This is a Public Health project. The recent increase of anti-retroviral treatment (ART) in public clinics in South Africa means that many more people have access to treatment. If patients become resistant to the standard ART package they are put on an alternative second-line ART; if that fails, there is no further public treatment option to control the HI virus. Yet, literature addressing facilitators and barriers to treatment adherence faced by patients on second-line ART is scarce.