Background: Antiretroviral therapy (ART) adherence is a primary determinant of the effectiveness of Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) treatment and is also considered a major predictor of survival among patients living with HIV/AIDS. The present study measures the level of adherence to antiretroviral drug therapy in Guntur district using Morisky medication adherence scale-8 (MMAS-8) and various factors influencing the degree of adherence.Methods: This was a cross sectional, semi structured questionnaire based study conducted over a period of 13 months at KMCH. MMAS-8 was used to assess the degree of adherence. A semi-structured questionnaire was designed to assess the factors influencing adherence.Results: A total of 354 patients participated in the study. 126 (36%) patients were highly adherent, 126 (36%) patients were moderately adherent and 102 (29%) patients were low adherent according to MMAS-8 score. Statistical analysis has shown that patients using the reminder tools, patients living with family had shown significant adherence to ART (p value <0.001).Conclusions: People who are taking ART in Guntur district are found to be moderate to high adherent according to MMAS-8. Degree of adherence to ART is found to be influenced by simplified treatment regimen, patient counselling and family support.