HIV and AIDS constitute a very serious problem in societies with a high HIV and AIDS prevalence, and require urgent and immediate attention at all levels. However, trained teachers can play a critical role in providing HIV and AIDS preventive education, thereby reducing HIV infections among young people. This synthesis report summarizes the main findings from case studies in Ethiopia, Kenya, Uganda and Zambia that examined the response of teacher training colleges to HIV and AIDS. The findings show that the epidemic is adversely affecting faculty, staff and the functioning of teacher training colleges, yet not much effort is being made to address it. The reason for this is not ignorance of the management, but rather the absence of any institutional policy frameworks on HIV and AIDS. Bureaucratic bottlenecks also limit institutional resource mobilization, and thus result in a shortage of teaching materials and inadequate capacities in the teaching of HIV and AIDS and life skills education. In addition, it was found that HIV and AIDS are highly stigmatized, colleges are ill-equipped with health facilities, and national policies on condom use are ambiguous. The report presents a discussion of these and other issues, and makes policy and programmatic recommendations for strengthening the response of teacher training colleges to HIV and AIDS.