The National Institute for Health and Care Excellence is recommending that HIV testing is routinely offered to millions of people living in areas with a high prevalence of the disease.

Under new guidelines, in areas where HIV rates are considered extremely high up to 3.7 million people who attend routine appointments could be offered a test for the virus by their GP, so that those who are positive can be treated more quickly and the risk disease transmission reduced.

Hospital doctors should offer the tests even when patients come to see them with unrelated problems, across 20 local authority areas with the highest rates of HIV, while an additional 7.9 million people across 54 local authority areas where prevalence of the disease is high should also be offered testing if they are having blood taken for another reason or when they sign up with a new GP practice.

"It is easier than ever before to access testing for HIV, but with thousands living with undiagnosed HIV we know there is much more to do," said Professor Gillian Leng, deputy chief executive of NICE. "We want to normalise HIV testing so it isn't viewed any differently from any other blood test. There are now highly effective treatments for HIV and it should no longer be seen with fear or stigma."

"One in eight of those affected by HIV are unaware of their situation, and so testing is vital in stopping the spread of this disease," added chief medical officer Dame Sally Davies.

Also responding to the new guidelines, Dr Philippa Matthews, Clinical Lead for HIV, sexual and reproductive health at the Royal College of General Practitioners, said the College supports the emphasis on using appropriate opportunities to offer tests to patients, but also stressed that there are barriers for GP surgeries to offer wide-scale HIV testing.

"Funding for such initiatives is currently decided by local councils, and there is no uniformity across the country. There is also the issue of effective implementation - including training and support for practices to adopt these schemes".

"It is also the case that GPs and our teams are already under immense resource and workforce pressures making it incredibly difficult to implement any new programme, this is compounded by the lack of a clear national approach".

Despite the issues, increasing HIV testing in primary care is a priority for the RCGP. "These NICE guidelines will support and encourage this, but they starkly highlight the need for a national approach."