Background: Enhanced regional surveillance in north west England suggests that the proportion of HIV positive people who are asylum seekers (AS) is increasing. Nationally, there is no empirical evidence that HIV positive AS use HIV services to a greater or lesser extent than HIV positive non-AS. This report compares stage of disease and use of services between HIV positive non-AS and AS. Methods: Data on those accessing HIV treatment and care (from hospitals and non-governmental organisations (NGOs)) in the north west of England for the first time January 2001-June 2004 (total 2204; AS 409) were extracted from the regional enhanced surveillance system. Results: Compared with non-AS, AS did not differ in stage of HIV disease on first contact (p>0.05), were no more likely to stay overnight in hospital (p>0.05), but had an average of one extra outpatient appointment per year (median seven compared with six, p=0.014). AS were much more likely to have accessed NGOs for support (43% compared with 27%: p<0.001). Conclusions: Use of specialist hospital services by HIV positive AS differs little from HIV positive persons who are not AS. However, HIV positive AS rely more on NGOs at a time when such voluntary services are under increasing financial pressures.