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The objective of this study was to determine 1)antiretroviral (ARV) medicationadherence and factorsassociatedwith controllingCD4 level and 2)incidence of adverse drug reaction(ADR). This cross-sectional descriptive study collected important variablesfrom HOSxP, NAP plus database, Medical recordswere reviewed. Sample were305 HIV-infected patients with ICD 10 code B20-24 who attending HIV/AIDs outpatientclinic atSungkha Hospital, Surin province.The average age and duration of antiretroviral (ARV) use of participants were 41.16±9.03 years, average duration of ARV medication use were 69.84±34.68 months, respectively. The rate of non-adherence measured by pill counts was 12.8% (taking less than 95% of prescribed doses). Risk factors for controllable of CD4were female (Odds ratio (OR) = 0.44; 95%CI: 0.26-0.72), ARV use for more than 60 months(OR=0.39, 95%CI: 0.23-0.65)and missing an appointment (OR=0.31, 95%CI: 0.14-0.67). The most of detected ADR of ARV medication was severe nausea vomiting. This study indicated many associated factors affected CD4 level control. The monitoring patients with theseassociated factors arecontinuouslyneeded.