L. Stranix-ChibandaS. BrummelJ. PilottoM. MutambanengweV. ChanaiwaT. MhembereM. KamateekaJ. AizireG. MashetoR. ChamangaM. MaluwaS. HanleyE. JoaoG. TheronN. NevrekarM. NyatiB. SantosL. AurpibulM. Mubiana-MbeweR. OliveiraT. AnekthananonP. MlayK. AngelidouC. TierneyL. ZiembaA. ColettiK. McCarthyM. BasarN. ChakhtouraR. BrowningJ. CurrierM. G. FowlerP. FlynnFHI 360Botswana Harvard AIDS Institute PartnershipCentre for the AIDS Programme of Research in South AfricaFrontier Science & Technology Research Foundation, Inc.Centre for Infectious Disease Research in ZambiaUNC Project-MalawiUniversity of Malawi College of MedicineMakerere UniversityKilimanjaro Christian Medical CentreHospital Nossa Senhora da ConceicaoHospital Geral de Rio de JaneiroUniversity of ZimbabweUniversity of California, Los AngelesSt. Jude Children's Research HospitalNational Institute of Child Health and Human DevelopmentNational Institute of Allergy and Infectious DiseasesFaculty of Medicine, Siriraj Hospital, Mahidol UniversityCenter for Biostatistics in AIDS ResearchUniversiteit StellenboschJohns Hopkins School of MedicineUniversidade Federal do Rio de JaneiroBJ Government Medical CollegeHospital Federal dos Servidores do EstadoChiang Mai UniversityPerinatal HIV Research Unit2020-01-272020-01-272019-09-01AIDS and Behavior. Vol.23, No.9 (2019), 2522-253115733254109071652-s2.0-85070339824https://repository.li.mahidol.ac.th/handle/20.500.14594/51456© 2019, The Author(s). The PROMISE trial enrolled asymptomatic HIV-infected pregnant and postpartum women not eligible for antiretroviral treatment (ART) per local guidelines and randomly assigned proven antiretroviral strategies to assess relative efficacy for perinatal prevention plus maternal/infant safety and maternal health. The START study subsequently demonstrated clear benefit in initiating ART regardless of CD4 count. Active PROMISE participants were informed of results and women not receiving ART were strongly recommended to immediately initiate treatment to optimize their own health. We recorded their decision and the primary reason given for accepting or rejecting the universal ART offer after receiving the START information. One-third of participants did not initiate ART after the initial session, wanting more time to consider. Six sessions were required to attain 95% uptake. The slow uptake of universal ART highlights the need to prepare individuals and sensitize communities regarding the personal and population benefits of the “Treat All” strategy.Mahidol UniversityMedicineArticleSCOPUS10.1007/s10461-019-02624-3