The first ever gender assessment tool for national HIV and TB responses to support countries in Global Fund applications builds on the UNAIDS HIV Gender Assessment Tool launched in 2013– and adapted to include TB.

In 2014, over 60% of TB incidences occurred in men. Despite higher HIV prevalence among women in sub-Saharan Africa, incidence of TB is higher in men except in women who are 15-24 years old in areas of high HIV prevalence. Male-specific risks of becoming ill with TB, for example, occurs when they have more social contacts, work in high-risk settings, smoke, possible high alcohol consumption, and limited health seeking behavior. Female-specific risks include higher stigma, delayed diagnosis, less access to treatment services and previous policies of passive TB case-finding. High rates of extra-pulmonary TB among women also mean they are harder to screen and diagnose. Gender-responsive TB services are needed to capture these different needs.

This tool is a document intended to assist countries in assessing their HIV and TB epidemics and responses from a gender perspective, to ensure the responses are gender sensitive, transformative and effective in responding to HIV and TB. The gender assessment identifies gender transformative priorities and actions to support countries in preparing gender sensitive concept notes and grant applications to the Global Fund to Fight AIDS, TB & Malaria.

The gender assessment process, led by national stakeholders and partners, helps to identify gender-related barriers to services as well as the specific needs of women, men, transgender people and key and vulnerable populations, in the context of HIV, TB or HIV/TB co-infection. The process also increases and reinforces political commitment and increases civil society engagement and capacity to better respond to these needs.

The tool describes the process step by step and is split into 4 relevant stages: