Objectives. This study assessed the outcome of implementing a policy of universal screening of patients with tuberculosis (TB) for HIV infection at a major metropolitan public health TB clinic. Methods. HIV serologic testing was completed on 768 (93%) of 825 eligible patients. Ninety-eight HIV- positive cases (13%) were compared with 670 HIV-negative cases. The presence of adult HIV risk factors was determined by structured interview and review of medical records. Results. One or more HIV risk factors were present in 93% of HIV-positive cases and 42% of HIV-negative cases. Conclusions. The metropolitan TB clinic is well suited for HIV screening, and HIV-antibody testing and counseling should be provided to all TB patients.