City officials estimate that 40 percent of the 830,000 people ages 18 to 64 in the Bronx have been tested for H.I.V. in the past year. Half of the remainder, about 250,000 people, have never been tested, and the goal is to test them first. Tests would be given at 40 designated sites, including clinics, community centers, churches and emergency rooms. Dr. Monica Sweeney, an assistant health commissioner for H.I.V. prevention, said the city had not set aside money specifically for the program, but would absorb the $12 cost of each test.

In organizing the campaign, which formally begins on Friday, Dr. Frieden has enlisted support from elected officials, health care providers and clergy members in the Bronx. But the proposal is raising some concerns.

Outside the Neighborhood and Family Health Center on East 149th Street in the South Bronx, Melissa Sierra, 20, expressed concern on Wednesday that the focus on the Bronx would reinforce “a lot of stereotypes” about the borough. “It might keep people away,” she said.

Dr. Frieden said the health department had chosen the borough because it had good relationships with clinics and hospitals there. “I think we are thinking of it, and the Bronx will think of it, as the Bronx being first to know, a community taking the lead in responding,” he said.

Robert E. Bank, chief operating officer of Gay Men’s Health Crisis , and Earl Brown, the deputy borough president in the Bronx, both said on Wednesday that they hoped the program would be extended citywide.

“ Brooklyn is a horribly devastated borough,” Mr. Bank said. “Manhattan is a highly impacted borough, Queens is a highly impacted borough.”

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Indeed, the rate of AIDS cases is highest in Manhattan, at 82 per 100,000 people, compared with 75 in the Bronx, 46 in Brooklyn, 26 in Queens and 16 on Staten Island , according to state health statistics compiled last year. But the rate of deaths from AIDS is highest in the Bronx, at 37 per 100,000 residents, compared with 21 for Manhattan, 19 for Brooklyn, 8 for Staten Island and 6 for Queens.

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City officials said that Bronx residents are already more likely to be tested than adults in other boroughs (they estimate that 28 percent of Manhattanites, 24 percent of adults in Queens, 29 percent in Brooklyn and 17 percent on Staten Island have been tested in the last year).

The campaign to make testing routine, as Dr. Frieden put it, comes after years of lobbying by him and others to overhaul strict state regulations, which have changed little since the dawn of the AIDS epidemic in the 1980s, when H.I.V. testing was perceived more as a public-health tracking system than as a diagnostic tool. The regulations require patients to give written permission for testing after being counseled on the process, which many doctors found onerous and time-consuming.

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Dr. Frieden said New York’s consent law is among the nation’s most rigid. The federal Centers for Disease Control and Prevention recommends routine H.I.V. testing with doctors simply informing patients that the test will be given unless they decline.

San Francisco County Hospital, Dr. Frieden said, saw an increase of 17 percent in testing and 36 percent in positive results within three months of switching from written to oral consent in 2006.

Dr. Futterman, who is also a professor of clinical pediatrics at Albert Einstein College of Medicine, said she hoped that changing the mentality surrounding H.I.V. testing to make it a routine part of a patient’s blood work — along with, say, cholesterol tests — would galvanize state legislators to ease its consent rules.

“Everything in AIDS has changed except the old testing paradigm,” Dr. Futterman said. “Old school was that you had to tell them everything that could happen. That starts to seem cruel. If you go for cancer diagnosis, they don’t make the doctor say what you’re going to do if your mammogram is positive.”

The written consent requirement, she said, has been a barrier in emergency rooms, where doctors often feel it interferes with more immediate needs.

Under the new initiative, hospital administrators in the Bronx have agreed to test in emergency rooms, while still following state consent law. Dr. Futterman said she had carefully constructed a script for doctors that follows state law but squeezes what is typically a 20-minute counseling and consent process into five minutes. A doctor with lots of experience could deliver the script in three minutes, she said, and her own record is one minute.

Using that streamlined process, Dr. Futterman said, she had increased the proportion of her patients being tested to 20 or 25 percent, from 10 percent. Dr. Frieden said that city clinics for sexually transmitted diseases had testing rates as high as 60 percent, and the city jail at Rikers Island tested nearly 30 percent.

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Mr. Bank said Gay Men’s Health Crisis opposes eliminating written consent, but would relax the process so that patients are given a form with two boxes, one saying they want to be tested, the other saying they do not.

In an effort to make H.I.V. testing less intimidating, the city will issue public service announcements and information on the 311 hot line. It is also posting tear-off sheets with addresses of testing centers in places like check-cashing stores, where residents can discreetly slip them into pockets.

“It’s not about one group doing it, it’s about everybody doing it,” said Dr. Sweeney of the health department. Community organizations, universities, churches and politicians, she said, “are going to have all their constituents that come to them for other services, they’re going to use it as an opportunity to say, ‘Get your H.I.V. test.’ ”