An HIV diagnosis during pregnancy can be distressing for women, impacting their mental health and their desire for a healthy pregnancy and child. This psychological burden highlights the need for comprehensive support systems. The study identifies several factors contributing to antiretroviral therapy (ART) default, including an inefficient health system marked by long wait times, inadequate counseling, limited consultation spaces, ARV stockouts, and dissatisfaction with care. Researchers conducted semi-structured, in-person interviews with 20 women aged 18 to 47 at a clinic in Thembisile-Hani, Mpumalanga, South Africa, using an exploratory-descriptive qualitative design. Four main themes emerged: lack of privacy and confidentiality, inadequate counseling and mental health support, fear and trauma related to an HIV diagnosis, and challenges with treatment adherence. Despite advancements in HIV care, communication and privacy concerns can hinder patients’ ability to stick to ARV therapy. The study emphasizes the significant impact of stigma, poor communication, and privacy issues on treatment adherence and the overall success of managing HIV.