BACKGROUND: Despite the synergy between the human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics, the public health responses have largely been separate. Detection of HIV among TB patients is crucial to the holistic management of HIV-TB co-infected patients.

OBJECTIVE: To assess the feasibility of screening all TB patients for HIV through referral to a voluntary counselling and testing centre.

DESIGN: This cross-sectional study of 4802 newly diagnosed TB patients between July 2005 and June 2006 was performed in Tamilnadu, India, at six sites.

RESULTS: Of 4802 patients invited, 69% were willing to participate in the test. The most significant variables that influenced willingness were sex, age and place of residence (P < 0.01). The other significant variables that influenced willingness to participate were higher education, being employed and being married (P < 0.05). The main reasons for refusal of HIV screening among the patients were ‘no risk behaviour’ (30%), followed by ‘too old’ (23%) and for reasons of privacy (12%).

CONCLUSIONS: The present study suggests that it is feasible to routinely test TB patients for HIV. However it is crucial for health providers to focus on an effective referral process keeping patient concerns in mind. Motivation strategies need to be sex-, age-, education- and residence-specific.