Any Lewisham resident joining a doctors' surgery may have to opt out of an HIV test, with primary care testing for the virus halving late diagnoses rates.

HIV can be treated with medication and have minimal side-effects if caught early on, but is a life-threatening condition if caught late.

In Lewisham, 8.36 per 1,000 people have HIV – higher than the London average of 5.69 and significantly higher than the England average of 2.3.

Lambeth has the highest rates of HIV per population, with 14.6 per 1,000 people living with the virus.

Lewisham Council’s director of public health Dr Danny Ruta said the rates of late diagnoses for HIV in the borough had halved in the last 10 years, with tests for those coming into A&E and other primary care services a factor behind the decrease.

“The proportion of people of a late diagnoses with HIV has come down dramatically, it’s one of the big international success stories with people all over the world coming to see what on earth we do,” he said.

“There is talk of every patient who registers with a GP having an HIV test and there being an opt-out,” he added.

The success of primary care HIV tests could be extended to include anyone joining a doctors’ surgery, he explained.

Money donated to the borough from the Elton John Aids Foundation could go a long way to improving early diagnoses of the virus.

“The Elton John Aids Foundation has just given £2m to Southwark and Lewisham and Lambeth to improve early diagnoses. If it was proportionate to the health need we should get at least a quarter of a million [to] really ramp up testing in primary care,” he said.

Dr Ruta said it was difficult to break through stigma to access those who most needed information around HIV prevention.

“Late diagnoses of HIV matters because its a minor long-term condition, you can almost not know you have HIV any more,” he said.

“As long as you keep taking the medication for life, it is almost an undetectable virus. If you catch it late it is still a life threatening condition,” he said.

“Getting that message across as well when you consider the stigma of HIV – we have done really well.”