Uganda, ravaged by HIV and AIDS started administering Antiretroviral Therapy (ART) in public health facilities in 2004. Being a new phenomenon, several things were not known about ART in resource limited settings. This paper presents challenges and implications of inaccurate identity and addresses of ART clients to different HIV care and treatment interventions in the country. Specifically it presents a challenge of tracing ART clients in their homes when they miss their scheduled clinic appointments, especially in the early days after enrolling on ART or when they finally drop out of care. Using a longitudinal study design, most data used in this paper was collected using exit interview schedules (at baseline in October 2008) and in-depth interviews (administered twice in 2011 and 2013) with one hundred ART clients. Supplementary data used included document reviews and key informant interviews conducted in 2016. The study participants were ART clients accessing treatment from Mbarara regional referral and Iganga district hospitals. Findings show that twenty five of the one hundred clients could not traced. It turns out that these twenty clients were “double identity clients”. Existence of double identity clients is not only a recipe for disharmony between sexual partners but could also lead to sub- optimal or non- adherence if doses are missed. The study arrived at the conclusion that stigma and discrimination of HIV+ individuals still exists thirty five years into the epidemic. Double identity ART clients casts some doubt on the accuracy of national ART figures.