Background: People living with HIV, who take Antiretroviral Therapy (ART), often enjoy long and healthy lives, but this therapy has well known metabolic adverse effects. Physical activity is found to be an important factor in improving these physiological parameters. This study aimed to determine physical activity level and associated factors among HIV patients in Ethiopia. Methods: An institutional based cross sectional study was conducted from May to June 2019. We selected a total of 422

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... HIV patients, attending antiretroviral therapy clinics in three selected hospitals in Southern Ethiopia. Data were collected at routine care consultations by nine trained nurses using a pre-tested structured questionnaire. The level of physical activity was measured by the international physical activity questionnaire (IPAQ). Result: The mean age of participants was 38.7±9.13 years. Of the participants, 68% were physically inactive, with a higher proportion of inactive women (74%) than men (61%) [(AOR=1.64, 95% CI: (1.07, 2.53)]. In addition, urban vs. rural residents [(AOR=2.57, 95% CI: (1.16, 5.72)] and patients who were on ART for ≥24 months [(AOR=1.1.88, 95% CI: (1.15, 3.08)] had higher odds of having a low physical activity level. Conclusion: Most people living with HIV and receiving ART have low physical activity levels. Especially female and urban living patients and those with longer treatment duration have low levels of physical activity. More insight is needed on the reasons for physical inactivity among HIV patients and physical activity programs for HIV patients in low-income countries need to be developed.