The study will evaluate interventions to improve engagement in HIV care following HIV diagnosis through a voluntary counseling and testing program. The specific aims are to (1) determine if a VCT-based intervention of CD4 count testing, alone or in combination with peer counseling, improves linkage to HIV/AIDS care; (2) assess the impact of the intervention on ART initiation. The study will recruit 450 HIV-positive individuals from VCTs and randomize a third to standard counseling and referral, a third to receive CD4 testing at the VCT with results return by phone after 1 weeks, and a third to receive the same CD4 testing combined with peer counseling. These combined investigations will create a comprehensive understanding of obstacles to appropriate HIV/AIDS care and result in new interventions to achieve measurable outcomes in applied settings.

Inclusion Criteria:

• At least 18 years or older and
• Testing HIV-positive for the first time at a voluntary counseling and testing (VCT) center.
• Willing to receive counseling to encourage linkage to care at a comprehensive care center (CCC).
• Willing to have a CD4 count test conducted at the enrollment visit.
• Willing to have a telephone follow-up where they may receive additional counseling and/or have their CD4 count results returned to them.
• Willing to be contacted over 1 year to determine if they linked to care.

Exclusion Criteria:

• Previous positive HIV test.
• Currently taking antiretroviral medications.
• Currently pregnant (females only).
• Currently participating in another research study or trial.
• Not planning to remain in Nairobi for the next 12 months (not including short trips out of Nairobi).