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Adherence is a term used to describe the act of following a course of medication in exactly the manner it is prescribed. Adherence is sometimes also called compliance. Adherence to ART is second largest predictor of progression to AIDS and death after CD4 count/reduced HIV RNA replication. In ART, adherence is essential for successful treatment and sustained viral control. To achieve treatment success requires near‐perfect adherence to combination ARV regimens. Very little is known about the adherence to ART in Nepal despite the initiation of the program more than half a decade ago. The general objective of the study is to determine the Adherence ART among People Living with HIV and AIDS in Far West, Nepal. The specific objectives are to determine the adherence rate to ART; to asses factors associated with adherence to ART; and to generate recommendations in the development of adherence optimizing interventions. This is a cross sectional study which employed both quantitative and qualitative methods to identify magnitude of adherence and to identify protective and risk factors to adherence to ART among HIV infected persons. The semi structured questionnaire schedule was adapted from The Challenges to ART, study conducted in Botswana, Tanzania and Uganda to understand access to adherence. The questionnaire was pre tested and modified to cultural context then translated in Nepali. Study was conducted in Far West of Nepal from May 2009 to September 2009 in all four ART sites. Clients of age 15 years above and taking ARVs for at least 3 months were enrolled in the study. A total of 176 samples allowed with 95 …