HIV/AIDS remains a major global public health challenge, with an estimated 40.8 million people living with HIV, 1.3 million new infections, and 630,000 annual deaths, indicating persistent gaps in testing and treatment (UNAIDS, 2024). In Ethiopia, over 603,000 people live with HIV, with Addis Ababa accounting for more than 110,000 cases and a prevalence of 3.42%, significantly higher than the national average (EPHI, 2023). Existing health monitoring systems such as HMIS largely focus on quantitative outputs and overlook client perspectives, satisfaction, and human rights concerns. This study aimed to strengthen HIV service delivery through a community-led monitoring approach in selected ART and key population clinics in Addis Ababa. A descriptive mixed-method design was employed, including a survey of 462 clients analyzed using SPSS, alongside 12 key informant interviews and 8 focus group discussions for qualitative insights. Findings revealed high levels of service accessibility (97.2%) and client satisfaction (98.4%). While 86% of clients reported consistent ART use, 14% experienced adherence challenges due to psychosocial factors. Notably, 53.7% of clients incurred costs for non-exempted services, particularly laboratory tests and opportunistic infection treatments. Human rights indicators were largely positive, with most clients reporting respectful care and minimal stigma, privacy violations, and waiting times. However, small proportions reported stigma (3.3%), privacy issues (~1%), and delays (2%), indicating areas needing improvement. The study concludes that HIV services in Addis Ababa are generally accessible and client-centered, but systemic gaps—particularly service costs and minor human rights violations—remain barriers. Strengthening community-led monitoring is essential to promote equitable, stigma-free, and high-quality HIV care.