December 1st is World AIDS Day. Our latest research highlights how community-driven initiatives and policy innovation are reshaping the fight against HIV – while global funding cuts threaten hard-won progress.
Emergency Departments: Expanding testing access through opt-out testing
A national initiative is now embedding opt-out HIV, hepatitis B, and hepatitis C testing into emergency departments across England. This approach:
- Identifies undiagnosed cases among patients who may not seek routine testing
- Connects individuals to care quickly
- Supports the UK’s goal of ending new HIV and hepatitis C cases by 2030
By integrating testing into high-traffic healthcare settings, this strategy ensures broader reach and earlier. Our research has helped optimise the implementation of the programme.
Global setback: US funding cuts threaten HIV prevention in Africa
In contrast to local innovation, a new study warns that US funding cuts to HIV pre-exposure prophylaxis (PrEP) programs in sub-Saharan Africa could lead to:
- 7,000 additional HIV infections in one year
- Over 10,000 new cases over five years
The cuts, which halted support for nearly 700,000 people in early 2025, jeopardise global efforts to curb HIV and underscore the need for sustained international investment.
Pharmacies as HIV Prevention Hubs
Our researchers have designed and implemented a pharmacy PrEP delivery pilot to improve HIV prevention. PrEP (pre-exposure prophylaxis), is medicine that prevents acquiring HIV through sex or injecting drugs. In England, PrEP is provided free via NHS sexual health clinics, but these can feel stigmatising, hard to access and limited in capacity. Our recent policy briefing highlights the potential for community pharmacies to play a key role in ending new HIV transmissions. The research suggests pharmacies could:
- Offer HIV testing and PrEP access
- Reach underserved populations
- Provide stigma-free, accessible care
Expanding pharmacy roles could accelerate progress toward the UK’s goal of zero new HIV transmissions by 2030.
Co-production Toolkit: A guide to developing equitable health services
Common Ambition Bristol (CAB), a major co-produced project co-led by African and Caribbean heritage communities. CAB has been working for the past four years to tackle health inequities and reduce HIV transmission in Bristol, by co-producing outreach, health promotion events and community clinics. CAB launched a Co-producing health and care services toolkit, developed with our University of Bristol researchers and community members. The toolkit offers practical guidance for service providers on:
- Sharing power and decision-making
- Improving communication and collaboration
- Embedding feedback and evaluation
- Aiming to reduce health disparities for minoritised communities
Barbershops and trust: Breaking barriers in HIV testing
In Bristol, a groundbreaking initiative is using barbershops as trusted community spaces to promote HIV testing among African and Caribbean men. The project, part of the Common Ambition Bristol (CAB) program, trained barbers to talk about sexual health and offer rapid HIV tests in their shops. This approach:
- Builds trust in familiar, culturally resonant spaces
- Reduces stigma around HIV testing
- Improves access for groups historically underserved by traditional health services
The success of this model shows how community-led efforts can dismantle barriers to care and foster more inclusive health systems.
Test early, treat equitably, end HIV
The UK government has set an ambitious target: to end new cases of HIV and hepatitis C in England by 2030 and ensure that everyone who tests positive receives the care they need.
Achieving this goal will depend on expanding access to early testing, prompt diagnosis, and effective treatment. Research shows that trusted community spaces, inclusive service design, and policy innovation all play a role in reaching underserved populations and reducing transmission. As these approaches continue to evolve, they offer valuable insights for shaping a more equitable and responsive healthcare system.
Professor Jeremy Horwood, NIHR HPRU EBS Theme lead and researcher from University of Bristol, NIHR ARC West and Centre for Academic Primary Care said:
“Ending new HIV transmissions by 2030 will require bold policy action and sustained investment. Our research demonstrates co-producing services with African and Caribbean heritage communities can break down barriers and building trust, integrating testing into emergency departments can make care accessible, and expanding PrEP access through pharmacies can transform prevention. These innovations show what’s possible when evidence informs policy and why global funding must keep pace with ambition.”
