No specific data on reasons of non-adherence were documented in that study and authors speculated on possible factors of non- adherence to cART and social or structural issues in their privately managed AIDS Care pilot study population. Not all settings in Africa are alike, neither can we expect that outcomes in a privately purchased cART program will be similar to a publicly funded one. This study compares survival and loss to follow-up of adolescents to children and adults using a large dataset from a nationally representative cohort of HIV patients receiving free cART in Uganda. This study is based on data collected routinely for clinical monitoring and evaluation purposes at TASO. Clinicians complete standardized patient forms detailing patient demograph- ics, clinical, psychosocial, and drug utilization data at each patient visit. These data are then entered into the TASO data collection database at each site by trained data capturers. All data are anonymized using a unique, confidential identification number. Clinic staff,LDK378 nurses and clinical officers or physicians offer adherence monitoring and clinical support. For community-based recipients of care, a field monitoring team equipped with motorcycles is responsible for patient adherence, social support, and follow-up. This team, which includes medical attendants who conduct HIV testing, adherence counselling, clinical observation, and provide cART to patients, visits patients who fail to show for any appointment for three months or longer and patients who have requested home-based care. We assessed the potential misclassification of mortality among those lost to follow-up by assuming that LDN-193189 of the patients lost to follow-up had died. We weighted this assumption according to individuals with lower baseline CD4 status using a random sequence generator. This figure of 50% mortality among defaulters is consistent with evaluations examining the extent of attrition associated with mortality. All significance tests were two- sided with a p-value of,0.05 considered significant. This study is the largest assessment of clinical outcomes among adolescents receiving cART in Africa. In this study, crude adolescent mortality was significantly different from child patients, yet, loss to follow-up was not. After adjusting for explanatory variables, we did not demonstrate a significance difference in either mortality or loss to follow up across groups. The recent report from southern Africa by Nachega et al. found that adolescents have worse outcomes compared to their adult counterparts in terms of virologic suppression and adherence, but did not explore survival. Nachega and colleagues examined adherence to cART as a possible predictor of virological suppression in adolescents compared to adults receiving cART from a private provider managed AIDS care programme in Southern Africa and found an increased rate of virological failure among adolescents when compared to adults. Possible explanations for increased virological failure in adolescents include poorer pharmacy refill adherence than adults and lack of social support. It is likely that outcomes such as mortality and adherence are influenced by region and programme level factors, which merit further research. As most adolescents would be infected at birth, many individuals would have died before achieving adolescence. As the number of adolescents enrolled in treatment grows and patient live longer, the question of adherence and retention will become increasingly important for health care practitioners. Often adolescents fall through the cracks between pediatric care and adult care.