Identification of patients with HIV infection should occur through a comprehensive approach that aims not only to strengthen the overall primary care system, but also to provide specialized care to patients most at risk for HIV and its complications. In Haiti, the ZL medical staff have found that the comprehensive “four pillars” approach identifies a majority of HIV-positive patients in need of care and provides a holistic system in which therapy can then be offered. HIV patients are thus efficiently identified and quickly receive necessary treatment. This not only improves health outcomes but also provides a sustainable model for the continuing care that HIV-positive patients in these settings so urgently need.