Research and analysis

Annual epidemiological spotlight on HIV in Yorkshire and Humber: 2023 data

Updated 17 September 2025

Applies to England

Summary

In 2023 there has been a change in the epidemiology and burden of human immunodeficiency virus (HIV). Compared to 2022, the number of newly diagnosed cases previously diagnosed abroad has increased. This has contributed to an increase in the number of new diagnoses in those who are older, heterosexual, female and Black African. This changing epidemiology is reflected both in Yorkshire and Humber and across England as a whole (1). A significant rise in the number of new HIV diagnoses can be seen across England, with evidence of widening inequalities, and larger increases in ethnic minority groups (1).

HIV remains an important public health problem in Yorkshire and Humber. There were 512 new HIV diagnoses in 2023, an increase of 72% compared to 2022. The rate per 100,000 increased from 5 in 2022 to 9 in 2023, giving Yorkshire and Humber the fifth  highest rate of new HIV diagnoses outside of London in 2023. Despite the increases in case numbers in the region, this is an improvement compared to 2022 when Yorkshire and Humber had the highest rate outside of London.

Across the local authorities in Yorkshire and Humber, Leeds reported the highest rate of new HIV diagnoses (16 per 100,000), followed by Barnsley (14 per 100,000), Sheffield (14 per 100,000) and Doncaster (11 per 100,000) which all reported rates above the regional average (9 per 100,000). The rate per 100,000 has increased in Barnsley and Doncaster compared to 2022 when they were both below the regional average. The rate of HIV per 100,000 remains highest in those in the most deprived deciles and lowest in the least deprived.

The number of people receiving an HIV test in England at sexual health services (SHS) continues to recover with an 8% increase compared to 2022, though this remains 4% lower than pre-pandemic levels. In Yorkshire and Humber 76,695 people were tested across all SHS, which represents an increase of 3% compared to 2022, though this is still a 7% decrease from 2019. The number of tests at specialist SHS per 100,000 population has increased in both genders, with a larger increase in males. All testing data should be interpreted with caution as online tests are not included in this count.

70% of new cases in Yorkshire and Humber were in people of Black African ethnicity in 2023, an increase from 48% in 2022. Heterosexual contact accounted for the majority of new diagnoses (78%). 44% of new diagnoses in Yorkshire and Humber were diagnosed late in the period from 2021 to 2023, similar to the England percentage of 43%. Heterosexuals and people of white ethnicity were more likely to be diagnosed late in Yorkshire and Humber.

89% of those newly diagnosed in Yorkshire and Humber started treatment within 91 days. Of those people who were HIV negative and recognised as having a pre-exposure prophylaxis (PrEP) need, 68% initiated or continued with PrEP.

Consistent use of PrEP can be an 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 important to HIV prevention.

New diagnoses

In 2023, 512 Yorkshire and Humber residents were newly diagnosed with HIV, accounting for 9% of new diagnoses in England. This represents a rise of 72% from 2022. Nationally, such a rise has also been observed. These regional and national increases are largely driven by rises in HIV in those previously diagnosed abroad. In those not previously diagnosed abroad, the numbers remain stable. New diagnosis rate for Yorkshire and Humber residents (9 per 100,000) was below that of England in 2023 (10 per 100,000). Whilst this is an increase for Yorkshire and Humber compared to 2022 (5 per 100,000), this is less of an increase than other regions have seen. In 2023, Yorkshire and Humber had the sixth highest rate of new diagnoses compared to the second highest in 2022.

Amongst local authorities in Yorkshire and Humber in 2023, Leeds had the highest rate of 16 per 100,000, which was the same as 2022. Barnsley had the second highest rate at 14 per 100,000, which is more than double the rate in 2022 (5 per 100,000). Sheffield and Doncaster also had rates above the regional average (16 and 11 per 100,000 respectively).

In 2023, 16% of all new diagnoses in Yorkshire and Humber residents were in gay, bisexual and other men who have sex with men (GBMSM), compared with 29% in 2022 and 49% in 2014. This proportional drop is due to the increase in HIV in those previously diagnosed abroad. The number of GBMSM resident in Yorkshire and Humber newly diagnosed with HIV (83, adjusted for missing information) was slightly lower than 2022 and 53% lower than in 2014. Of the GBMSM newly diagnosed with HIV 38% were White and 28% were UK-born.

