Background: HIV/AIDS is known to be one of the most catastrophic diseases that have confrontedrnhumanity in living memory. Even though there are segments of disadvantaged social groups who arernat risk HIV infection due to their lower level of socio economic capacity it is believed that peoplernwith disability are more vulnerable to HIV infection.rnObjective: To assess the risky sexual practices, accessibility and utilization of HIV service amongrnpeople with disability in Addis Ababa City Administration.rnMaterials and methods: Between September 2010 and April 2011, a cross sectional communityrnbased survey was conducted using interviewer administered questionnaire of 417 people withrndisabilities found from associations of people with disabilities in Addis Ababa City Administration.rnThis was supplemented with focus group discussions with disabilities for access and utilization ofrnHIV services. The findings were described and analyzed using SPSS version 16.rnResult: Based on the findings, more than half (60%) of study participants were sexually active and arnthird of them (28.4%) had initiated sex before 18 years. Almost half (48%) of these did not userncondoms consistently and 33.6% had multiple sexual partners. Majority (92.8%) have informationrnfor existence of HIV services in the country. About 72% of all participants have ever utilized somernkind of HIV services ever. Female respondents were nearly 2.5 times more likely to use condomsrnthan males irrespective of type of disabilities [AOR (95%CI) 2.46 (1.28-4.71)]. Those ever marriedrnwere 2.5 times more likely to use condoms than singles [AOR (95%CI) 2.54(1.49-4.35)]. Visuallyrnimpaired participants are about 2 times more likely to have multiple sexual partners than those ofrnphysically impaired [AOR (95%CI) 1.90(1.02-3.55)]. In addition, those who were singles are 45%rnless likely to have multiple sexual partners than those of ever married [AOR (95%CI) 0.55(0.31-rn0.97)]. Regarding utilization of HIV services, hearing impaired participants were about two timesrnmore likely to have utilized any HIV services than those of visual impaired [AOR (95%CI)rn2.12(1.13-3.98)].rnConclusions: In general, the findings in this study showed poor access to information, lessrnconvenient of facilities and low utilization of HIV service among people with disabilities. Improvingrnaccess to information on HIV through targeting PWDs, support to HIV service providers inrndeveloping disability sensitive communication materials and improving health service deliveryrnsystems to take care of disability are recommended