 Our long term goal is the development and successful implementation of an HIV care system that can facilitate the achievement of universal access to and maximize retention in ART programs in SSA. The major objective of this proposal is to develop and assess a community-based ART delivery model established on the platform of a HIV-infected peer-group ART Co-op and facilitated by CHWs. Our central hypothesis is that the durability of the patients ART regimen requiring no change to second line for failure will remain equivalent to those seen in clinic regularly and that clinic outcomes such as adherence to visits clinic visits for the control group and ART Co-ops for the intervention group, retention in care receiving care or being seen in an ART Co-op group within 3 months of the last scheduled visit, adherence to ART90s ART taken on timewill be similar between this community-based model and the standard of care. We base this hypothesis on our previous studies utilizing task-shifting to provide ART care as well as recent data from Mozambique49on the use of community ART-Groups. 