As the proportion of HIV in Yorkshire and Humber in GBMSM has fallen, the proportion of cases likely acquired through heterosexual contact has risen. In 2023, heterosexual contact accounted for 78% of new diagnoses in Yorkshire and Humber residents. Of these, 88% were in people born in Africa (309) with most of these cases being in those were previously diagnosed abroad (239). Black Africans represented 70% of all newly diagnosed Yorkshire and Humber residents in 2023 (compared to 48% in 2022 and 28% in 2014). A small proportion of new diagnoses in 2023 were in Black Caribbeans (less than 1%). Infections in UK born persons accounted for just 6% of all heterosexually acquired cases in 2023.

Injecting drug use continues to account for a small fraction of new diagnoses in Yorkshire and Humber residents, just 2% in 2023.

The number of new diagnoses was highest in the 35 to 44 year age group in both males and females in 2023. This is a change from 2022, when the largest number new diagnoses in males was in the 25 to 34 year age group. The was also an increase in the number of new diagnoses in females in the 35 to 44 year age group, from 55 in 2022 to 128 in 2023. The increase in the age of new diagnoses is likely due to the increase in new diagnoses in people previously diagnosed abroad.

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. A late HIV diagnosis is defined as having a CD4 count below 350 cells per cubic millimeter (mm³) of blood within 91 days of diagnosis and no evidence of a recent infection (2). 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 Yorkshire and Humber residents with HIV are diagnosed late, 44% over the period 2021 to 2023, although this is marginally lower than for England (43%). It is also of note that in 2023 the percentage of new diagnoses who are diagnosed late has decreased across all probable routes of infection, when removing those previously diagnosed abroad. Amongst the local authorities there is significant variation in the percentage diagnosed late, with East Riding of Yorkshire having the highest percentage at 83% diagnosed late to North East Lincolnshire at the lowest with 20% diagnosed late.

Heterosexuals were more likely to be diagnosed late (44% of males, 39% of females) than GBMSM (39%). There is little variation in the proportion of late diagnoses by ethnic group, although Black Africans were slightly less likely to be diagnosed late than those of White ethnicity (43% and 48% respectively).

People living with diagnosed HIV

The 6,450 people living with diagnosed HIV in Yorkshire and Humber in 2023 was 8% higher than in 2022 and 47% higher than in 2014. 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 Yorkshire and Humber in 2023 was 2 per 1,000 residents aged 15 to 59 years. This was equal to the 2 per 1,000 observed in England as a whole (small differences may be hidden by rounding). Amongst the other regions, Yorkshire had the third lowest rate per 1,000 with only the South West (1) and North East (1) having a lower prevalence. Two local authorities in Yorkshire and Humber had a diagnosed HIV prevalence in excess of 2 per 1,000 population aged 15 to 59 in 2023, which is the threshold for expanded HIV testing. They were Leeds (3) and Sheffield (2).

The 2 most common probable routes of transmission for Yorkshire and Humber residents living with diagnosed HIV in 2023 were sex between men and women (60%) and sex between men (36%).

In 2023, 41% of those living with diagnosed HIV in Yorkshire and Humber were aged between 35 and 49 years, and 46% were aged 50 years and over (up from 25% in 2014). Males represented 60% of Yorkshire and Humber residents living with diagnosed HIV in 2023 and females represented 40%.

In 2023, 48% of Yorkshire and Humber residents living with diagnosed HIV were White and 41% 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 (33 per 1,000) than in the White population (1 per 1,000).

Continuum of HIV care

In England, excluding London in 2023, 99% of HIV diagnosed residents were receiving antiretroviral treatment. Of these, 98% were virally suppressed (viral load of less than 200) and were very unlikely to pass on HIV, even if having sex without condoms (untransmissible virus). This compares to 98% in England as a whole receiving ART and 98% of these virally suppressed.

