Executive summary:
• HIV is now a treatable medical condition and the majority of those living with the virus remain fit and well on treatment.
• Despite this a significant number of people in the United Kingdom are unaware of their HIV infection and remain at risk to their own health and of passing their virus unwittingly on to others.
• Late diagnosis is the most important factor associated with HIV-related morbidity and mortality in the UK.
• Patients should therefore be offered and encouraged to accept HIV testing in a wider range of settings than is currently the case.
• Patients with specific indicator conditions should be routinely recommended to have an HIV test.
• All doctors, nurses and midwives should be able to obtain informed consent for an HIV test in the same way that they currently do for any other medical investigation.

Who should be offered a test?
Universal HIV testing is recommended in all of the following settings:
1. GUM or sexual health clinics
2. antenatal services
3. termination of pregnancy services
4. drug dependency programmes
5. healthcare services for those diagnosed with tuberculosis, hepatitis B, hepatitis C and lymphoma.

HIV testing should be also routinely offered and recommended to the following patients:
1. all patients presenting for healthcare where HIV, including primary HIV infection, enters the differential diagnosis (see table of indicator diseases and section on primary HIV infection)
2. all patients diagnosed with a sexually transmitted infection
3. all sexual partners of men and women known to be HIV positive
4. all men who have disclosed sexual contact with other men
5. all female sexual contacts of men who have sex with men
6. all patients reporting a history of injecting drug use
7. all men and women known to be from a country of high HIV prevalence (>1%*)
8. all men and women who report sexual contact abroad or in the UK with individuals from countries of high HIV prevalence.