Latar Belakang: Jumlah pengguna NAPZA suntik (penasun) terinfeksi HIV/AIDS (ODHA/orang dengan HIV AIDS) yang menjalani terapi antiretroviral (ART/antiretroviral therapy) dan metadon bersamaan makin meningkat. ODHA penasun di Indonesia rentan terko-infeksi oleh penyakit tuberkulosis (TB) dan hepatitis virus. Kombinasi konsumsi ARV, metadon, obat-obat untuk ko-infeksi, dan NAPZA secara bersamaan berefek negatif pada kepatuhan optimal ODHA pada ART. Tujuan: Memberi gambaran kepatuhan ODHA penasun yang menjalani ART dan metadon, dengan/tanpa ko-infeksi TB/hepatitis virus. Metode: Sejumlah 34 ODHA penasun yang menjalani terapi ARV di kios Atma Jaya dan puskesmas Tambora, pada Oktober - Desember 2012, mengikuti studi potong lintang ini. Responden mengisi kuesioner data demografis, status infeksi hepatitis virus dan TB, terapi ARV dan metadon, serta kepatuhan ART (self-report). Hasil: Grup 1 terdiri dari 20 ODHA penasun (58,8%) sedang/pernah terko-infeksi TB/hepatitis virus (9 orang terko-infeksi hanya TB dan sudah selesai terapi TB, 6 orang sedang dalam pengobatan TB, dan 5 orang terinfeksi virus hepatitis saja). Grup 2 terdiri dari 14 ODHA penasun (41,2%) tanpa koinfeksi TB dan hepatitis virus. Kepatuhan ART optimal dicapai oleh 9 orang (45%) pada grup 1, yaitu: 6 dari 9 (66,7%) responden yang selesai berobat TB, 1 dari 6 (16,7%) responden yang sedang berobat TB, dan 2 dari 5 (40%) responden yang menderita hepatitis virus. Di grup 2 terdapat 6 orang (42,9%) yang mencapai kepatuhan ART optimal. Simpulan: ART optimal dicapai < 50% total responden. Pada responden yang terko-infeksi; ART optimal dicapai oleh 66,7% responden yang telah menyelesaikan terapi TB, 16,7% responden yang belum menyelesaikan terapi TB, dan 40% responden yang menderita hepatitis virus.Background: People living with HIV/AIDS (PLWHA) who are intravenous drug users (IVDU) are increasing in number, and mostly are on both antiretroviral therapy (ART) and methadone maintenance therapy (MMT). In Indonesia, PLWHA and IVDU are more easily infected with tuberculosis (TB) and/or viral hepatitis. Co-infections and drug interaction may negatively affect their adherence to ART. Goal: To observe ART adherence among IVDU who were on MMT with PLWHA with/without co-infections (TB and/or viral hepatitis). Method: Thirty-four PLWHA who were IVDU from kios Atma Jaya and Tambora public primary health care participated in this cross-sectional study from October to December 2012. They filled out questionnaires on demographic data, previous viral hepatitis and TB infection, ART & MMT data, and adherence to ART by self report. Results: Group 1: 20 (58.8%) respondents were/had been co infected with TB/viral hepatitis (9 respondents had finished TB treatment, 6 respondents were on TB treatment, 5 respondents had untreated viral hepatitis only). Group 2: 14 (41.2%) respondents had never been co-infected with TB/ viral hepatitis. We found that nine respondents in group 1 (45%) and six respondents in group 2 (42,9%) adhered optimally to ART. Six (66,7%) respondents who had finished TB treatment, one respondent (16,7%) who were on TB drugs, and two respondents (40%) who had untreated viral hepatitis, adhered optimally to ART. Conclusions: Less than 50% respondents adhered optimally to ART. Respondents who had optimal ART adherence among those who had finished TB treatment, who were on TB drugs, and who had untreated viral hepatitis were 66.7%, 16.7%, and 40%.