City-run medical clinics will no longer require written consent and counseling sessions before testing people for HIV in a bid to increase the number of people screened for the virus, officials said Wednesday.

The city, at the forefront of the AIDS fight, becomes the first known entity in the U.S. to formally loosen consent and counseling requirements. The new policy was implemented Tuesday in the city clinics and two hospitals that test patients. Last year, 240 people tested positive out of the 6,000 tested in San Francisco.

The federal Centers for Disease Control and Prevention is contemplating making similar recommendations. The aim is to expand testing to find as many as 250,000 of the 1 million Americans with HIV who don't know they are infected and are most responsible for the spread of the virus.

San Francisco doctors will now be required to get only verbal patient permission for testing, lessening paperwork and burdensome bureaucracy.

"We hope others follow this common sense approach," said Dr. Jeffrey Klausner, director of the city's sexually transmitted disease prevention.

Many AIDS activists and other critics, however, fear the changes could lead to patient privacy abuses. Also, the lack of counseling might mean more people who test positive would fail to seek treatment.

"Unfortunately, HIV follows women of color and HIV follows poverty," said Diana Bruce of the Washington-based AIDS Alliance for Children, Youth & Families. "This population needs testing that is culturally competent, that builds their trust," and of which they have been informed in writing.

Dana Van Gorder of the San Francisco AIDS Foundation supports streamlining the testing process.

The city's General Hospital "has provided model care for HIV throughout the epidemic and I trust them to making good decisions about these changes," Van Gorder said in an e-mail.