OBJECTIVES:  The efficacy of HIV medication depends on near perfect adherence to medication regimens by individuals. The aim of this study was to examine the degree of adherence and associated factors for Veterans using the Consolidated Mail Order Pharmacy (CMOP) System at one Veteran Administration (VA) site. METHODS: A cross-sectional study design was used to assess self-reported Veteran’s adherence rates at one Midwestern VA Hospital Infectious Disease Clinic. A combination of telephone and in-person methods were used for recruitment and data collection to reach maximum number of patients. Adherence was measured using the Brief Medication Questionnaire (BMQ) survey. All 57 Veterans who were contacted consented to participate. Thirteen others with HIV could not be reached. RESULTS:  The sample consisted primarily of white (66.7%), male (96.5%) respondents with a mean age of 54.4 years (SD=8.0) and an average of 4.3 comorbidities (SD=2.2) along with a positive diagnosis for HIV. More than half used a combination of two medications to keep their viral loads in check (57.89%). Almost 48% of patients were non-adherent (30% sporadically and 17.5 % regularly non-adherent) with HIV medications. About 33% reported having refill issues for their HIV medications and 43% doubted how well the medication worked for them. Raltegravir was the most commonly used medication amongst Veterans, followed by a combination medication of tenofovir & emtricitabine. The combination drug with lopinavir and ritonavir was found to be the least well tolerated drug, followed by the combination drug with rilpivirine, tenofovir and emtricitabine. Adherence was significantly associated with finding the medication bothersome (p=0.031). CONCLUSIONS: The results suggest both practical issues and medication beliefs may affect adherence rates. Tailored interventions targeting these factors should be explored to address non-adherence by this vulnerable population, particularly given that the VA system is the largest single healthcare provider for patients with HIV.