With advances in medication therapy, HIV has become a chronic illness successfully treated provided the patient is able to achieve adherence with the prescribed anti-retroviral medication regimen. The numbers of new HIV cases each year are increasing in women, especially women of color. Moreover, the rates of infection for incarcerated women are double that of incarcerated men. Incarcerated women frequently come from environments burdened with violence, substance and physical abuse, homelessness, child-care issues and mental illness. Such burdens negatively impact the ability of the women to adhere to the medication plan. The purpose of this study was to explore incarcerated HIV positive women's beliefs of the barriers and facilitators to ART adherence, the role of healthcare provider relationships with adherence and how issues of medical privacy influence ability or desire to adhere while incarcerated. Through qualitative exploratory, descriptive inquiry, a secondary analysis using a pre-existing set of interviews with HIV positive female inmates was conducted to determine the answers to the research questions. Factors identified influencing ART adherence were the medication line, stigma, the routine, administration choice (directly observed therapy or keep own prescription), a relationship with the healthcare provider, policies within the prison, education and medical privacy.