In 2009 there were an estimated 22.5 million individuals living with HIV infection in sub-Saharan Africa and 1.8 million new infections. [1] Only 37% of those living in sub-Saharan Africa who were eligible for treatment were receiving antiretroviral therapy as of 2009, [1] and only 54% of pregnant women with HIV infection and 20% of their infants received drugs to prevent mother-to-child transmission. While these data indicate marked progress since 2000, there is considerable variation in coverage from country to country. [2] Factors that may explain these disparities have not been well-described, and developing a better understanding of these contributing factors may help to generate new strategies to improve HIV care across resource-limited settings