This paper reports on the quality of life of patients enrolled in the public sector antiretroviral treatment programme in the Free State province of South Africa. Statistical analysis of cross-sectional data reveals that it is not access to treatment "per se" that enhances the quality of life of those who have come forward for ART. Rather, it is the health benefits associated with treatment, levels of stigmatisation, quality health care services, and the ability of persons to access support and care, both from within and outside the health care sector, that are independently associated with improvements in and differences in levels of quality of life.