Rosen S, Maskew M, Larson BA, et al. - In the SLATE study, researchers evaluated a simple clinical algorithm to guide nurses and other clinical staff to determine eligibility for same-day treatment and to initiate ART at the patient’s first clinic visit. Patients coming to three public-sector clinics in South Africa and three in Kenya for an HIV test or pretreatment care were randomized to be offered either same-day ART initiation under the SLATE algorithm or regular (standard-of-care) procedures for ART initiation. Four screening tools were used in the SLATE algorithm—a symptom self-report, medical history questionnaire, physical examination, and readiness assessment—to determine eligibility for same-day initiation or refer for further care. ART initiation on the same day (ie, in a single visit) was done among half of the patients in South Africa and 70% of them in Kenya following the implementation of SLATE algorithm; most who could not 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. Eight months after study enrollment, little or no difference in retention in care or viral suppression rates was observed, with very poor retention in both countries. Treatment initiation on the same day, if possible, was preferred by nearly every patient in the study (98%). These findings suggest the eligibility and willingness of at least half of all HIV-positive patients who come to clinics and are not yet on HIV treatment for same-day initiation; initiation can safely be done without waiting for laboratory test results, and the vast majority of patients would like this option.