For Yorkshire and Humber residents, the proportion starting treatment within 91 days of diagnosis for the period 2021 to 2023 was 89%. This compares to 84% for England.

People living with undiagnosed HIV

In 2023, it is estimated that 5% (Credible Interval (CrI) 4% to 7%) of people living with HIV in England, excluding London were undiagnosed. This equates to an estimated 3,407 (CrI 2,627 to 4,787) undiagnosed people.

It is estimated that 1,100 GBMSM in England, outside London, are undiagnosed (CrI 600 to 2,100) and 2,200 heterosexuals (CrI 1,700 to 3,200), including 1,200 Black Africans. In England, outside London, the proportion undiagnosed varied by exposure group with the highest proportion undiagnosed among people living with HIV who inject drugs (9%, CrI 2% to 20%), non Black African heterosexual women (7%, 5% to 11%), and Black African heterosexual men (7%, 5% to 11%).

HIV testing

A total of 51,175 people were tested in specialist sexual health services (SSHSs, excludes non-specialist and online) in Yorkshire and Humber in 2023, a decrease of 32% since 2019 and an increase of 12% since 2022. The HIV testing rate (per 100,000 population) at all sexual health services (SHSs, includes specialist and non-specialist and online) in Yorkshire and Humber was 1,657, which is lower than the England rate of 2,771. The testing rate in Yorkshire and Humber was the lowest of all regions in England. HIV testing rates in all SHSs in Yorkshire and Humber is higher in men (1,627) than women (1,572).

PrEP

In 2023, 8% of HIV-negative Yorkshire and Humber residents accessing SHSs in England were defined as having a PrEP need, among whom 68% initiated or continued PrEP. Of those with PrEP need, 89% had this need identified at a clinical consultation. Among GBMSM, the group with greatest need, 74% were identified as having a PrEP need, of whom 90% were identified at a clinical consultation. 72% of those with a PrEP need initiated or continued PrEP. 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 important to HIV prevention.

HIV in England

The 2021 HIV Action Plan for England (3) sets an ambition to reduce HIV transmission by 80% between 2019 and 2025. The HIV Action Plan monitoring and evaluation framework report published in November 2024 further summarises progress made towards the ambitions of the HIV Action Plan (2). Although considerable progress has been made, it is unlikely that the 2025 interim ambitions will be met. 

The number of people first diagnosed with HIV in England has risen by 15% in 2023 and there is further evidence of widening inequalities (1). Most of the increase in HIV diagnoses between 2022 and 2023 in England was among adults exposed through sex between men and women living outside London (increase of 51% among men exposed through sex with women and 44% among women exposed through sex with men). For both GBMSM and heterosexual adults, the 2023 rise has disproportionately affected ethnic minority groups. Further provision of services that are culturally competent and accessible to diverse populations is needed. 

Overall testing rates increased substantially since 2022 in England but have not fully recovered to those observed in 2019 for some demographic groups (1). The increasing levels of testing and fall in positivity over the past 5 years may be suggestive of an overall fall in HIV transmission in GBMSM, but not a continued reduction. The rise in HIV testing together with a higher and sustained positivity in Black African heterosexuals may be suggestive of ongoing transmission. However, this number is likely affected by changing patterns of migration with a recent rise in people diagnosed with HIV abroad arriving in England. 

In England in 2023, for the first time, over half of all HIV diagnoses were among those previously diagnosed abroad. Most of those previously diagnosed with HIV abroad have evidence of existing treatment in the form of viral suppression within a month of their England presentation and are rapidly linked to care following presentation in England, ensuring good clinical outcomes and prevention of onward transmission. Services need resilience to ensure appropriate and accessible capacity for recently arrived populations. 

Migration patterns for the UK support this observed shift in the HIV burden in England. However, although immigration into the UK increased sharply following the COVID-19 pandemic, provisional estimates for July 2022 to June 2023 show a slowing of immigration during this period (4). Most people arriving in the UK for the period July 2022 to June 2023 were non-EU nationals, mainly migrants coming for work, largely using health and care visas (4). 

