Background/introduction South East London has the UK highest rates of heterosexual HIV acquisition and also significant numbers of HIV positive MSM. Our current uptake of HIV testing is 84%. Risk assessment is the subject of the current BASHH national audit.

Aim(s)/objectives Trying to achieve highest possible uptake of HIV testing by GUM attenders we examined a group of new male attenders who refused HIV tests looking at their risk and reasons for refusal.

Methods A review of clinic notes of 50 consecutive male patients who refused an HIV test at first ever clinic visit comparing to the preceding new male patient accepting an HIV test.

ResultsOf 5 MSM refusing HIV test all had a reason documented 4 reporting recent test and 1 very recent exposure; only 21/45 (47%) heterosexual men had documented reason for refusal.

Discussion MSM in our centre who decline HIV testing are more likely to report recent/ever testing and around 40% of all new attendees report a previous HIV test. It is of concern that patients who refuse testing have higher rate of STI diagnoses increasing their likelihood of HIV acquisition. The outcome of this audit is to re-visit our documentation of reasons for declining HIV testing and re-inforce strategies to improve uptake in this group