One of the Theni District Positive regular social events which provide relaxation, comfort and support, India © Gideon Mendel for the Alliance A peer education leads a life skills session © Nell Freeman for the Alliance

TB and HIV

HIV lab technician in Cote d’Ivoire © Nell Freeman/AllianceTalk given on TB by health educator, Palaniswamy, India © Gideon Mendel/Alliance

    TB causes a disproportionate burden on people living with HIV 

Women at the Multi Purpose Social Service Society, India © Jenny Matthews/Alliance

Introduction

Tuberculosis (TB) accounts for a quarter of all AIDS-related deaths. It is the most common cause of death for people living with HIV.

TB is the most common opportunistic infection among people living with HIV. Globally, it is estimated that 350,000 (0.32 million–0.39 million) deaths from TB occur annually among people who are HIV-positive, accounting for nearly 25% of HIV-related deaths.  At the end of 2011, there were approximately 1.1 million cases of TB/HIV co-infection, which causes significant disease burden.

Because of this there is an urgent need to address HIV and TB together.

Read more: Integrating TB and HIV programmes - putting lessons into practice

Global picture

TB infection is very common, with roughly one third of the world’s population infected with latent (inactive or ‘silent’) TB infection.  There are about 9 million new cases of TB every year and about 2 million deaths caused by TB. Of these new cases an estimated 13% were HIV positive. Read more in the WHO Global Tuberculosis control 2011 report.

The HIV epidemic has eroded many of the gains in TB control globally.

There is an urgent need to address HIV and TB together because HIV increases the chances that latent TB infection can become active TB disease and it also increases the risk of death from TB disease.

People living with both HIV and TB face a number of challenges. These include:

  • Dual stigma and discrimination
  • Weak referral systems between TB and HIV services
  • Poor TB infection control measures at health facilities
  • Limited access to isoniazid preventive therapy
  • Human rights violations from law enforcement and health services

Access to TB/HIV integrated services is limited at community level. The Alliance is trying to address this gap through our programmes.

The Alliance approach

For individuals:

  • Increasing awareness of TB/HIV and knowledge about TB/HIV status
  • Education and counselling on TB infection control measures
  • TB case detection and referrals among people with HIV
  • HIV testing and counselling for TB patients
  • Adherence support for TB medications through DOTS and peer support
  • Adherence support for Antiretroviral therapy for people living with HIV
  • HIV prevention, treatment, care and support

For communities:

  • Reducing the stigma associated with TB and HIV
  • Mobilising communities to focus on TB/HIV
  • Increasing case detection and screening for TB
  • Providing referrals to services for people living with HIV and people living with TB (and their contacts)

At the national level:

  • Strengthening the advocacy for and scale up of  TB/HIV programming
  • Reducing the stigma associated with TB and HIV
  • Advocating for increased funding for HIV/TB collaborative activities.
  • Engaging with governments and national TB programs for increased engagement of civil society and communities in TB control

The work on TB/HIV integration is co-ordinated by an Alliance wide working group and community of practice.  In addition, the Alliance is developing materials to support capacity building and training in all aspects of TB-HIV activities (see Related Publications box).

Find out more about Alliance interventions in this fact sheet

Country programmes

The Alliance has presence in 15 of the 22 high burden TB countries. We work on TB/HIV through our programs in:

Drawing on the global experience of the Alliance

The Alliance has remained an active contributor to global TB policy through the work and experience of its partners across the globe. The Alliance is a member of the TB HIV working group of the STOP TB partnership, and an active participant in the TB TEAM, the technical support mechanism for Stop TB partnership. The Alliance also provides general technical support through its Regional Technical Support Hubs

Our partners