This study examined factors associated with self-reported ART nonadherence during the COVID-19 pandemic among Miami-Dade County Ryan White HIV/AIDS Program (RWHAP) clients. A cross-sectional survey was conducted from October 2020-January 2021 in English, Spanish, and Haitian Creole. The survey included questions on self-reported ART adherence, HIV care access (compared to before the pandemic), social and economic pandemic impacts, and demographics. We carried out descriptive bivariate analyses and weighted logistic regression to estimate unadjusted and adjusted odds ratios (aORs) for self-reported nonadherence. 12.7% of participants reported ART nonadherence. Adjusting for age, sex, race/ethnicity, and nativity, factors associated with nonadherence included greater difficulty accessing an HIV doctor compared with before the COVID-19 pandemic (aOR=3.6, 95% CI: 1.4–9.2) and experiencing financial impacts due to the pandemic (aOR=4.2, 95% CI: 1.5–12.2). Ensuring RWHAP clients maintain access to HIV medical care providers and receive support for financial shocks are critical to sustaining ART adherence.