Liverpool Hospitals to introduce ‘Opt-Out’ HIV testing

Liverpool’s fight against blood-borne viruses is taking a huge step forward.

Opt-out Testing for HIV, Hepatitis B, and Hepatitis C is being introduced to Accident and Emergency (A&E) departments at Aintree University Hospital and the Royal Liverpool University Hospital.

This initiative ensures that all patients undergoing routine blood tests in A&E are automatically screened for these viruses unless they choose to opt out.

This expansion aims to increase testing rates, identify undiagnosed cases, and address health inequalities by reaching individuals who may not realise they are at risk.

Opt-out testing will help identify those living with undiagnosed HIV, Hepatitis B, or Hepatitis C in Liverpool, supporting early diagnosis and access to life-saving treatment.

While there is no cure for HIV, early diagnosis combined with highly effective treatment allows individuals to live a normal life span. Furthermore, effective HIV treatment ensures that people cannot pass the virus to others, a concept known as U=U (Undetectable = Untransmittable).

Resources allocated through this initiative will also support vital counselling and peer support services to guide newly diagnosed individuals into appropriate care and treatment pathways.

This innovative approach normalises testing for blood-borne viruses as part of routine health care and offers an opportunity to re-engage individuals who have previously been diagnosed but are not currently in care. By including all patients, opt-out testing helps reduce inequities in access and addresses barriers for those who may not perceive themselves to be at risk.

Liverpool will be among the first cities in the UK to implement this testing in A&E, following successful pilots in London, Brighton, Birmingham, and Manchester. These pilots identified nearly 1,000 cases of HIV and over 3,000 cases of Hepatitis B and C in just 18 months.

This initiative builds on Liverpool’s track record of innovation in sexual health care. Advances in STI testing and treatment have enabled many patients in the city to receive their results and start treatment within hours. Additionally, online testing services and rapid laboratory results have expanded access to care.

Liverpool continues to make significant progress towards achieving zero new HIV transmissions by 2030. As a ‘Fast Track City,’ part of a global network committed to ending HIV and AIDS, Liverpool has reduced the number of undiagnosed cases from 115 four years ago to an estimated 45–50 today. The expansion of opt-out testing will further support efforts to locate and support those individuals.

Councillor Harry Doyle, Cabinet Member for Culture, Health, and Wellbeing, said:

“Access to testing is crucial, providing a vital opportunity for people to know their status and stay healthy. This initiative ensures those who might not see themselves as at risk can still benefit from testing and, if necessary, receive support. Alongside this, sexual health services and online testing options remain available to everyone.”

Professor Matthew Ashton, Director of Public Health at Liverpool City Council, said:

“Liverpool has a proud history of delivering bold public health interventions, and we are once again at the forefront of innovation with this initiative. Opt-out blood-borne viruses testing in A&E departments will help reduce inequalities and ensure more people know their status, receive the support they need, and stay healthy. Unique approaches like this are essential if we are to achieve zero new HIV transmissions by 2030 and empower our local population.”

Dr Jim Gardner, Group Chief Medical Officer at NHS University Hospitals of Liverpool Group, which runs both Aintree University Hospital and Royal Liverpool University Hospital, said: 

“Through making the screening of these blood-borne viruses a part of routine care in our emergency departments, it means that we can stop the stigma that’s often associated and reduce health inequalities for our local communities. Not only can we support patients with access to the care they need, but through this initiative we can now potentially save someone’s life who would have previously remained undiagnosed.”

Dr Paul Hine, HIV Clinical Lead at NHS University Hospitals of Liverpool Group, and Key Opinion Lead for Fast Track Cities, said:

“Introducing opt out HIV testing is a great step forward for the people of Liverpool. Earlier diagnosis of HIV saves lives. HIV is fully treatable, so having a diagnosis will help ensure people get treatment that can enable them to live healthy and happy lives. With effective treatment, people with HIV can’t pass it on. This initiative will also help us to get back in touch with people who may have previously been diagnosed with HIV but who are not being seen for care.”

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