Andrew was co-Principal Investigator of IeDEA-SA from its inception until 2011. During this time, he completed his PhD on the effectiveness of ART in Khayelitsha and in the Western Cape, following adults for up to five years on ART and examining temporal trends over seven years, during a time when ART services expanded dramatically in the province. Andrew explored associations with a range of clinical outcomes, and regimen durability and tolerability are described, together with regimen effectiveness when ART is administered to patients co-infected with TB. The results chapters are in the form of published/submitted papers [1, 2, 3, 4, 5] covering: correction for under-ascertainment of mortality through linkages with the death registry; the tolerability of commonly-used first-line ART; the effectiveness of ART co-administered with TB treatment; an in-depth description of the Khayelitsha population demonstrating comparability with many urban settings in the region; and evidence that outcomes have not been compromised by the expansion of ART services. The thesis concludes that the analyses provide reassurance that the anticipated benefits of ART have not been eroded by health system weaknesses or contextual challenges.