The implementation of an NHS England funded programme of emergency departments (ED) opt-out testing for bloodborne viruses in April 2022 has contributed to the increase in HIV diagnoses in 20232. The increase in HIV diagnoses seen in 2023 is only partially due to the increase in testing effort due to ED opt-out testing. This is particularly apparent outside of London, where there was a 21% increase in diagnoses after adjustment for ED opt-out testing (2). 

Access to PrEP has been increasing on an annual basis since 2020. However, inequalities in access remain with unmet needs by specific exposure groups. 

The rising number of late diagnoses, particularly among Black African populations demonstrates an urgent need to improve access to testing and the full implementation of HIV testing guidelines. 

For those diagnosed and linked to services, HIV care remains excellent with 98% of people with diagnosed HIV being treated and 98% of people on treatment virally suppressed (1). People seen for HIV care are ageing, with over half aged 50 years and over in 2023 compared to 10 years ago. This highlights the need for joined up health and social care services to meet the needs of the ageing population. 

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 those testing HIV negative, while a positive result leads to essential HIV care and treatment, 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. GBMSM should have tests for HIV and STIs annually, or every 3 months if having condomless sex with new or casual partners.  

HIV pre-exposure prophylaxis (PrEP) is available for free from specialist SHS 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 SHS, awareness, accessibility and uptake of primary prevention initiatives is variable for different population groups (1). 

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 SHS and most emergency departments. 

Symptoms due to HIV and acquired immune deficiency syndrome (AIDS) 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 infection 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 (5). Reducing stigma in healthcare services will encourage people from seeking the healthcare services they need.  

Specialist SHS 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. For more information and advice visit the NHS page on Sexual health services or call 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 the following areas from the national HIV Action plan monitoring and evaluation framework.

Implementation and monitoring of the British HIV Association (BHIVA), British Association for Sexual Health and HIV (BASHH) and British Infection Association (BIA) Adult HIV testing guidelines 2020, including opt-out in sexual health services, subject to agreed support mechanisms for implementation.

Continuation of ED opt-out testing in very high and high prevalence HIV areas (subject to results of the final evaluation of the programme due in October 2025).

Scaling up community testing focusing on those groups that are more likely to benefit from HIV testing in these settings such as ethnic minority populations.

Understanding reasons behind the decline of HIV testing in women.

Scaling up of partner notification activities.

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

Reducing inequalities in access and uptake to PrEP through implementation of the PrEP roadmap.

Charts, tables and maps

Figure 1. Rate of new HIV diagnoses per 100,000 population (all ages) by UKHSA region of residence, 2023

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

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

Figure 1 shows that London reported the highest rate of new HIV diagnoses per 100,000 population in 2023. Yorkshire and Humber reported the sixth highest rate (17.2 and 9.2 respectively).

Figure 2. Rate of new HIV diagnoses per 100,000 population (all ages) by upper tier local authority of residence, Yorkshire and Humber residents, 2023

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

The number of new diagnoses will depend on accessibility of testing as well as infection and transmission. 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 that the colour coding does not relate to new diagnosis but to the data in the diagnosed prevalence section later.

Figure 2 shows that Leeds reported the highest rate of new HIV diagnoses (16 per 100,000) in 2023 and Barnsley and Sheffield reported the second and third highest (both 14 per 100,000). The regional rate was 9.2 per 100,000.

Figure 3. New HIV diagnoses and deaths, Yorkshire and Humber, 2014 to 2023 [note 1]

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

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: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Figure 3 shows that between 2014 and 2023 the number of new HIV diagnoses has increased from 366 in 2014 to 512 in 2023. There was a decreasing trend from 2014 to 2020, which was followed by an increase from 2020 to 2023. The number of deaths between 2014 and 2023 has also increased from 39 to 61. The number of deaths began to rise after 2018, however this coincides with improved ascertainment of death as a result of the National HIV Mortality Review.

It is however important to note that an extended reporting delay may be seen for deaths as these are not always notified directly to the HIV surveillance system. In addition, region of death may not be established immediately.

