England has committed to eliminating HIV transmission by 20301. Although significant progress has been made in reducing new HIV diagnoses, existing evidence suggests increased investment in prevention efforts is required to meet the elimination target2,3.
Pre-exposure prophylaxis (PrEP) is widely available through sexual health services in England: In 2024, 111,000 individuals accessed PrEP in sexual health services (SHS), the majority of whom are gay, bisexual and other men who have sex with men (GBMSM). However, the scale of additional PrEP uptake required to achieve the HIV Commission’s elimination goals has not previously been quantified across different population groups3.
What we did
We used a validated cohort model to estimate annual new HIV transmissions in England between 2026 and 2030 across four population groups: gay, bisexual and other men who have sex with men (GBMSM), heterosexual men, women, and people who inject drugs2.
The modelling approach estimated:
- Current projected HIV transmission trajectories if existing prevention levels remain unchanged.
- Target transmission trajectories required to meet the 2030 HIV elimination goals.
- The number of HIV transmissions that would need to be prevented to reach the goal.
- The additional number of people who would need to receive PrEP to avert these infections.
We assumed 70% of new PrEP users receive daily oral and 30% long-acting injectables, and incorporated variation in baseline incidence and PrEP adherence by population group. Other prevention interventions (e.g. HIV testing) were held constant at baseline levels (2023).
Key findings
We found that approximately 3,100 HIV transmissions would need to be prevented between 2026 and 2030 for England to meet its HIV transmission elimination goals.
To achieve this reduction through expanded PrEP use alone, we estimated that around 60,500 additional people would need to receive PrEP during this period.
The estimated additional number of people requiring PrEP varied across population groups: heterosexual men (29,400), women (26,700), GBMSM (2,400), and people who inject drugs (2,000).
Implications
Our findings indicate that expanding access to HIV prevention services, particularly for heterosexuals at risk of HIV acquisition, is necessary to achieve England’s 2030 HIV transmission elimination ambitions. Expanding outreach outside of sexual health services is vital to reach those with an unmet need.
Our estimates do not present the complete population that could benefit from PrEP. Recent evidence estimated ~389,000 individuals have an unmet PrEP need in England. Unmet need was highest among heterosexual women and men4, many of whom do not access sexual health services.
While our analyses focus on PrEP, investment in a combination of prevention strategies is essential to reach the goal. The analysis further highlights that the UK Health Security Agency’s HIV transmission elimination goals are currently under review, and future changes to these targets could influence the estimated level of intervention required.
Read the full poster here.
This work was commissioned and funded by Gilead Sciences and carried out independently by Aquarius Population Health.
Citation: Bates L, McGreevy A. Estimating the number of individuals who need to receive PrEP to meet England’s 2030 HIV transmission elimination goals. Poster presentation. Aquarius Population Health, London, UK. 2026. Available here: https://aquariusph.com/portfolio/prep-to-meet-2030-hiv-elimination-goals-england/
To learn more about our work in HIV prevention, public health modelling and population health strategy, please visit our website or email us at info@aquariusph.com.
References:
- Build an NHS fit for the future. The Labour Party [Internet]. [cited 2026 Mar 2]. Available from: https://labour.org.uk/change/build-an-nhs-fit-for-the-future/
- How can England achieve HIV transmission elimination? Modelling the impact of current HIV prevention efforts on progress towards the 2030 elimination goal. Aquarius Population Health [Internet]. [cited 2026 Mar 2]. Available from: https://aquariusph.com/reports/howcan-england-achieve-hiv-transmission-elimination-modelling-the-impact-of-current-hivprevention-efforts-on-progress-towards-the-2030-elimination-goal/
- GOV.UK [Internet]. [cited 2026 Mar 2]. HIV testing, PrEP, new HIV diagnoses and care outcomes for people accessing HIV services: 2025 report. Available from: https://www.gov.uk/government/statistics/hiv-annual-data-tables/hiv-testing-prep-new-hivdiagnoses-and-care-outcomes-for-people-accessing-hiv-services-2025-report
- Huntington SE, Bates L, Coukan F, Adams EJ. Estimating the number of people who could benefit from HIV pre-exposure prophylaxis (PrEP) in England and the unmet need. Sex Transm Infect. 2025 Nov 17;101(8):506–12. doi:10.1136/sextrans-2024-056456 PubMed PMID: 40619164; PubMed Central PMCID: PMC12703335