Mody A, Eshun-Wilson I, Sikombe K, et al. - A group-based trajectory analysis was applied on a cohort of HIV-infected adults newly started on antiretroviral therapy (ART) between August 1, 2013, and February 1, 2015, across 64 clinics in Zambia to identify groups defined by engagement patterns over time and to evaluate their relationship with mortality. The study cohort comprised 38,879 patients. Among the new ART starters, six trajectory groups were identified: (1) 28.5% of patients exhibited consistently high adherence and retention; (2) 22.2% displayed early nonadherence but consistent retention; (3) 21.6% displayed gradually decreasing adherence and retention; (4) 8.6% recorded early loss to follow-up (LTFU, > 90 days late for last visit) with later reengagement; (5) 8.7% displayed early LTFU without reengagement; and (6) 10.4% had late LTFU without reengagement. Following adjusted multivariable Poisson regression, one of the strongest predictors of mortality was found to be trajectory group membership. Higher rates of mortality were observed in the “early LTFU with reengagement” group, the “early LTFU” group, and the “late LTFU” group vs the group with consistently high adherence/retention.