Figure 4. New HIV diagnoses by whether a person had been previously diagnosed abroad, Yorkshire and Humber, 2019 to 2023

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).
The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Figure 4 shows that between 2019 and 2023 the number of new HIV diagnoses previously diagnosed abroad has increased, particularly between 2022 and 2023. The number of new HIV diagnoses not previously diagnosed abroad has remained stable.

Figure 5a. New HIV diagnoses by probable route of acquiring HIV (adjusted for missing route information), Yorkshire and Humber residents, 2014 to 2023

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

NPDA means not previously diagnosed abroad.

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

Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Figure 5a shows that between 2014 and 2023 the number of new HIV diagnoses with a probable infection routes of sex between men and women and other infection routes increased from 167 to 400 and 21 to 29 respectively. All other probable routes of infection decreased.

Figure 5b. New HIV diagnoses detailed ‘other’ route of acquiring HIV (not adjusted for missing information), Yorkshire and Humber residents, 2014 to 2023

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).
The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Figure 5b shows the detailed breakdown for other routes of probable infection shows low numbers for each type of probable route, with 7 new diagnoses from intravenous drug use and other and 18 new diagnoses from mother-to-child.

Figure 6a. Number of new HIV diagnoses by age group and gender, Yorkshire and Humber residents, 2023

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

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

Figure 6a shows that of the new HIV diagnoses reported in 2023 in Yorkshire and Humber residents, the highest number of new diagnoses was reported in females. The largest number of new HIV diagnoses were reported in the females aged 35 to 44 group (128 diagnoses), the males aged 35 to 44 group (80 diagnoses), and the females aged 25 to 34 group (72 diagnoses). Data for less than 15s was not included due to the development of a new surveillance system.

Figure 6b. Number of new HIV diagnoses by age group and gender, split by whether first diagnosed in the UK or abroad, Yorkshire and Humber residents, 2023

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

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

Figure 6b shows that the number of new HIV diagnoses reported in Yorkshire and Humber in 2023 was highest in those previously diagnosed abroad. The largest number of new HIV diagnoses were reported in females aged 35 to 44 previously diagnosed abroad (106).

Figure 6c. Number of new HIV diagnoses by age group and probable route of acquiring HIV, male Yorkshire and Humber residents aged 15 to 64 years, 2023

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

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

Figure 6c shows that the majority of new HIV diagnoses in those whose probable route of infection is through sex between men are in the 25 to 34 year age group (32 diagnoses), followed by the 35 to 44 year age group (23 diagnoses). This contrasts against those with all other routes of infection, where the majority of cases are in the 35 to 44 year age group (47 diagnoses) followed by the 45 to 54 year age group (35 diagnoses).

Figure 7a. Number of new HIV diagnoses probably acquired through sex between men by age group and year of first UK HIV diagnosis, Yorkshire and Humber residents aged 15 to 64 years, 2014 to 2023

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).
The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Figure 7a shows that between 2014 and 2023 the number of new HIV diagnoses probably acquired through sex between men has decreased in every age group.

Figure 7b. Number of new HIV diagnoses probably acquired through sex between men and women by age group (in years) and year of first UK HIV diagnosis, Yorkshire and Humber residents aged 15 to 64 years, 2014 to 2023

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

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

Note: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Figure 7b shows that between 2014 and 2023 the number of new HIV diagnoses probably acquired through sex between men and women has increased in every age group except the 15 to 24 age group which has decreased. The largest increase is seen in the 35 to 44 age group which was 56 in 2014 and is 163 in 2023.

Figure 8. Number of new HIV diagnoses by ethnic group (adjusted for missing ethnic group information), Yorkshire and Humber residents, 2014 to 2023

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

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

Note: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Figure 8 shows that the number of new HIV diagnoses has increased in the Black African, Black African (NPDA) and other ethnic groups between 2014 and 2023. The number of new HIV diagnoses have stayed consistent or decreased in every other ethnic group.

