIV PrEP need and initiation or continuation among residents attending specialist sexual health services (SHSs) in the North West in 2024 by population group. Three population groups are displayed: gay and bisexual men, heterosexual men, and heterosexual women.

Three categories of PrEP are displayed: PrEP need, PrEP need identified, and PrEP initiated or continued. ‘PrEP need’ represents the percentage of people attending SHSs who were at substantial HIV risk and could benefit from receiving PrEP. This assessment of risk is based on a combination of clinical codes reported through GUMCAD within the previous 12 months of each consultation including PrEP eligibility codes, and other clinical or behavioural markers known to indicate higher risk of HIV seroconversion in the year following an attendance. PrEP need is defined differently for different population groups. Further details are available in the PrEP monitoring and evaluation framework. ‘PrEP need identified’ represents the percentage of people in the ‘PrEP need’ category who had their need identified at a clinical consultation. ‘PrEP initiated or continued’ represents the percentage of people in the ‘PrEP need’ category who take PrEP (started or continued PrEP in 2024).

Information on data sources

HIV and AIDS New Diagnoses and Deaths (HANDD) collects information on new HIV diagnoses, AIDS at diagnosis and deaths among people diagnosed with HIV. Information is received from laboratories, specialist SHSs, GPs and other services where HIV testing takes place in England, Wales and Northern Ireland. The Recent Infection Testing Algorithm (RITA) and CD4 surveillance scheme are linked to HANDD to assess trends in recent and late diagnoses. Data is deduplicated across regions and therefore figures may differ from country-specific data.

The Survey of Prevalent HIV Infections Diagnosed (SOPHID) began in 1995 and was a cross-sectional survey of all adults living with diagnosed HIV infection who attend for HIV care in England, Wales and Northern Ireland. SOPHID collected information about the individual’s place of residence along with epidemiological data including clinical stage and antiretroviral therapy (ART). In 2015, SOPHID reporting in England was replaced by the HIV and AIDS Reporting System (HARS) which captures information at every attendance for HIV care.

Date of data extract: October 2024. Updates to HANDD and SOPHID/HARS made after this date will not be reflected in this report.

Confidence intervals for rates in the figures have been calculated to the 95% level using the Byar’s method; confidence intervals for percentages have been calculated to the 95% level using the Wilson Score method. Confidence intervals presented in the text are produced by Bayesian analysis.

The most recent ONS mid-year estimates at the time of analysis were used as denominators for rates. Unless otherwise stated, for UTLAs 2024 estimates were used (published June 2024), for MSOAs 2022 estimates were used (published Nov-2024), for LTLAs 2021 estimates were used (published Nov-2022), and for LSOAs 2022 estimates were used (published November 2024).

The data behind charts showing absolute numbers may have been adjusted for missing information; however, unless stated otherwise, the numbers in the summary section are the numbers as reported, that is unadjusted counts. Where charts are displaying adjusted data this is indicated in the chart title. Where figures have been ‘adjusted for missing information’, this means that when unknown values are present (for example route of probable exposure = ‘unknown’), they are proportionally distributed amongst other groups for the purposes of analysis (for example if A = 12, B = 4, C = 2, and unknown = 6, the 6 ‘unknown’ values are distributed proportionally among groups A, B, and C to give A = 15, B = 6, C = 3).

The denominators for all percentages exclude records for which information was unknown, that is the proportion of new diagnoses where probable route of exposure was gay and bisexual men would be calculated using new diagnoses for which route of exposure was known as the denominator.

All analyses in this report are residence-based and reflect the patient’s place of residence at diagnosis.

Numbers may change as more information becomes available to assign area of residence to cases and historical data is refreshed accordingly.

Further information

Access Sexual and Reproductive Health Profiles for further information on a whole range of sexual health indicators.

For more information on local sexual health data sources, access the UKHSA guide.

For the annual epidemiological spotlight on STIs in North West, 2024 data, access Sexually transmitted infections: North West data.

National HIV report: 2024 data

Local authorities have access to additional HIV and STI intelligence via the Data Exchange and the HIV and STI web portal. They should also have received a set of tables containing HIV data specific to their authority. They should contact fes.northwest@ukhsa.gov.uk if they do not have access to this information.

About the Field Service

The Field Service was established in 2018 as a national service comprising geographically dispersed multi-disciplinary teams integrating expertise in Field Epidemiology, Real-time Syndromic Surveillance and Public Health Microbiology to strengthen the surveillance, intelligence and response functions of UKHSA.

You can contact your local FS team at FES.NorthWest@ukhsa.gov.uk

If you have any comments or feedback regarding this report or the Field Service, contact FES.NorthWest@ukhsa.gov.uk

Acknowledgements

We would like to thank:

• local sexual health and HIV clinics for supplying the HIV data
• the Institute of Child Health
• UKHSA Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division (BSHSH) for collection, analysis and distribution of data

References

1. Brown Alison E, Shah Ammi, Martin Veronique, Chau Cuong, Djuretic Tamara. ‘People diagnosed with HIV before continuing care in England are extremely unlikely to pass on HIV in England’ HIV Medicine 2025: volume 26, issue 10, pages 1,626 to 1,627.
2. Shah Ammi, Mackay Neil, Kitt Hannah, Harrison Catriona, Okumu-Camerra Kadeen, Ratna Natasha and others. ‘HIV testing, PrEP, new HIV diagnoses and care outcomes for people accessing HIV services: 2025 report’ Annual official statistics data release (data to end of December 2024)