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BackgroundReturning to treatment following interruptions is crucial for achieving optimal HIV care outcomes. In Uganda, despite a 20% treatment interruption rate, only 58% of clients successfully resume treatment. Evidence on determinants of returning to treatment remains limited. This study aimed to identify determinants of return to HIV treatment after interruption in Katakwi District, Uganda.MethodsWe conducted a cross-sectional study at three high-volume antiretroviral therapy (ART) clinics in Katakwi District. Data were collected using face-to-face interviews from study adult participants and analyzed using Poisson generalized estimating equations (GEE) with robust standard errors to identify factors independently associated with a return to care.ResultsThe rate of return to care was 63.9%. Clients without an occupation were less likely to return (aRR = 0.80, 95% CI: 0.73–0.88, p ConclusionReturn to HIV care was associated with occupation, distance to the facility, community beliefs, and belonging to a community support group. Interventions to improve re-engagement should include targeted economic support for unemployed clients, community-based anti-stigma campaigns, flexible clinic hours, and improved rural access through mobile clinics. Continuous client education at both the facility and community levels is essential.