Purpose: To assess medication adherence and health status in ambulatory HIV positive patients in Akwa Ibom State, Nigeria.Methods: The 7-item Adherence to Refills and Medication Scale (ARMS-7) was used to assess medication adherence among 500 HIV positive patients in three secondary health facilities in Akwa Ibom State, Nigeria. A single-item question (measuring self-rated health) and depression (CESD-R) questionnaire were also used to evaluate the patients. Recent CD4 count and viral load were obtained from the patients’ folders. The association between independent and dependent variables was evaluated using logistic regression analysis.Results: Only 56 (11.7%) respondents reported 100% adherence to their medications; 190 (39.7%) rated their health as being ‘very good’ and 51 (10.7%) reported being depressed. Respondents who were single were more likely to be nonadherent (aOR = 2.665, 95% CI = 1.336 - 5.318; p = 0.005), and the nonadherent patients were more likely to have lower CD4 cell counts (aOR = 0.998, CI = 0.996 – 0.999; p = 0.007). Those who rated their health as ‘fair’ or ‘poor’ were more likely to be nonadherent (aOR= 11.380, CI = 1.527 – 84.785; p=0.018) and depressed (aOR = 2.748, CI = 1.469 – 5.141; p = 0.002). Patients who were unemployed were more likely to rate their health as fair/poor (aOR = 1.890, CI = 1.197 – 2.985; p=0.006).Conclusion: This work has shown that even though most of the HIV positive patients perceive their health as being very good, their adherence to medications was poor which is directly related to their unemployment status. Intervention to improve adherence directed at socio-economic status of the individual patient is recommended. Keywords: Medication adherence; Depression; Self-rated health; Nigeria