<p>Background : As life expectancy of people living with HIV/AIDS (PLHIV) is changing, the reproductive health needs of clients are constantly changing and becoming increasingly important. In particular, as PLHA realize that with treatment, HIV infection is no longer a death sentence, they endeavor to actualize their normal life obligations and prospects, which may include resumption of sexual relations and future fertility desire. Objective : To assess sexual practice, fertility desire and family planning practices of PLHIV on ART at Dilla Hospital,SNNPR, Ethiopia. Methods : Cross sectional study with systematic random sampling. Conclusion : PLHIV are sexually active, continue to desire children and want to space and limit their fertility. In this study socio-demographic issues influenced sexual practices, fertility desire and demand for contraception. PLWHA could benefit from counseling in sexuality as a whole, but not just risk reduction. Safe sexual activity is an important facet of the overall quality of life of PLHIV</p>