 We will conduct formative research assessment of secondary data, FGDs and KIIs to guide the development and refinement of the ART Co-ops model as proposed in Specific Aim 1. A randomized prospective trial will compare the outcomes of subjects enrolled in the ART Co-ops Model to those receiving standard of care in Specific Aim 3. This study will be conducted at the AMPATH Partnership clinic in Kitale, Kenya, part of an HIV care and treatment program currently operating in 108 clinics in western Kenya 60-61. The AMPATH clinic in Kitale currently has over 19,000 patients enrolled with 12,000 on ART. This is one of AMPATHs most rapidly growing clinic populations which makes it an ideal site for studying and implementing the use of a community care model. 