Life-long ART for pregnant and breastfeeding women (Option B+) was rolled-out in Zimbabwe from 2014 with simultaneous raising of the CD4 treatment-threshold in non-pregnant/breastfeeding adults and children >5 years to 500 cells/mm. Lablite is an implementation project in Zimbabwe, Malawi and Uganda evaluating ART rollout. Routine patient-level data were collected for 6 months prior to and 12 months after Option B+ rollout at a district hospital and three primary care facilities in Zimbabwe (two with outreach ART; one with no ART provision prior to Option B+). Between September 2013-February 2015 there were 1,686 ART initiations in the four facilities; 91% adults and 9% children aged 350 after the CD4-threshold increase. Estimated 12-month retention on ART was 79% (69%-87%) in Option B+ women (significantly lower in younger women, p=0.01), versus 93% (91%-95%) in other adults (difference p