Background: Highly Active Antiretroviral Therapy (HAART) regimens greatly reduce thernmorbidity and mortality associated with HIV infection, high adherence for an optimal response tornHAART is requirement. Unfortunately, adherence to HAART is difficult and poor adherence isrncommon. Low adherence and the closely related phenomenon of drug resistance are thought to bernthe most important reasons for failed ARVs treatment. Better QOL score may relate with betterrnadherence to HAART regimens, better PHS and MHS score.rnObjective: To determine the cutTent adherence rate and its determinants as well as to assessrnquality of life of patients among PLWHA currently on HAART in Afar Region, Ethiopia.rnMethod: A cross-sectional Survey on assessment of factors affecting adherence to HAART wasrnconducted between August 2007 and October 2007 in selected health institution of Afar Region,rnand both qualitative and quantitative data collection methods were employed in the stud y.rnResults: A total of 422 PLWHA and currently on HAART were participated in the study. Studyrnparticipants were 222(52.6%) females and 200(47.4%) males, most of participants were in thernage group of 25-44. According to 15-days recall self-report, 402(95.3%) of participants werernadherent to doses of HAART. Adherence rate obtained from unannounced pill-count was alsorn53%. Traveling so could not keep the routine, too busy, lack of food and difficult to take manyrnpills were the most common reasons reported for missed doses. In multiple logistic regress ionrnamong the socio-demographic variables, employment was associated with better adherence scorern(OR, .001; CI, .001-.344, P=.026). Pill burden (OR= .001, CI .001-.089, P=O.OOI) and long timernwith virus (OR=.044, CI, .003-.714), P=0.028) were associated with better self-reportedrnadherence. Age (OR= 1l.822, CI 1.274-109.65, P=0.030), gender (OR= 16.19, CI 1.111 - 232. 18,rnP=.046), level of education (OR= 12.899, CI l.007-165.242, P=0.049) also long time withrnHAART (OR= 33.391, CI, l.066-1046.279, P=0.046) among factors weakly associates withrnadherence. Shortage of medicines for OIs, quality of care, lack of income, and lack of food werernreported among the factors more affect adherence among most of FGDs participants. Stigma,rnregimen factors like pill burden, side effect and structural issues were reported as factors lessrnaffects adherence to HAART. Adherence was assoc iated with better PHS and M HS sco re, whichrnis to mean better QOL.rnConclnsion: self report HAART adherence rate in th is population is better than studies in hi ghrnincome countr ies as well as in Africa and in other Regions of Ethiopia, in spite of the fact th atrnpatients in Ethiopia face a large number of economical problems. However, non-adherencernremains an unsettling barrier for treatment success and is ever-present among patients receivingrnARYs therapy. To improve adherence establishing reliable drug supply, training of ex tra numberrnof staffs, simplifying dosage regimens and confidentiality should be mai ntained. Also study withrnintervention with some adherence support program may help to address factors on non ad herence.rnKey words: Highly Active Antiretroviral Therapy (HAART), Adherence, HIY/AlDS, Quality orrnLife (QOL), SF-36, Afar Region, Ethiopia.