Clinic staff were offered guideline-based training, including high VL management, CD4+ testing, pregnancy and postpartum ART management, prophylaxis for opportunistic infections, TB diagnosis and management, individual client care and preparation for ‘chronic clubs’, and completion of clinical summary chartsPatient education focused on chronic clubs and viral suppressionFeedback was given to clinicians managing a client, where appropriate. This evidence concerns the gene CD4 and tuberculosis.