Background For one to register ART success, good adherence is of utmost importance. With Art paradigm shift clients face a number of challenges in the long term that requires long term strategies for success.

A study to assess the major ART adherence coping strategies among clients enrolled on treatment with a four years and above experience was conducted.

Method This was a cross sectional study by design using semi structured questionnaires. Data was analysed using logistic regression model. Convenient sampling targeting a total of 400 TASO clients aged 18 years and above, with over four years experience on ART first line Regimen.

Results A total of 400 clients were interviewed and 43% coped by using reminders, 0.3% by their times of brushing their teeth, 7.5% by before and after morning and evening prayers, 1% by counsellors support, 9.5% by their medicine companions and 38.8% had this as a habit.

Conclusion Majority of the clients use reminders for good adherence in the long term. Baseline adherence preparation is very important since it directly leads to development of positive adherence habits.