The countries of the European Union (EU) have committed to achieving the global UNAIDS targets and the United Nations’ Sustainable Development Goal (SDG) 3.3 (1,2–4). These goals aim to significantly reduce new infections, expand access to prevention tools such as pre-exposure prophylaxis (PrEP) and ensure equitable access to testing and care, particularly in key populations. Many countries aim to achieve zero new HIV transmissions by 2030, often defined by a 95% reduction in transmissions since 2010 (5). Despite these efforts, approximately 25,000 new HIV diagnoses occur each year in the EU/EEA (1,6), and more than 50% of these diagnoses are considered late stage (CD4 count < 350) (6,7). We used an HIV transmission model to estimate the number of new HIV infections 2025-2030 if current intervention levels stay the same. We also estimate the short- and long-term economic consequences of these new infections.

In 2019, the previous UK government set the ambitious target of eliminating HIV transmission within England by 2030 with the current government affirming their commitment to the goal in their 2024 manifesto and commissioning a new HIV action plan in England (1,2). While great progress has been made in HIV prevention and treatment in England, with England reaching the UNAIDS 95-95-95 target in 2023 (3), past evidence suggested that the goal of ‘elimination’ by 2030 is unlikely to be met for Gay, Bisexual, and other Men who have Sex with Men (GBMSM) if prevention interventions remain at current levels (4–6). No research has been done to evaluate this question for other groups, such as women. We expand on previous modelling work by analysing transmissions for other groups (GBMSM, heterosexual men, women, and people who inject drugs) and using more recent data to capture England’s increased prevention intervention efforts, including expanding the use of PrEP and introducing ED opt-out HIV screening in high-prevalence areas. Additionally, we assessed the impact on Black African heterosexual men and women as subgroups. This work was commissioned and funded by Gilead Sciences. The work was carried out independently by Aquarius Population Health.