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Several attrition steps exist in the continuum of care pathway: patients lost to care between testing HIV-positive and going for a CD4 test6; CD4 test result not available and/or lost7,8; patient not returning for their CD4 test result; and lack of uptake of care from eligibility to initiation of ART even in those who return for test results.9 These challenges may be overcome by point-of-care (POC) testing10, resulting in less attrition over time.2,4 It has been suggested that POC CD4 testing in those who do not return for their results would potentially increase enrolment pre-ART.9 POC CD4 testing was shown to modestly increase linkage to care and reduce pre-treatment loss to follow-up in fixed and mobile clinics.2,11,12,13 Factors contributing to pre-treatment loss to follow-up have been previously documented.8,14,15,16,17

southern african journal of hiv medicine

PIMA<sup>TM</sup> point-of-care testing for CD4 counts in predicting antiretroviral initiation in HIV-infected individuals in KwaZulu-Natal, Durban, South Africa

PIMATM point-of-care testing for CD4 counts in predicting antiretroviral initiation in HIV-infected individuals in KwaZulu-Natal, Durban, South Africa

PIMA^TM point-of-care testing for CD4 counts in predicting antiretroviral initiation in HIV-infected individuals in KwaZulu-Natal, Durban, South Africa