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A target to eliminate Human Immuno-deficiency Virus (HIV) transmission inEngland by 2030 was set in early 2019. Estimates of recent trends in HIVprevalence, particularly the number of people living with undiagnosed HIV, byexposure group, ethnicity, gender, age group and region, are essential tomonitor progress towards elimination. A Bayesian synthesis of evidence frommultiple surveillance, demographic and survey datasets relevant to HIV inEngland is employed to estimate trends in: the number of people living with HIV(PLWH); the proportion of these people unaware of their HIV infection; and thecorresponding prevalence of undiagnosed HIV. All estimates are stratified byexposure group, ethnicity, gender, age group (15-34, 35-44, 45-59, 60-74),region (London, outside London) and year (2012-2017). The total number of PLWHaged 15-74 in England increased from 82,400 (95% credible interval, CrI, 78,700to 89,100) in 2012 to 89,500 (95% CrI 87,400 to 93,300) in 2017. The proportiondiagnosed steadily increased from 84% (95% CrI 77 to 88%) to 92% (95% CrI 89 to94%) over the same time period, corresponding to a halving in the number ofundiagnosed infections from 13,500 (95% CrI 9,800 to 20,200) to 6,900 (95% CrI4,900 to 10,700). This decrease is equivalent to a halving in prevalence ofundiagnosed infection and is reflected in all sub-groups of gay, bisexual andother men who have sex with men and most sub-groups of black Africanheterosexuals. However, decreases were not detected for some sub-groups ofother ethnicity heterosexuals, particularly outside London. In 2016, the JointUnited Nations Programme on HIV/ AIDS target of diagnosing 90% of people livingwith HIV was reached in England. To achieve HIV elimination by 2030, currenttesting efforts should be enhanced to address the numbers of heterosexualsliving with undiagnosed HIV, especially outside London.

Implications for HIV elimination by 2030 of recent trends in undiagnosed infection in England: an evidence synthesis