We assess HIV and hepatitis testing and counseling in drug treatment programs in Hungary, a country with low rates of HIV but high rates of hepatitis C among injection drug users. The official context of drug treatment programs is described, and using key informants from representative drug treatment programs, the practice of HIV and hepatitis testing and counseling in such programs is assessed. Although HIV testing and counseling occurs, testing and counseling for hepatitis B and C are rare, especially in outpatient settings, and sexual risk in the drug use context is ineffectively addressed by treatment programs. Drug treatment centers are not adequately addressing the need to provide either HIV or hepatitis prevention services. There is an urgent need for preventing HIV and related infections among drug users by integrating HIV and hepatitis B and C prevention with drug treatment.