Back ground: Despite the increased emphasis on ART and other health care services for HIVrninfected individual, issues of fertility and child bearing have received relatively little attention. Inrnparticular, little is known about actual fertility desire and determinants of fertility desires amongrnHIV- infected women and men who are receiving ART. The desire of infected persons to havernchildren in the future has significant implication for the transmission of HIV to sexual partners orrnnewborns.rnObjective: To assess fertility needs of people living with HIV/AIDS who were on ART in fourrnRegional Hospitals of Addis Ababa.rnMethods: The study was conducted in Addis Ababa from August 2009 to June 2010. It was arncross-sectional study supplemented by qualitative in-depth interview on a sample size of 444.rnQuota sampling technique was used to select the study participants. Data were entered andrncleaned using EPI info version 3.4.3 and analyzed using SPSS version 15.0 for windows.rnResult: Nearly half of the study subjects (46.2%), female 101(49.3%) and men104 (50.7%)rndesired to have children. Multivariate analyses indicate that those respondents who werernmarried/ in relation and single were significant associated with desire for children (adjusted OR:rn2.60, 95% CI: 1.47- 4.59) and (adjusted OR: 2.93, 95% CI: 1.47-5.85), respectively and thosernwho had one child or none were also more likely to desire children than those who had two orrnmore children (adjusted OR: 18.31, 95% CI: 10.17-32.96)rnConclusion: A substantial proportion of HIV-infected women and men receiving ART in thernstudy would like to have children in the future. The fact that many HIV- infected adults desire tornhave children has important implication for the prevention of vertical and heterosexualrntransmission of HIV and the need of incorporating fertility- related counseling as well as advicernregarding safe conception and child birth and services like PMTCT as appropriate, in to HIVrntreatment services