2have indicated that HCWs have an increased risk of TB disease compared with the general population. The risk for TB disease is even higher among HCWs co-infected with HIV. Studies from South Africa found an HIV prevalence among HCWs of 15.7% in 4 provinces in 2002 3 and of 11.5% in 2 hospitals in Gauteng in 2005. 4 Many sub-Saharan African countries face a severe shortage of qualified HCWs as a result of the dual HIV/TB epidemic, which has triggered task shifting to a range of lay community health care workers (CHWs) – for example, home-based care workers, lay counsellors and adherence supporters, for both TB and highly active antiretroviral therapy (HAART). CHWs may experience a considerable occupational TB risk; however, their risk of TB disease and HIV prevalence has never been documented. The TB/HIV Care Association is a non-governmental organisation that employs CHWs to provide adherence support to both TB patients and patients taking HAART. The Desmond Tutu HIV Foundation partnered with the TB/HIV Care Association to provide HIV and TB testing to their CHWs, and subsequently determined the prevalence of diagnosed and undiagnosed TB and HIV among them. Methods