This research project will be conducted within the AMPATH catchment area, in six Divisions in western Kenya, each of which is geographically and administratively divided into Community Units (CUs) of approximately 6,000 individuals: Burnt Forest (4 CUs), Chulaimbo (8), Endebess (4), Kapsara (6), Matunda (4), and Moi's Bridge (6). Each Division has rural health facilities (rural health centers and rural dispensaries) staffed by clinical officers (mid-level practitioners) and nurses, while CHWs are in the villages. There has been a longstanding positive relationship among AMPATH, healthcare providers, and the communities. The CDM program has an established presence in all these communities.