In the District of Columbia (DC), the human immunodeficiency virus (HIV) case rate is nearly 10 times the U.S. rate and higher than comparable U.S. cities, such as Baltimore, Philadelphia, New York City, Detroit, and Chicago. In June 2006, the DC Department of Health (DCDOH) began implementing CDC's 2006 recommendations for routine, voluntary HIV screening in health-care settings. To describe recent trends in HIV disease and testing, CDC and DCDOH analyzed DC HIV case surveillance data, HIV testing data, and data from the Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicated that the rate of newly diagnosed acquired immunodeficiency syndrome (AIDS) cases decreased consistently, from 164 cases per 100,000 in 2004 to 137 in 2007 and 107 in 2008. Among newly diagnosed AIDS cases, the number and rate were higher among blacks/African Americans compared with whites and Hispanics/Latinos. During 2005-2007, BRFSS results showed a significant increase in the proportion of the population that had been tested for HIV within the past 12 months, from 15% to 19%. Although the causes of the improvement in these indicators are unknown and cannot be linked to any specific intervention, they suggest improvements in the delivery of HIV testing and linkage to care services in DC. To address continuing racial disparities, DCDOH has increased HIV education and prevention efforts through enhanced collaborations, working with DC residents as spokespersons for local marketing campaigns and creating toolkits for health-care providers to expand HIV testing and linkage to care.