There is rightly a huge global effort to enable women living with HIV to have long, productive lives through treatment access. To improve women's health and know how to best optimize facilitators and minimize barriers to access and adherence, more needs to be understood about these issues from women's own perspectives. In this study, women's key barriers in accessing HIV treatment was reviewed in three phases through: a literature review, focus group discussions and interviews and country case studies. The results presented are predominantly based on women's own experiences. Recommendations are proposed regarding laws, policies and programmes which are rights-based, gendered and embrace diversity to maximize women's access and adherence to medication and for their long-term sexual and reproductive health.