There are probably multiple reasons for not initiating ART despite known HIV infection among our participants, including loss to follow-up before ART initiation despite eligibility.19 ART coverage at community level can be improved by introducing novel HIV interventions, for example HIV self-testing and home initiation of ART.13 ART initiation criteria are currently moving towards universal ART initiation, irrespective of CD4 cell count.20 Here, CD4 is linked to HIV infectious disease.