Background: The detection of HIV in Egypt is started by screening for HIV antibodies or antigen by EIA and confirming the reactive samples by Western blot test (WB). In many countries, a new algorithm has been proposed by Centers for Disease Control and Prevention that uses an HIV-1/HIV-2 antibody differentiation immunoassay instead of WB or immunofluoresence (IFA) for confirmation. The initially reactive specimens are followed by same day confirmation rapid assay that approved by FDA and if this test is negative they make a nucleic acid test (NAT) to confirm. Objectives: comparing different diagnostic tests results with WB result in HIV diagnosis and detecting the accuracy of each assay. Methods: This study was conducted from January 2016 to September 2017 on 100 people who were seeking for HIV diagnosis. Blood samples were tested by Fourth generation Enzyme linked immunosorbent assay (ELISA), Multispot rapid diagnostic test, and nested PCR. Results: The sensitivity was the best with ELISA. PCR was the most specific test, followed by Multispot, and finally ELISA. Conclusion: This algorithm provides accurate results in short time.