Adherence outcomes in patients with the most severe complications of AIDS, Kaposi''s sarcoma (KS), the commonest AIDS related cancer, is unknown. This books reports on 35 patients prospectively evaluated over 12 months for adherence to highly active antiretroviral therapy (HAART) in a clinical trial of ARVs for management of AIDS KS in KwaZulu- Natal (KZN). Twenty of the initial patients also recieved Chemotherapy (CXT). Adherence was assessed by 7-day self-report. Patients who reported >95% mean adherence were classified as being adherent to HAART. HIV-1 viral load (VL) and CD4+ cell counts were correlated with adherence to HAART. Mean adherence was 86%.This is the first study to show high adherence rates in patients with AIDS KS, receiving HAART, with and without chemotherapy (CTX), specifically in KwaZulu- Natal South Africa. This experience indicates that adherence to generic fixed-dose combination of stavudine, lamivudine and nevirapine is effective and hold much promise.