The study assessed adherence of adult female HIV patients to anti-retro viral therapy at Kajjansi Health Center IV, Wakiso District, Uganda. It was guided by three objectives which are; i) to investigate socio-demographic factors influencing adherence to anti-retro viral therapy among adult female HIV patients at Kajjansi Health Center IV, Wakiso District, Uganda, ii) to explore healthcare system-related factors affecting adherence to anti-retro viral therapy among adult female HIV patients at Kajjansi Health Center IV, Wakiso District, Uganda and iii) to examine psychosocial factors contributing to adherence or non-adherence to anti-retro viral therapy among adult female HIV patients at Kajjansi Health Center IV, Wakiso District, Uganda. The research study used a cross-sectional survey design focused on quantitative and qualitative approaches to collect data from 232 respondents who had been randomly and purposively picked for the sample of which only 221 participated hence providing a response rate of 95.2%. The study findings revealed a correlation coefficient between socio-demographic factors and adherence to anti-retro viral therapy =0.721**, significant at 0.001 level of a two tailed test (r = 0.721, P< 0.05), suggesting a high positive relationship; a correlation coefficient of 0.436**, significant at 0.001 level of a two tailed test (r = 0.436, P< 0.05), implying a weak positive significant relationship between healthcare system-related factors and adherence to anti-retro viral therapy; a correlation coefficient of 0.667**, significant at 0.001 level of a two tailed test (r = 0.677, P< 0.05), implying a high positive significant relationship between psychosocial factors and adherence to anti-retro viral therapy. The study concluded that socio-demographic factors and psychosocial factors as critical factors in influencing adherence to anti-retro viral therapy. It was concluded that socio-demographic factors, such as income level and education, play a crucial role in shaping patients' ability to adhere to ART by affecting their access to resources and support. It was also indicated that the influence of psychosocial support, combined with favorable socio demographic conditions and effective healthcare system support, creates a more comprehensive framework for improving adherence rates. Basing on this, the study recommends that the patients should be encouraged to establish personal reminder systems, such as setting alarms or using mobile phone applications designed for medication adherence. It was also suggested that Kajjansi Health Center IV should implement a structured patient follow-up program that involves regular home visits by healthcare workers to reinforce medication adherence

A Dissertation Submitted to the School of Sciences in Partial Fulfillment of the Requirements for the Award of Masters in Public Health of Nkumba University