Increased availability of antiretroviral treatment for HIV makes the goal of universal access attainable. However, in most resource constrained settings where existing health systems are largely dysfunctional, major barriers to achieving this goal remain. While treatments with antiretroviral drugs (ART) are the focal point of HIV management, it is increasingly recognized that ART alone will not be sufficient to adequately deal with the lifelong consequences of the disease. In addition, the current global economic downturn will continue to impact on funding for HIV care and support, making the search for sustainable solutions more urgent. This article reviews the current evidence base on the impact of community-based programs on HIV/AIDS treatment and general health outcomes, as well as their contribution to ensuring sustained care for HIV-positive people. Our findings suggest that these programs overall have a positive impact on various dimensions of HIV treatment and care, and make a significant contribution to health and HIV outcomes. The authors argue that better use of community platforms for HIV treatment and care programs could be critical for attaining desired goals and should be prioritized at all levels of program design, implementation, and monitoring and evaluation.