The London Regional Office of the Communicable Disease Surveillance Centre (CDSC) has stated that all patients diagnosed with tuberculosis (TB) should be offered an HIV test.¹ We sought to implement this by introducing a programme within two central London hospitals with high rates of TB, where TB specialist nurses saw all patients early in their treatment course and discussed HIV testing. A standard protocol was used which covered the reasons for offering a test, the “pros and cons” of testing, and the actual process involved (including how the results would be given). Staff training and support was supplied by local HIV psychologists. Pretest discussion took an average of 10–15 minutes per patient and was usually performed within the first month of treatment.

Between July 2002 and July 2003 there were 247 …