The purpose of this study was to explore and to describe the experiences of nurses and HIV-positive patients regarding the antiretroviral therapy (ART) programme in primary healthcare (PHC) settings in Lesotho. A descriptive qualitative design was used to collect data which were analysed using a constant comparative analysis. Purposive sampling was used to select participants who participated in focus group discussions. Five themes and 19 sub-themes emerged from the data analysis, namely the ART programme, ART service delivery, unavailability of antiretrovirals (ARVs), staff providing ART services, and satisfaction with ART. The results showed that many HIV-positive individuals accessed ART in PHC settings. Nurses symptomatically managed patients, while patients used alternative healthcare providers owing to inadequate resources and malfunctioning equipment. Even though the nurses were proficient in ART service provision, they were few resulting in work overload and provision of inadequate services. The time taken to provide ART services was dependent on conditions of service providers, the number of patients and the availability of basic utilities such as water. Follow-up care was inadequate for HIV-positive individuals who worked in South Africa. Multiple testing was evident owing to the lack of adequate counselling and untoward incentives. ARVs purported hunger, while stigma was still evident. Conclusively, to ensure effective delivery of ART, retention in care is vital. PHC facilities must therefore be equipped adequately with sustainable equipment, and have scaled-up routine monitoring and evaluation for the effective implementation of the ART programme.