Figure 9. Number of new HIV diagnoses by world region of birth (adjusted for missing world region of birth information), Yorkshire and Humber residents, 2014 to 2023

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

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

Note: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Figure 9 shows that between 2014 and 2023, the number of new HIV diagnoses by region of birth has increased in the categories of those born in Africa and those born in all other countries. The number of new HIV diagnoses in people born in the UK has decreased since 2014

Table 1. Number of new HIV diagnoses by ethnic group and whether born abroad, Yorkshire and Humber residents, 2019 to 2023

Ethnic group	UK-born	Born abroad	Unknown country of birth
White	260	69	32
Black African	2	205	10
Black Caribbean	5	5	1
Other	26	68	6
Unknown	9	22	81

Source: UKHSA, HIV and AIDS New Diagnoses and Deaths (HANDD).
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 2019 to 2023. 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.

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

Note: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Table 1 shows that between 2019 and 2023, in Yorkshire and Humber, the highest number of new HIV diagnoses in the UK-born population was in those of white ethnicity (260).  Of those born abroad, the majority were of Black African ethnicity (205).

Figure 10a. New HIV diagnoses in GBMSM not previously diagnosed abroad by whether born abroad, Yorkshire and Humber residents, 2014 to 2023

Source: UKHSA, HANDD.
The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Figure 10a shows that between 2014 and 2023, the number of new HIV diagnoses in GBMSM not previously diagnosed abroad has decreased steadily in those that are UK-born, with a sharper drop from 2022. In those born abroad the number of new HIV diagnoses remains stable.

Figure 10b. New HIV diagnoses in heterosexuals not previously diagnosed abroad by whether born abroad, Yorkshire and Humber residents, 2014 to 2023

Source: UKHSA, HANDD.
The number of new diagnoses will depend on accessibility of testing as well as infection and transmission.

Note: Numbers may rise as further reports are received and more information is obtained. This is more likely to affect more recent years, particularly 2023.

Figure 10b shows that the number of new HIV diagnoses in heterosexuals born abroad but not previously diagnosed abroad decreased 2014 to 2020, but has been followed by a sharp increase from 2020 to 2023. Amongst UK-born heterosexuals not previously diagnosed abroad, there has been a steady decrease in the number of new diagnoses from 2014 to 2023.

Figure 11. Percentage of new HIV diagnoses, by local authority of residence, that were diagnosed late, Yorkshire and Humber, aged 15 years and over, 2021 to 2023

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 of less than 350 cells per mm³. The underlying population will impact on the proportion diagnosed late, for example GBMSM are less likely to be diagnosed late.

Figure 11 shows that East Riding of Yorkshire was the local authority which reported the highest percentage of late HIV diagnoses, followed by Barnsley and Kingston upon Hull (83%, 64% and 62% respectively).

Figure 12a. Percentage and number of new HIV diagnoses by probable route of infection that were diagnosed late, Yorkshire and Humber residents, aged 15 years and over, 2021 to 2023

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 of less than 350 cells per mm³. Proportions are only shown for the sex between men, heterosexual contact (males), heterosexual contact (females) and injecting drug use exposure groups and are withheld for any of these categories if they contain fewer than 5 late diagnoses.

Figure 12a shows that amongst those aged 15 years and over who were not previously diagnosed abroad, the percentage of new HIV diagnoses that were diagnosed late was highest amongst injection drug users (70%), between 2021 and 2023.

Figure 12b. Percentage and number of new HIV diagnoses by ethnic group that were diagnosed late, Yorkshire and Humber residents, aged 15 years and over, 2021 to 2023

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 of less than 350 cells per 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 or Bangladeshi.

Figure 12b shows that amongst those aged 15 years and over, between 2021 and 2023 the percentage of new HIV diagnoses not previously diagnosed abroad that were diagnosed late was highest amongst people of white ethnicity (48%).

Figure 13. Percentage of new HIV diagnoses that were diagnosed late by probable route of infection and year of first UK HIV diagnosis, Yorkshire and Humber residents, aged 15 years and over, 2014 to 2023

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 of less than 350 cells per mm³.

Figure 13 shows that in 2023, 62% of people with a new HIV infection from other infection routes were diagnosed late. Between 2014 and 2023 the percentage of new HIV infections acquired through sex between men and women, which were diagnosed late, decreased from 56% to 34%.  The percentage of new HIV infections acquired through sex between men, which were diagnosed late has increased from 24% to 27%.

