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In 2015, Wolverhampton had the highest rates (15.8 per 100,000) of newly diagnosed HIV in West Midlands and In the West Midlands incidence rates in the black African ethnic group remain much higher than those for other ethnic groups, with a relative risk of 34 compared with the white group in 2015. This clearly shows the importance of the NICE Guidelines PH33 which was published in 2011 which aimed to increase the uptake of HIV testing in Black Africans and we wanted to audit this guidance.A list of patients classified as being of Black African ethnicity who were admitted to the Acute Medical Unit at Royal Wolverhampton NHS Trust between April 2015 and January 2016 was obtained. Their medical notes and blood test results were retrospectively analysed for evidence of testing or any discussion of HIV tests.50 case notes were retrospectively reviewed. An HIV test was not offered in 87% of admissions despite 15% of them presenting with signs of clinical indicator diseases. Only 6 patients were offered a test during their admission, of which 5 of them accepted. 1 of these tests was HIV positive and the patient was referred for further care to the HIV service within the trust.There remains a barrier to HIV testing in high risk populations in non-GUM settings despite NICE guidance published several years ago. Recommendations include the need to identify existing barriers by surveying doctors and providing education on how to overcome them, and the addition of prompts on clerking proformas may encourage universal testing.