Introduction; Because of ART access and its good life effect, it is expected that PLWHA need rnand intention would change with the regard to reproductive health like to get married, desire to rnhave children, and to have sexual partners among others. In Ethiopia, HIV positive individuals rnmay or may not have desire to have children and want to use family planning. But the extent of rnthese desires and how it varies by individual, social, health and demographic characteristics is not rnwell understood rnObjectives; To assess fertility desire and family planning need among PLWHA following ARV rncare unit in selected ART clinics of Horro Guduru Wollega Zone, Oromia National Regional State rnMethods; A cross sectional institution based study that employs quantitative supplemented by rnqualitative in-depth interview was conducted from March 12 to April 28, 2012. Three hundred rntwenty one PLWHA (men and women) who were in reproductive age and had taken at least one rnvisit at ART care from the selected ART care unit during the study period were interviewed for the rnpurpose of the study. Three ART clinics were selected conveniently based on daily patient flow. rnThe collected data was analyzed using SPSS version 16.0. Logistic regression was used to control rnconfounding variables. rnResults; Seventy three (57.9%) of the males and 76 (39%) of the females desired to have children, rngiving a total of 149(46.4%) of all study participants. PLWHA who desired children were younger rnages [AOR: 3.3, (95%CI: 1.3-8.9)], married [AOR: 5.8, (95%CI: 2.7-12.8)], have no children rn[AOR: 75, (95%CI: 20.1-273.3)] and males [AOR; 1.9, (95%CI: 1.02-3.62)] than their counter rnparts. One hundred forty nine (46.4%) were using different types of family planning methods rnduring the survey period. Injectables 72(50.3%) and condom 130(70.2%) were the most rncommonly used type of family planning method before and after HIV diagnosis respectively. rnCondom was the preferred method of family planning method among people living with rnHIV/AIDS rnConclusions and recommendations; Considerable numbers (46.4%) of PLWHA want to have a rnchild currently or in the near future. Who desired children tend to use family planning methods in rnthe future. Thus, regardless of educational status, the childless as well as the youngest should be rnregarded as groups to be particularly targeted by counseling, and to be provided with information rnabout reproductive rights and options