This paper presents the findings of a study conducted to analyze the reasons for taking antiretroviral medications among patients living with HIV and their association with treatment outcomes in Ethiopia. The study focused on understanding adherence patterns, the stage of HIV infection, duration of antiretroviral therapy (ART), viral load levels, and treatment regimens among patients. The majority of patients in the study initiated antiretroviral therapy based on their CD4 count, in line with current HIV treatment guidelines. Adherence to antiretroviral medications was found to be critical for achieving viral suppression and preventing drug resistance. Furthermore, the study revealed that a significant proportion of patients initiated antiretroviral therapy at a later stage of HIV disease, highlighting the importance of strategies to improve early diagnosis and promote early initiation of ART to improve health outcomes. Monitoring viral load levels after the start of ART was crucial in assessing treatment effectiveness. The study also found that the majority of patients were on first-line treatment, while a small proportion required second-line treatment due to treatment failure or drug resistance. However, some patients experienced side effects, suggesting the need for research into strategies to mitigate these effects and promote adherence. In conclusion, this study underscores the importance of patient adherence to antiretroviral medications for successful HIV treatment. The findings emphasize the need for early diagnosis, timely initiation of ART, and regular monitoring of patients' health to achieve and maintain optimal health outcomes among those living with HIV.