While initiation of Anti-Retroviral Therapy (ART) in patients with CD4 counts less than 350 has been generally accepted as standard of care for most patients with HIV, there has been little consensus or data on outcomes when therapy is initiated at higher CD4 counts. Two groundbreaking studies in HIV, START and TEMPRANO, were recently presented at the International AIDS Society 2015 meeting and released online at the New England Journal of Medicine. The TEMPRANO study group assessed risk of death and HIV-related illness with early (CD4 >500) vs. deferred ART in sub-Saharan African subjects and found reduction in both endpoints. The INSIGHT START study group also found that the initiation of ART in HIV+ adults with a CD4+ count > 500 provided net benefit. The results from these two studies will change the game in terms of recommending ART for all HIV + persons regardless of CD4 count across the world.