Sierra Leone is still recovering from the trauma of the eleven-year civil conflict. Poverty is widely spread, deep and severe with over 57% of the people unable to meet their basic nutritional needs. This was a cross-sectional study to assess nutrition and adherence to ART among PLHA. HIV and AIDS are gradually becoming a threat to the socio-economic development. Postwar environment, prostitution, high rate of early sexual intercourse aggravate the spread of HIV infection. Although antiretroviral therapy (ART) is presently available and free of cost, a very low percentage of people living with HIV and AIDS (PLHAs) are seeking it. There is a strong suspicion that people do not have adequate food and nutrition and this could be one of the major obstacles. The interaction of HIV and AIDS with nutritional status has been a distinguishing characteristic of the disease course since the earliest days of the epidemic. The term 'slim disease' was often used in endemic areas such as sub-Saharan Africa associated with HIV/AIDS and related diseases.