Figure 14. Percentage of new HIV diagnoses that were diagnosed late in GBMSM and heterosexuals by whether born abroad, Yorkshire and Humber residents, aged 15 years and over, 2021 to 2023

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 of less than 350 cells per mm³.

Figure 14 shows that amongst GBMSM diagnosed in 2021 to2023 with no prior diagnosis abroad, the percentage of new HIV diagnoses that were diagnosed late in Yorkshire and Humber is higher in those born in the UK (40%), than those born abroad (38%). Amongst heterosexuals, the percentage of new HIV diagnoses that were diagnosed late in Yorkshire and Humber is higher in those born abroad (41%) than born in the UK (40%).

Figure 15. Age distribution of new HIV diagnoses that were diagnosed late by year of first UK HIV diagnosis, Yorkshire and Humber residents, aged 15 years and over, 2014 to 2023

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 of less than 350 cells per mm³.

Figure 15 shows that in 2023, the majority of new diagnoses that were diagnosed late (with no previous diagnosis abroad) were in the 35 to 44 age group. The percentage of 25 to 34-year-olds that were diagnosed late has decreased compared to previous years.

Figure 16. Diagnosed HIV prevalence per 1,000 residents aged 15 to 59 years by UKHSA region, 2023

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

Figure 16 shows that HIV prevalence (per 1,000 residents) is highest in London (5.2), followed by North West (2.1) and West Midlands (2.0). Yorkshire and Humber reports the third lowest HIV prevalence at 1.7 per 1,000.

Figure 17. Number of residents living with diagnosed HIV and accessing care, Yorkshire and Humber, 2014 to 2023

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

Figure 17 shows that in Yorkshire and Humber the number of residents living with diagnosed HIV and accessing care has increased from 4,391 in 2014 to 6,450 in 2024.

Figure 18. Number of residents living with diagnosed HIV and accessing care by probable route of transmission (adjusted for missing route information), Yorkshire and Humber, 2023

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

Figure 18 shows that the number of residents living with diagnosed HIV and accessing care in Yorkshire and Humber, using data from 2023, is highest amongst those who have sex between men and women (3,859), and lowest amongst those whose likely transmission route was via blood or healthcare worker (63).

Figure 19. Percentage of residents with diagnosed HIV who are accessing care in each age group, Yorkshire and Humber, 2014 and 2023

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

Figure 19 shows that between 2014 and 2023 the percentage of those diagnosed with HIV and accessing care has decreased in all age groups, apart from for those who are aged 50 years and over. Amongst this age group it has increased from 25% to 46%.

Figure 20. Diagnosed HIV prevalence per 1,000 residents by ethnic group (all ages), Yorkshire and Humber, 2023

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

Figure 20 shows that in Yorkshire and Humber in 2023, people of Black African ethnicity have the highest prevalence of HIV (32.9 per 1,000). Prevalence in all other ethnicities is below 5.0 per 1,000.

Figure 21. Rate of HIV diagnoses per 1,000 population by Index of Multiple Deprivation decile, Yorkshire and Humber, 2023

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

Figure 21 shows that in 2023, HIV prevalence is highest in the Index of Multiple Deprivation decile 1 (the most deprived 10%) (2.2 per 1,000) and decreases as deprivation decreases.

Figure 22. Diagnosed HIV prevalence per 1,000 residents aged 15 to 59 years by local authority, Yorkshire and Humber, 2023

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

Figure 22 shows that in 2023, HIV prevalence (per 1,000 residents) amongst those aged 15 to 59 in Yorkshire and Humber is highest in Leeds, followed by Sheffield and Barnsley.

Figure 23. Diagnosed HIV prevalence per 1,000 residents aged 15 to 59 years by local authority, Yorkshire and Humber, 2023

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

Figure 23 shows that in 2023, HIV prevalence (per 1,000 residents) amongst those aged 15 to 59 in Yorkshire and Humber is highest in Leeds with all other local authorities reporting lower rates.

