Guidelines to initiate ART in treatment naïve patients at the time of the study recommended starting treatment when CD4+ T cell counts declined below 500 cells/mm3 or there was a history of AIDS.[23] In practice, many JHUAS providers were offering ART to all patients, even those with CD4+ T cell levels over 500, and some patients not on ART during the study period had been previously, but did not continue due to low medication adherence. Here, CD4 is linked to AIDS.