The risk score identifies HIV-1 serodiscordant couples with high risk of transmission for whom extra effort should be taken to overcome barriers to using HIV-1 prevention methods, including delays in ART initiation. Many HIV-1 infected partners in this study had high CD4 counts and by current guidelines, their indication for ART initiation was for the prevention benefit of their uninfected partner [12, 13]. Counseling of HIV-1 serodiscordant couples should emphasize the clinical and prevention benefits of ART, including for HIV-1 infected persons with higher CD4 and who are asymptomatic. In one review of ART initiation among HIV-1 infected partners in HIV-1 serodiscordant partnerships in East Africa, half of those found to be eligible delayed ART initiation by more than six months, with the delay more pronounced for those with higher CD4 counts . Importantly, for maximal public health impact, PrEP may be reserved for couples during periods when they are at high risk of HIV-1 transmission. Thus, for the Partners Demonstration Project, where the goal was to demonstrate that higher-risk couples could be recruited and retained, couples who did not meet the risk score criteria were counseled about their ongoing HIV-1 risk and referred to public health clinics where they could access ART, as well as counseling services, STI screening and treatment, and medical male circumcision. PrEP is an effective strategy for HIV-1 serodiscordant couples when the infected partner delays ART initiation or for a time-limited period (e.g., 6 months) after ART initiation by the infected partner prior to becoming virally suppressed . Future PrEP programs may use a similar scoring criterion to prioritize subsets of couples for PrEP; local context, including resource availability, would likely also shape prioritization decisions.