The timely detection of treatment failure allows health workers to provide additionaladherence support for patients or to make changes in treatment regimen (4, 5). In theabsence of viral load monitoring, treatment failure is often missed, resulting in HIVdisease progression, the accumulation of HIV drug resistant strains, and higher risks offurther HIV transmission (6–8). In addition, inadequate access to viral load testing makesit difficult to monitor the overall impact of ART programs, including measurement ofprogress toward the “third 90”—the goal that 90% of people on ART achieve viralsuppression (9).