Background: HIV counseling and testing is fundamental to both HIV/AIDS preventionrnand treatment. Patients need to know their sero-status to benefit from available care andrntreatment options. Provider Initiated HIV Counseling and Testing has been implementedrnin most health facilities utilizing Directly Observed Treatment Short course to increasernuptake of HIV counseling and testing as the most important opportunity. Different factorsrnmight affect the up take of PIHCT services which demand timely assessment.rnObjective: the objective of the study was to assess the acceptability of PIHCT andrnfactors influencing its service uptake among TB and non TB patients in Shashemenerntown of West Arsi Zone.rnMethods: Institution-based, comparative cross-sectional study was conducted fromrnJanuary to Feburary 2010, on 237 TB patients attending Tuberculosis clinics and 236 nonrnTB patients who were offered PIHCT from outpatient department in Shashemene hospitalrnand Shashemene health center. Data were collected using consecutive sampling until thernrequired sample size was attained using structured questionnairernResults: Majority of the participants were male 136(57.4%) among TB and150 (63.3%)rnamong non TB, in the age group 25-34 years 79(33.3%) among TB and 93(39.4%) nonrnTB, musilim by religion 116(50%) among TB and 116(50%) among non TB. Among 473rnstudy participants 86.3% (89.9% TB vs 82.6% non TB) had accepted PIHCT. TB patientsrnare more likely to accept PICHT than non TB patients at AOR= 2.4; 95% CI (1.3, 4.6).rnThose who support importance of PIHCT were more likely to accept PIHCT at AOR=14;rn95% CI (6.1, 33.4) than those who are against PIHCT.rnConclusions: The acceptance rate of PIHCT is relatively higher in this study; TB patientsrnwere more likely to accept PIHCT than non TB patients. The programme needs to bernstrengthened in all settings for both TB and non TB patients since HIV testing andrncounseling stands out as paramount both in treatment and in prevention of HIV/AIDS.