Monitoring and audit

Public Health Scotland publishes the annual HIV in Scotland report (annual) including data on HIV testing, new diagnoses of HIV, demographics and late diagnoses. The Sexual health and blood borne virus action plan: 2023 to 2026, data monitoring plan, published in June 2025, outlines the developments undertaken to further enhance reporting. 

From April 2026, Scotland moved from manual to automated data collection, via the NaSH HIV module, in use or under implementation in all HIV clinical services across Scotland. All cases of late diagnosis (that is with a CD4 count <350/mm3, including very late diagnosis, where CD4 count<200/mm3) are reviewed locally supported by the National Late Diagnosis Protocol agreed in 2018. Where indicated, local reviews include discussions with primary and secondary care services regarding potential missed opportunities for HIV diagnosis. Local DATIX and adverse event reporting systems may also be employed where significant harm or risk of harm is identified. Collection of information on late diagnosis is now incorporated in the NaSH HIV module and modifications to include the recording of missed opportunities for testing in all new diagnoses are in development to further improve monitoring. 

SHPN HIV Clinical Leads initiated a bi-annual National Late Diagnosis and Mortality Multidisciplinary Team Meeting in 2025 to identify common themes and to share learning from cases in which significant harm due to late diagnosis has occurred. This supports local teams to take forward actions to support improvements in testing. 

Planned revisions to the Sexual health and blood borne virus action plan: 2023 to 2026, data monitoring plan include the development of metrics to monitor indicator condition testing rates, to include the percentage of people with an HIV indicator condition tested for HIV (by prioritised condition and setting). The revised plan is due for publication in June 2026. 

This will require linkage of laboratory data from Scotland's NHS HIV specialist testing laboratories to multiple other databases held at PHS and will be a complex undertaking. 

To support indicator testing in sexually transmitted infections (STIs) and other blood borne viruses (BBVs), a programme management approach will be pursued, supported by data improvements to record the percentage of people tested for HIV by individual STI in Sexual and Reproductive Healthcare (SRH) services. Testing, where indicated, in the other speciality areas of SRH such as Long-Acting Reversible Contraception (LARC) and Abortion Care will be included and monitored. 

Local audits of testing rates by service and by indicator condition have been undertaken in secondary care services across Scotland. In the future, the aim is that data improvements will support and simplify the process of routine monitoring of testing rates by condition across boards and allow audits by indication and by setting, including in primary care.