Universal testing for HIV should be introduced in areas of the country with the highest rates of the disease, the UK's public health agency says.
The move would reduce the number of people infected with HIV who do not know they have it – estimated to be more than 20,000 – and speed treatment for those diagnosed late, the Health Protection Agency (HPA) said.
Latest figures show about 91,500 people in the UK were living with the disease in 2010, with a quarter of those unaware they had it. Of the 6,600 newly diagnosed in 2010, half were identified after drug treatment should have started. One in five people visiting a sexually transmitted disease clinic refused the offer of an HIV test. The HPA says universal testing in high-prevalence areas would normalise the process.
Every new patient who registers with a GP or is admitted to hospital in the areas with the highest prevalence of HIV should be offered an HIV test, the agency says. The move was recommended by the National Institute for Clinical Excellence (Nice) in March.
There are 38 areas with high prevalence of the infection – 27 in London and the rest in areas such as Brighton and Manchester.
Valerie Delpech, head of HIV surveillance at the HPA, said: "We want to see increased access to testing. Research has shown it is feasible to undertake and acceptable to patients. It will help reduce the number of people unaware of their HIV status and increase the chances of early diagnosis, when treatment is more successful."
Among the 680 people with HIV who died in 2010, two-thirds were diagnosed late, she said. The HPA's annual HIV in the UK report found infections acquired within the UK almost doubled in the past decade from 1,950 in 2001 to 3,640 in 2010.
Gay men are at greatest risk. Last year, more than 3,000 were diagnosed with HIV – the highest annual number. One in 20 gay men are now infected nationally and one in 11 in London.
Deborah Jack, chief executive of the National Aids Trust, said: "The number of people who don't know they have HIV is a serious issue. People shouldn't be scared of testing, but they should be of undiagnosed HIV.
"The advances in treatment have been one of the biggest success stories since the virus first emerged, but too many people test too late."
Sir Nick Partridge, chief executive of the Terrence Higgins Trust, said: "HIV rates remain dangerously high – to reduce them we all have to take responsibility for our sexual health."
The number of UK HIV sufferers. One in four is unaware they have it