In 2009, around 86,500 people in the UK had HIV infection, of whom around a quarter were unaware of their condition.1 Of adults diagnosed in that year, around half were already at a late stage of disease (with a CD4 count below 350 cells/μL or presenting with an AIDS-defining event).1–3 Such late diagnosis represents a missed opportunity for treatment and prevention, and is associated with significant morbidity and mortality, reduced response to antiretroviral drugs and increased healthcare costs.4–6 In genitourinary medicine (GUM) clinics and during antenatal care, there is a high uptake rate of routine testing (i.e. HIV tests are offered as part of standard care and the individual has the option to decline).7 Increasing such testing across other healthcare settings could reduce late diagnosis. Here we examine issues around routine HIV testing.
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