Background: Antiretroviral drugs delay progression of HIV disease and improve the quality of life in the HIV infected people. A very high levels of adherence is required for ART to be effective long term and to prevent the emergence of resistant viral strains. The objectives were to assess the adherence of anti-retro viral treatment and its determinants and to estimate the status of CD4 count before and after ART in HIV patients.Methods: The study was a cross sectional study conducted in ART center Hamidia hospital at Bhopal, Madhya Pradesh. 256 participants with HIV who had registered in the center and receiving ART for the past 6 months were included in the study. A predesigned questionnaire was used for the study. Data was analysed using Epi Info. The significance of proportion were calculated using chi square test (p<0.05).Results: All the respondents knew that unprotected sexual contact, contaminated Blood transfusion and infected syringes were the major modes of transmission of HIV. About 60 (41.96%) in 143 patient with CD4 count <200 improved to >350. Majority of respondents 195 (76.17%) missed the dose often and 61 (23.83%) did not miss the dose at all. The major reasons for missing dose of ART regimen were forgot to take medicines (57.95%), alcoholic state (26.15%) and long duration of treatment (47.17%).Conclusions: The majority of patient missed the doses due to socio demographic and treatment related factors. A good treatment adherence is linked with the good quality drug and better environment in the clinics throughout the treatment period.

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