In India, the nationwide lockdown was implemented from March to May 2020 due to COVID-19 pandemic. As of March 2020, there were 13.08 lakh PLHIV availing ART free of cost from Government run ART centres, To maintain the continuum of care, National AIDS Control Programme (NACP) of India adopted Multi Months Dispensation (MMD) through ART centres and Community Dispensation of ART through the various Targeted Interventions (TI) and Community Based Organizations (CBO). A mixed methods study was designed, with desk review of programmatic data, semi qualitative interviews of 250 PLHIV and 15 In-Depth Interviews of ART centre and TI/CBO staff to document the process, strengths and challenges of these strategies in Surat city of South Gujarat. While administrative, technical and networking strengths were documented, manpower constraints, interrupted laboratory services, migration and relatively passive role of PLHIV in availing services were major challenges described in this study among several others.