Background: Thirty years on into the HIV epidemic women comprise over 50% of the global HIV prevalence, yet only 74% of pregnant women achieved optimal ART adherence in both developing and developed countries. Antiretroviral therapy for pregnant women is essential for reducing vertical transmission and maintaining their own health. Understanding adherence and the predictors of adherence is therefore necessary to provide appropriate prevention and treatment modalities to this key population. There is currently limited knowledge of adherence among HIV-positive women in the Caribbean region in general, and Guyana specifically. To gain an understanding of these dynamics, the primary objective of this thesis was to explore and identify the factors associated with ART adherence within the Guyana setting.