The contrasting cultures of HIV and tuberculosis care.

Abstract

The growing burden of HIV and tuberculosis (TB) coinfection has prompted enhanced collaboration or integration of services between HIV and TB programs in high-burden countries. The disparate paradigms or cultures of HIV and TB care, however, have challenged integration efforts. Historically, TB programs have been based in a traditional, public health approach whereas HIV programs have been rooted in an individualized, patient-centred approach. While these distinct approaches may be a product of their diverse social and clinical epidemiologies, and the disparate levels of political support and advocacy tied to HIV and TB disease control, they may influence the ways in which dual services are accepted and utilized by affected communities. We urge HIV and TB programs to recognize and address their cultural differences in integration efforts to build a more cohesive and successful framework of HIV/TB care.