Background In 2011 there were 6,280 new HIV diagnoses in the UK, of which 47% were diagnosed late (CD4 cell count 2/1,000 adult population. We evaluated compliance with BHIVA-guidelines on HIV testing outside of STI and antenatal settings.

Methods We carried out a systematic review searching MEDLINE, EMBASE and conference abstracts using variations of “HIV”, “testing” and “UK” to identify relevant studies, and used meta-analysis to calculate an overall HIV testing prevalence.

Results Thirty-three UK studies measuring HIV testing in BHIVA-guideline recommended settings were identified. Overall, 37.9% of eligible patients had HIV tests. Thirteen studies reported levels of HIV test offer and uptake: in 10 studies < 50% of eligible patients were offered a test; of those offered, uptake ranged from 47.9%–100%, with 11 reporting > 65% uptake. Twenty-one studies reported seropositivity (range: 0.0%–11.8%).

Conclusion There appears to be poor compliance with the 2008 BHIVA-guidelines for testing outside of STI and antenatal clinics. Over 60% of eligible patients remained untested. Test offer rates were lower than uptake, suggesting clinician-barriers may be stronger than patient-barriers to increasing testing. Greater clinician training in routine HIV testing and improved HIV testing surveillance in clinical settings may be required to further encourage increased HIV testing in the UK.