This research mainly focused on men and women who are living with the life long HIVrntreatment drugs (ART). It has taken a gender lens to identify the socio-cultural andrneconomic challenges and opportunities they encounter in an effort to fulfill thernrequirements associated with ART. The requirements under which participants werernexamined include adherence, monitoring health status, nutrition, Khat and alcohol usernand safer sexual practices. In-depth interviews and focus group discussions were thernmajor source of data collection tools and a small scale survey was also conducted.rnAccordingly, findings revealed that poverty, fear of stigma and gender based violencerninfluence the adherence condition of women to greater extents than men. It is alsornfound out that women’s household responsibilities and men’s difficult workingrnenvironment challenges their ability to monitor their health status to the level ART usernrequire. With regard to fulfilling the nutritional requirements of ART, beyond the generalrnlimitation of access to sufficient food, gender related norms are affecting men andrnwomen differently. Men are more challenged by their inability to prepare and serverntheir own food while women give priorities to feed other family members.rnThe study has found out that the use of Khat and alcohol by men taking ART is at thernminimal level. But rather starting ART has become the cut off point from suchrnaddictions and related risky and violent behaviors. Findings on meeting thernrequirements of practicing safe sex revealed that women’s lack of sexual negotiationrnpower further exposing them to re- infection and contracting drug resistant HIV strain.rnRegarding identified opportunities; free provision of ART, food assistance targeting poorrnwomen, financial assistance for some men in the formal sector and family acceptancernand support for adherence are the major ones. In general, the study has shown thatrngender based differences can influence the challenges and opportunities of meeting thernrequirements of ART from a variety of directions