Based on the WHO data, 24.7 million people live with HIV in sub-Saharan Africa (SSA) in 2013. 70 % of new HIV infection in the world is in SSA.

In 2013, more than 12.9 million people with HIV are treated by a HAART worldwide of which 11.7 million in LMICs.

We can obviously consider HIV like a worldwide public health problem. So by referring causes of death in PLHIV in high-income countries, cancer in LMICs must be considered as a priority in HIV patients care.

Many data concern epidemiology of HIV-associated cancers from high-income countries. Our knowledge of the epidemiology of HIV-associated cancers in LMICs is limited. The reasons include weaknesses in healthcare infrastructure for diagnosing malignancies and limited epidemiological expertise in these countries. Moreover, many cancers are probably undiagnosed or untreated, so comprehensive information from cancer registries cannot be obtained [6].

Thus, we rely on high-income countries epidemiological profile and evolution in HIV-associated malignancies to assume evolution in low-middle income countries.

By significantly increasing the access of PLHIV in low- and middle-income countries to HAART [25], life expectancy and incidence of selected malignancies in an older population have increased [26, 27], and mortality due to infectious complications of HIV has decreased.

Treatment of PLHIV must be optimal in controlling HIV with a low viral replication and a higher number of CD4 cells, such as recommended in the WHO guidelines [9].

Cancer treatment will depend on tumor type and international recommendation guidelines such as described in the previous chapters.

Problems of drug interactions are the same as in high-income countries, and a special care is needed. The challenge will be in accessibility in specific treatments and their costs.

Because of a higher incidence of associated infections, it is important to test and treat them, particularly for HBV and tuberculosis, and to prevent the strongyloïdes hyperinfection with ivermectin under corticosteroid therapy, commonly used in cancer treatments.

Hence, developing prevention, early diagnoses, and cancer infrastructure might be a key to develop a better patient care. Unfortunately, cancer infrastructures are underdeveloped particularly in SSA [28]. Adebamowo et al. study suggests that the infrastructure for cancer should comprise four elements: physical infrastructure, qualified staff, supportive policies, and supportive laws [6]. Established HIV care infrastructure in SSA would be a base to support the training of cancer care professionals, but efforts are needed to increase the human capacity for patients care with HIV-associated malignancies. Partnerships between international and US institutions have already begun and must be continued to address this need [29].