Background
People living with HIV/AIDS have substantially greater need for water, sanitation, and hygiene. Encouraging hygiene education for People Living with HIV/AIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended.

Methods
A cross-sectional study was carried during 2009 to assess water, sanitation status and hygiene practices and associated factors among People Living with HIV/AIDS in home based care services in Gondar city of Ethiopia. A systematic random sampling was used to select study subjects from 900 Home Based Care clients of People Living HIV/AIDS in Gondar city. Data was collected from 296 People Living with HIV/AIDS from two NGO’s in the city. For in-depth interview, four different categories were participated. Logistic regression and thematic framework analysis were performed for quantitative and qualitative part respectively.

Results
Two hundred ninety four subjects (72.8% (214) females and 27.2% (80) males) were studied. The mean age was 35.8?±?8.7 years. In the study, 42.9% (126) of the households have unimproved water status, 67% (197) of the households have unimproved sanitation status, and 51.7% (152) of the households have poor hygienic practice. Diarrhoea with water status; educational status and latrine availability with sanitation status; and hand washing device availability and economical reasons for the affordability of soap with hygienic practice were significantly associated. Economical reasons and hygiene education were factors that affect water, sanitation, and hygienic practice. Stigma and discrimination were minimized as a factor in the study area.

Conclusions
There is high burden of water, sanitation and hygiene in people living HIV/AIDS in home based care services. Encouraging hygiene education for people living HIVAIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended.