Rosen S, Maskew M, Larson BA, et al. - In view of the recommendation by both the World Health Organization and many national governments in sub-Saharan Africa for initiation of antiretroviral treatment (ART) in patients diagnosed with HIV as quick as they can, if possible, on the same day as their HIV diagnosis, known as “same-day initiation”, researchers conducted the SLATE study appraising a simple clinical algorithm that may guide nurses and other clinical staff on how to offer same-day initiation to most patients while still providing all the care that HIV patients need. Patients coming to three public-sector clinics in South Africa and three in Kenya for an HIV test or pretreatment care to be offered were individually randomized to either same-day ART initiation under the SLATE algorithm or regular (standard-of-care) procedures for ART initiation. The intervention allowed ART initiation on the same day (ie, in a single visit) in half of the patients in South Africa and 70% of them in Kenya; cases who could not initiate ART mostly had symptoms of tuberculosis (TB) and required a TB test before starting ART. Treatment initiation within 7 and 28 days of study enrollment was increased by 27% and 10% in South Africa and by 13% and 6% in Kenya in correlation with the implementation of algorithm. These findings illustrate that at least half of all HIV-positive patients who arrive at clinics and are not yet on HIV treatment are eligible and willing for same-day initiation. Initiation in these cases can safely be executed without waiting for laboratory test results, and the vast majority of patients would favor this option. Further investigation in common reasons for delaying ART initiation, such as the presence of TB symptoms or providers’ concerns about treatment adherence, is recommended as the benefits of administering medications on the day of diagnosis may surpass some of these risks.