Background: The advent of antiretroviral treatment has contributed a lot in decline of HIV AIDSrnrelated morbidity and mortality. While ART enables people living with HIV to regain their sexualrncapability, new challenges to prevent HIV transmission to sero discordant partner and reinfectionrnwith new drug resistant virus have risen.rnObjectives: To assess magnitude and factors associated with consistent condom use among PeoplernLiving with HIV/AIDS who are on HAART in health institutions of Hosanna town.rnMethods: Mixed methods research was conducted. The quantitative institutions based crossrnsectional design was followed by a qualitative in-depth interview. Using systematic randomrnsampling method 394 individuals were selected and six in-depth interviews with PLWHA on ARTrncoupled with three in-depth interviews with ART counselor were held using theoretical sampling. Arnstructured pretested questionnaire and interview guide were used. EPI info, SPSS and open codernsoftwares were used for analysis. Descriptive statistics, binary and multiple logistic regressionsrnwere computed.rnResults: Consistent condom use among sexually active ART clients was 51.2 %( 95% CI: 46.3,rn56.1). Respondents who have been on ART for 12 to 24 months [AOR=0.26:95% CI 0.07, 0.93]rnand perceived that ART can reduce HIV transmission [AOR=0.18:95% CI 0.09, 0.35] were lessrnlikely to use condom consistently. Where as partner status being negative [AOR=2.45:95% CI 1.14,rn5.35] was more likely to use condom. Qualitative findings also show that low risk perception tornHIV, feeling of invulnerability and non disclosure of HIV status to maintain relationship influencernconsistent condom use among ART attendees.rnConclusion and recommendation: Consistent condom use among ART attendees was low.rnPerception that ART can reduce HIV transmission, duration of ART and partner status wasrnpredictors for consistent condom use. The study highlighted the need for ART programs to includernfollow up counseling that emphasize on consistent condom use with all partners irrespective ofrnpartner status, serostatus disclosure, partner testing and treatment optimisms