Dr Philippa Matthews, Clinical Lead for HIV, sexual and reproductive health for the Royal College of GPs, said: "Treatments for HIV now ensure that it is possible to live a long and healthy life with the infection. Yet, around a quarter of people with HIV in the UK are undiagnosed, so do not have access to this life-saving treatment.

"We welcome the emphasis in today's NICE guidance on using appropriate opportunities to offer tests to patients, with an emphasis on additional approaches in areas of high and extremely high prevalence rates of HIV. This is something that the College supports, and is promoting through our new programme, which aims to develop and support a range of strategies for increasing HIV testing in primary care.

"However, as the guidelines acknowledge, 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.

"Furthermore, there are sensitivities that GPs need to take into account when offering HIV tests to patients who are usually visiting the GP for reasons not connected with HIV; a conversation that is difficult within the frustrating constraints of the standard 10-minute consultation. Despite this, many doctors and nurses in high prevalence areas are doing an incredible job at integrating HIV testing into relevant routine care.

"It is important that we do what we can to increase HIV testing in primary care - this is a priority for the RCGP. These NICE guidelines will support and encourage this, but they starkly highlight the need for a national approach, one which reflects these prevalence groups and both funds and requires Local Authorities to act.

"The College is engaged in a range of activities to support GPs and our teams to deliver improved diagnosis and the best possible care for HIV patients. The tools and resources included in the NICE guidelines on how to put them into practice will be useful."