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Research findings confirmed universities' campuses in Africa constitute a potentially fertile breeding ground for HIV & AIDS. Higher health education institutions in particular have two major responsibilities in the prevention of HIV. They must protect themselves from infection in the one hand and must gear themselves to respond more dynamically to the needs of an HIV and AIDS-infected society in the other hand. This study tried to investigate the prospect & challenges of private health colleges against HIV and AIDS through effective mainstreaming approach to respond the pandemic which is the most tragic not only health problems of our days but also the most development challenge of a country in most African countries including Ethiopia.