BackgroundrnHIV counseling and testing is the critical entry-point for engagement into treatment and care as well asrnfor primary and secondary HIV prevention efforts. Despite the importance of this step, most HIV-infectedrnpatients globally, and particularly in resource-poor settings, are unaware of their HIV status and thernuptake of Voluntary Counseling and Testing (VCT) services is relatively limited. Missed opportunitiesrnfor addressing HIV testing remain unacceptably high when patients seek medical care in the period beforerntheir HIV diagnosis. HIV counseling and testing is increasingly shifting from the client-initiated towardsrnother modalities, especially provider-initiated testing and counselling.rnObjectives: The objective of this study was to asses the magnitude of PITC acceptance and disclosurernand factors related to them among out patient department patents.rnMethods: A facility based cross sectional quantitative survey was conducted from Dec. 1 to Jan. 10 onrn414 clients attending out patient department in Debre Birhan Referral Hospital. Data were collected usingrnstructured questionnaire, entered into EPI info version 3.5.1 and analyzed by SPSS version 16. Logisticrnregression model was used to assess factors associated with PITC acceptance and disclosure of test result.rnResult: A total of 414 subjects (response rate, 100 %) responded to the questionnaires. Acceptance ofrnPITC among OPD patients was 83.6%. Adjusted correlates of PITC acceptance included female genderrn(AOR=2.27, 95% CI=1.16-4.42) and knowledge of HIV transmission (AOR=4.08, 95% CI=1.98-9.91).rnIndividuals with protestant religion were less likely to accept PITC (AOR=0.21, 95% CI=0.06-0.72). Keyrnbarriers to accept PITC included being apparently healthy (25%), being tested before (22.1%) and fear ofrnstigma and discrimination (19.1%).rnThe vast majority 120 (90.5%) of the married respondents who had ever been tested for HIV disclosedrntheir result to at least one person. Of 346 respondents, who accepted PITC, 288 (83.2%) had a plan torndisclose their result to any other person. Compared with the age group 45 and above, subjects 15-24 yearsrnold were less likely to disclose their HIV status (AOR=0.16, 95% CI=0.04-0.62). Disclosure of test resultrnwas associated with occupation (AOR=5.42, 95% CI=1.44-20.43) and test result negative (AOR=4.00,rn95% CI=1.53-10.47). The reasons for non disclosure were fear of stigma 37 (62.7%) followed by fear ofrnblame 8 (13.6%).rnConclusion and recommendation: In this study, PITC acceptance was promising and should bernexpanded to other health facilities. Efforts should be strengthened to decrease factors which impede HIVrntest result disclosure.