In the UK, an estimated 101 200 people are living with HIV, 13% of whom are unaware of their infection 1. The first national guidelines for HIV testing published in 2008 recommended the universal offer of an HIV test in health care services for persons diagnosed with hepatitis B and C 2. The latest National Institute for Health and Care Excellence (NICE) testing guidelines (released in December 2016) continue to recommend offering HIV tests to people with HIV indicator conditions, which include hepatitis B and hepatitis C, and in services treating people for hepatitis B and hepatitis C 3. Using the Sentinel Surveillance of Blood Borne Virus Testing (SSBBV), linked to the national HIV and AIDS Reporting System (HARS), we investigated the extent to which the guidelines are being followed. HIV testing information was extracted from the SSBBV for all adults (≥ 15 years old) with a first positive test between 2010 and 2014 for hepatitis C virus (HCV) antibodies, indicative of being ever infected, or for hepatitis B virus (HBV) surface antigen. Persons tested within the SSBBV were matched, using deterministic and probabilistic methodologies, to the HARS, and persons identified as diagnosed with HIV infection prior to their hepatitis diagnosis were excluded. Persons testing HBV positive in antenatal services were also excluded, as women are routinely tested for HIV and HBV as part of the antenatal screening programme. Among persons who tested positive for HCV (32 114), 38.7% (12 429) were tested for HIV on the same day as their HCV test, 6.7% (2158) were tested in the following 6 months, and 54.6% (17 527) had no record of an HIV test during the 6-month period following their positive HCV test (Table 1). Among persons who tested positive for HBV (16 086), the corresponding figures were 34.8% (5593), 10.7% (1722) and 54.5% (8771). In persons who were HCV positive, HIV testing was less likely in older persons [adjusted odds ratio (aOR) per 10-year increase 0.88; 95% confidence interval (CI) 0.86–0.90] and in persons diagnosed in primary care (aOR: 0.6; 95% CI: 0.6–0.7) when compared with secondary care. In persons who were HBV positive, HIV testing was less likely in older persons (aOR per 10-year increase 0.94; 95% CI: 0.92–0.97), but more likely in men (aOR: 1.2; 95% CI: 1.1–1.3) and in those diagnosed in primary care (aOR: 1.2; 95% CI: 1.1–1.3) and sexual health services (aOR: 1.9; 95% CI: 1.7–2.0) when compared with secondary care. The HIV positivity rate in persons tested for HIV within 6 months was 1.9% among persons who were HCV positive and 2.4% among persons who were HBV positive. Of those with no record of an HIV test within 6 months (HCV: 17 527; HBV: 8771), 13 (0.1%) and 10 (0.1%) persons were diagnosed with HIV infection after the 6-month period, respectively, 77% and 60% of whom were diagnosed within 2 years. Although some persons may have received an HIV test in a service not covered by the SSBBV or were lost to follow-up once diagnosed with hepatitis, these data suggest that HIV testing following a positive test for hepatitis is suboptimal in England, regardless of clinical setting. Opportunities have been missed to diagnose persons coinfected with HIV and to offer education on HIV risk reduction strategies. HIV testing rates were higher in sexual health services, but < 20% of individuals with hepatitis are diagnosed within this setting, and greater awareness and implementation of the most recent NICE HIV testing guidelines are needed among all health professionals.