HIV patient are more prone to be co–infected with TB which is leading cause of death.  OBJECTIVE: – To assess factors associated with non–adherence of HIV positive patients to DOTS. METHODOLOGY:– It was the cross sectional hospital based study, carried out in ART and DOTS centre of tertiary care hospital RIMS, Ranchi, Jharkhand. The period of study was from Nov 2013 – Jan 2014. RESULT: – Out of 30 patients in ART centre, 9 (30%) patient developed TB, of which 6 (67%) had pulmonary TB. Among 9 TB patient, 5 (56%) were adherent to DOTS while 4 (44%) were not. Half of the patients 2 (50%) were non– adherence due to travel expenses and half (50%) were due of difficulty in travelling to DOTS centre and poor patient information and communication CONCLUSION: – Counseling and IEC important to adherence to DOTS.