Figure 24. Diagnosed HIV prevalence per 1,000 residents (all ages) by middle super outer area of residence Yorkshire and Humber, 2023

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

Figure 24 shows that in 2023, HIV prevalence (per 1,000 residents) amongst those aged 15 to 59 in Yorkshire and Humber is highest across a variety of middle super output areas including many in Leeds and Sheffield.

Figure 25. The continuum of HIV care, 2023

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

Figure 25 shows that in England, excluding London, surpassed the UNAIDS 90:90:90 target for HIV care in 2023, with 95% of individuals diagnosed with HIV knowing their infection status and of these 93% were on treatment and 91% had viral suppression.

Figure 26. HIV testing rate per 100,000 by population group, Yorkshire and Humber residents, 2019 to 2023

Source: UKHSA, GUMCAD.

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.

Figure 26 shows that in HIV testing rate per 100,000 population in Yorkshire and Humber residents in 2023 is higher in males than females (1,627 and 1,572 respectively). Testing rates overall are slightly below, but similar to 2019 rates (1,657 in 2023 and 1,692 in 2019).

Table 2. People tested for HIV by population group, Yorkshire and Humber residents attending all SHSs, 2019 to 2023

Gender/sexual orientation	2019	2020	2021	2022	2023	% change
2019 to 2023	% change
2022 to 2023
Heterosexual men	27,998	15,900	16,709	18,963	19,974	-29%	5%
GBMSM	6,618	6,854	10,222	10,996	10,363	57%	-6%
Subtotal (men)	38,305	24,632	28,990	33,311	34,721	-9%	4%
Hetero/bisexual women	39,219	28,221	32,620	34,384	34,610	-12%	1%
WOSW	306	424	647	563	448	46%	-20%
Subtotal (women)	43,338	30,707	35,448	38,163	39,314	-9%	3%
Total (all genders)	82,066	55,700	65,371	74,325	76,695	-7%	3%

Source: UKHSA, GUMCAD.

Table 2 shows that in 2023 in Yorkshire and Humber, across all SHSs 76,695 people were tested for HIV, this is a 3% increase compared to 2022 and a 7% decrease compared to 2019. Between 2022 and 2023 the number of people tested for HIV decreased in the GBMSM and WOSW populations but increased in all others.

Figure 27. HIV pre-exposure prophylaxis (PrEP) need and initiation or continuation in residents attending specialist sexual health services (SHSs), Yorkshire and Humber, 2023

Source: UKHSA, GUMCAD.

Figure 27 is a column chart showing information about PrEP need and use by gender and sexual orientation in 2023. The first column represents the percentage of Yorkshire and Humber 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 27 shows that in Yorkshire and Humber in 2023, 74% of GBMSM attending specialist SHSs were determined to be in need of PrEP, of those 90% were identified by the clinic of whom 72% initiated or continued treatment. Heterosexual or bisexual women had the lowest PrEP need at less than 1%. 100% of WOSW with a PrEP need were identified at SHSs.

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 and 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. For UTLAs 2023 estimates were used (published Jun 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 Nov 2024).

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, meaning 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 infection = ‘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, meaning the proportion of new diagnoses where probable route of infection was sex between men would be calculated using new diagnoses for which route of infection 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

For more information on a whole range of sexual health indicators visit Sexual and Reproductive Health Profiles.

For more information on local sexual health data sources visit Sexual health, reproductive health and HIV in England: a guide to local and national data

Annual epidemiological spotlight on STIs in Yorkshire and Humber: 2023 data

National HIV report: 2023 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 YHREU@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 YHFS@ukhsa.gov.uk.

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

Acknowledgements

We would like to thank the following:

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

References

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2. Schoemig V, Martin V, Shah A, Okumu-Camerra K, Mackay N, Bera S, Kitt H, Kelly C, Kolawole T, Ratna N, Chau C, Duretić T, Brown A and contributors HIV Action Plan monitoring and evaluation framework 2024 report: Report summarising progress from 2019 to 2023 November 2024, UK Health Security Agency, London

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5. Office for National Statistics (ONS), ONS website, statistical bulletin Long-term international migration, provisional: year ending June 2023, 23 November 2023