HIV Action Plan monitoring and evaluation framework 2022 report: accessible text description of the flowcharts
Updated 1 December 2023
Applies to England
Figure 1. Overview of the HIV themes
Identifying and addressing inequalities throughout all 5 themes
Theme 1. Maintain people’s negative HIV status
For intermediate outcomes
- prevent those who test negative from acquiring HIV
- increase access or use of PrEP
- prevent HIV acquisition among those who do not test
Long-term outcome: 2025 HIV Action Plan
80% reduction in the number of people first diagnosed in England.
Long-term outcome: 2030 UNAIDS targets
Zero new HIV transmissions.
Theme 2. Reduce number of people living with HIV who are undiagnosed
For intermediate outcome
- increase number of people tested
Long-term outcome A: 2025 HIV Action Plan
80% reduction in the number of people first diagnosed in England.
Long-term outcome A: 2030 UNAIDS targets
Zero new HIV transmissions.
Long-term outcomes B: 2025 HIV Action Plan
50% reduction in the number of people diagnosed with AIDS within 3 months of HIV diagnosis.
50% reduction in deaths from HIV or AIDS.
Long-term outcome B: 2030 UNAIDS targets
Zero AIDS-related deaths.
Theme 3. Reduce number of people with transmissible levels of virus
For intermediate outcomes
- minimise time from diagnosis to treatment and care
- achieve undetectable virus rapidly in people recently diagnosed
- maintain undetectable virus in people living with diagnosed HIV
- maintain people on treatment
Long-term outcome: 2025 HIV Action Plan
80% reduction in the number of people first diagnosed in England.
Long-term outcome: 2030 UNAIDS targets
Zero new HIV transmissions.
Theme 4. Manage and prevent co-morbidities and HIV-related conditions in people living with HIV
For intermediate outcome
- maintain people on treatment
Long-term outcome: 2025 HIV Action Plan
50% reduction in deaths from HIV or AIDS.
Long-term outcome: 2030 UNAIDS targets
Zero AIDS-related deaths.
Theme 5. Improve quality of life and reduce stigma
Long-term outcome: 2025 HIV Action Plan
Improve quality of life and address stigma.
Long-term outcome: 2030 UNAIDS targets
Zero discrimination.
Figure 8. Flowchart for theme 1: maintain people’s HIV status negative
Theme 1. Maintain people’s negative HIV status
For intermediate outcomes
1. Increase effectiveness of partner notification.
Leads to Theme 1 directly and via:
- increased access to combination prevention
2. Identify missed opportunities for prevention.
Leads to Theme 1 via:
- increased access to combination prevention
3. Increased number of people eligible for PrEP and people receiving PrEP.
Leads to Theme 1 via:
- increased access to combination prevention
- keep negative people who did not test
- keep people who tested negative
4. Increase number of condoms, needle exchange
5. Increase number of eligible people receiving PEP
6. Improve people’s risk perception
All lead to Theme 1 via:
- increased access to combination prevention
7. Increase awareness in clinicians and the general public (in particular U=U).
Leads to increased access to combination prevention via:
- improved people’s risk perception (intermediate outcome 6)
8. Reduce number of people living with undiagnosed HIV (Theme 2).
Leads to Theme 1 directly.
Figure 9. Flowchart for theme 2: reduce the number of people living with undiagnosed HIV
Theme 2. Reduce the number of people living with HIV who are undiagnosed
For intermediate outcomes
1. Identify missed opportunities for testing.
2. Understand reasons for not offering tests to eligible attendees.
3. Ensure implementation of testing guidelines.
All lead to Theme 2 via:
- increased number of eligible people offered a test
- increased number of people tested
4. Understand barriers to accepting testing.
Leads to Theme 2 via:
- increased uptake of offer of a test
- increased number of people tested
5. Increase number of people tested more than once per year (high risk population).
Leads to Theme 2 via:
- increased frequency of testing
- increased number of people tested
6. Increased effectiveness of partner notification.
Leads to Theme 2 directly.
7. Maintain people’s HIV status negative (Theme 1).
Leads to Theme 2 directly.
8. Reduce the number of people living with transmissible levels of virus (Theme 3).
Leads to Theme 2 directly.
Figure 12. Flowchart for theme 3: reduce the number of people with transmissible levels of virus
Theme 3. Reduce the number of people with transmissible levels of virus
For intermediate outcomes
1. Rapid transfer to care.
2. Increased number of people who start treatment promptly.
Lead to Theme 3 via:
- reduced time from diagnosis to treatment and care
- reduced time to undetectable viral load (VL) in people recently diagnosed
3. Increased number of people retained in care.
4. Improved access to mental health, substance misuse, psychosocial and peer support.
5. Improved quality of life.
6. Increased number of people re-engaged in care.
Lead to Theme 3 via:
- increased number of people on effective treatment
- reduced number of people living with diagnosed HIV who have a detectable VL
Figure 15. Flowchart for theme 4: manage and prevent co-morbidities and HIV related conditions in people living with HIV
Theme 4. Manage and prevent co-morbidities and HIV-related conditions in people living with HIV
For intermediate outcome
1. Improved care and care coordination for people living with HIV.
Directly leads to Theme 4.
Figure 16. Flowchart for theme 5: reduce stigma
Theme 5. Reduce stigma
For intermediate outcomes
1. Improving knowledge, behaviour and attitudes of general population.
Leads to Theme 5 via:
- reduced experienced stigma in community
2. Improving knowledge, behaviour and attitudes of healthcare workers.
Leads to Theme 5 via:
- reduced experienced stigma in healthcare settings
3. Ensuring fair and equitable access to HIV testing and prevention.
4. Ensuring fair and equitable access to HIV care.
5. Ensuring fair and equitable access to other healthcare and health-related services (for example mental health support).
Lead to Theme 5 via:
• reduced inequalities