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Objectives. Given that HIV/AIDS in sub-Saharan Africa is largely spread through heterosexual contact, there is marked variation in levels of gender equity across sub-Saharan African countries, and levels of gender equity are likely to influence both exposure to sexual practices that increase the likelihood of exposure to HIV and the efficacy of prevention programs, we hypothesize that levels of gender equity account for the levels of and changes in the prevalence of HIV/AIDS across sub-Saharan African countries. Methods. We explore this hypothesis by first discussing the role of gender and several other contextual variables in the spread of HIV/AIDS. The resulting model is tested with regression analyses of both the level and change of HIV/AIDS in sub-Saharan African. Result. We find strong support for our hypothesis. Conclusion. This suggests that further policy attention be given to gender equity in combating HIV/AIDS. [ABSTRACT FROM AUTHOR]

Sub-Saharan Africa carries the overwhelming share of the global burden of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) and of HIV-associated tuberculosis (TB). The impact of HIV on TB patients and programmes has implications for TB control policies. The impact on patients includes the effect of HIV on diagnosis and on the patterns of HIV-related TB, the response of HIV-infected TB patients to TB treatment, the benefits of antiretroviral therapy (ART), and the quality and continuity of care for TB patients. The impact on national TB programmes (NTPs) includes increased case load, impaired NTP performance, increased need for access to ART and difficulties in reaching TB control targets. Implications for policies include the need to promote TB and HIV/AIDS programme collaboration, aimed at improving NTP performance (TB case-finding and treatment outcomes), quality and continuity of care, and monitoring and interpretation of progress towards TB control targets. In order to provide the recommended international standard of care for TB patients, clinicians need to be aware of the impact of HIV on TB patients and programmes and the implications for the policies that provide the framework for this standard. Conversely, policy-makers need to understand the impact of HIV on TB patients and programmes. This can help to ensure a firm evidence base for TB control policies aiming at the high standard of patient care that is at the heart of TB and HIV programmes. [ABSTRACT FROM AUTHOR]