HIV incidence rates approach 10% per year in young African women in KwaZulu Natal Province, South Africa. In this study we linked a pathway out of poverty program to a surveillance program for acute HIV infection. Termed FRESH, for Females Rising through Education, Support and Health, the study engages women aged 18–23 in Umlazi Township in a twice-weekly curriculum of empowerment and life skillstraining, HIV prevention education, and job readiness, with the goal of having each participant become employed or return to school at the end of 1 year. At each twice weekly visit, a finger prick blood draw is performed for HIV RNA detection. At first detection of viral RNA, combination antiviral therapy (cART) is initiated. Of the 29 cases of treated acute infection, approximately 75% have been in Fiebig Stage I. The lowest peak viremia achieved with immediate cART was 440 RNA copies per milliliter plasma, with viremia cleared in less than 7 days. The impact of limited antigen exposure on the development of humoral and cellular immune responses will be discussed.