Mody A, Eshun-Wilson I, Sikombe K, et al. - Group-based multi-trajectory modeling was used in order to identify how adherence and retention in care changes over time among HIV-infected persons newly beginning antiretroviral therapy (ART) in Zambia and determine the relationship between different patterns of engagement and the following mortality. Across subpopulations stratified by baseline patient features, the longitudinal patterns of engagement behavior that were characterized persisted to be very constant. On the basis of multinomial logistic regression, sociodemographic, clinical, and facility-level features at the time of ART initiation were not robustly related to membership in any trajectory group. In adjusted multivariable Poisson regression, trajectory group membership was one of the most robust predictors of mortality, with the “early loss to follow-up (LTFU) with re-engagement” group, the “early LTFU” group, and the “late LTFU” group with greater rates of mortality compared with group with constantly high adherence/retention. Hence, among new ART initiators in Zambia, six individual subgroups that exhibited peculiar engagement trajectories over time and that were related to marked variations in the following risk of mortality were noted.