Despite being curable, tuberculosis (TB) is the leading cause of death among people with HIV.With one-third of the world latently infected with TB,it threatens to reverse many of the gains made through the global scale up of HIV care and treatment. Simply put, TB control is failing people with HIV. According to the World Health Organization (WHO), the most commonly used diagnostic tool used to detect TB, smear microscopy, is estimated to miss about 50% of cases of active TB disease. Because HIV-positive people are more likely to have smear-negative disease, they are at great risk of being misdiagnosed. Autopsy studies in resource limited settings have shown up to 50% of HIV-related deaths were due to undiagnosed TB. Compounding the situation is the fact that the most powerful class of anti-TB drugs, rifamycins, has drug-drug interactions with a number of HIV antiretrovirals (ARVs).
There is a need for a better understanding among people living with HIV about the synergistic effect of TB and HIV. Just as they did in pushing for access to ARVs and better services, people with HIV must be literate in the scientific as well as the policy implications of TB and TB/HIV coinfection in order to advocate for better and more effective TB diagnostics, care and treatment for HIV-positive people. HIV activists have been at the forefront of advocacy efforts for research, resources, and scale up of HIV/AIDS prevention, care, and treatment. This is in stark contrast to the dearth of TB activism. As TB fuels the HIV epidemic in many parts of the world, there is a vital role that HIV activists have to play in addressing the crisis of TB/HIV coinfection.
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