Draft guidelines on provider-initiated HIV testing and counselling (PITC) have recently been circulated by WHO/UNAIDS for comment. Shifting the responsibility for initiating HIV testing away from the service user to the service offer of an where the HIV epidemic is generalized, and in certain health care settings where the epidemic is concentrated or low-level. The stated purpose of scaling up PITC is “to facilitate earlier and more widespread knowledge of HIV status and greater access to HIV prevention, treatment, care and support”. In order to achieve this, the new guidelines strive for “complementarity between clinical, public health and human rights objectives” On paper, much of the draft guidance appears to strike a reasonable balance is retained in the implementation of HIV counselling and testing programmes and services.