The study aimed to examine the interplay of health communication practices and motivation for cervical cancer early detection and treatment in Women Living with HIV: in the focus of Menelik II Comprehensive Specialized Hospital. This study assessed the impacts of communication at different levels for sustainable behavioral change: uncovered the health communication practices that were implemented to prevent and control cervical cancer for Women Living with HIV in the hospital setting and pinpointed how the socio-ecological factors interact with the motivational aspects that shape the women's experiences and behavioral change in relation to precancerous treatment. A qualitative study approach and explanatory research design were deployed to address the above objectives of the study. Data were collected through individual in-depth interviews and focus group discussions. A purposive sampling technique was deployed to select client participants((Women Living with HIV) and discussants(Women Living with HIV) and the health facility. Similarly, a convenience or availability sampling technique was utilized to select healthcare providers for the individual in-depth interview. Therefore, 9 participants (7 clients and 2 healthcare providers) for the individual in-depth interview and 12 clients’ for the focus group discussions were included as participants of this study. The data gathered utilizing the above instruments were organized and analyzed thematically with the guiding spirit of Self-determination theory and the Socio-Ecological model. Unlike other studies by some researchers, this study’s findings revealed that Women Living with HIV in Menelik II Comprehensive Specialized Hospital are not exposed to awareness campaigns or health education even though they are close to the healthcare system. It has rigorously increased misconceptions about the disease. As a result, it highly dictates the women’s autonomy to undertake screening and their sustainable behavioral change; clients’ relatedness in patient-provider communication, and their competence. In line with this, the study reveals the underutilization of participatory activities at the health facility. In addition, cultural norms related to culture, religious beliefs, and traditional medicine are impacting women’s intrinsic motivation a concept that revolves around better learning, performance, and well-being. In line with this, the study reveals that cultural norms, autonomy support, and emotional support impact patients’ preference for the gender of the health professional and their relatedness with female healthcare providers and competence for sustainable behavior change. Organizational factors related to insufficient human resources, training opportunities, functionality, and lack of equipment impact health outcomes, clients’ autonomy, and the communication environment are the other findings of this study. However, room comfort and medical navigation service from ART(Antiretroviral Therapy)clinic show good implications for the clients’(Women living with HIV)intrinsic motivation. Therefore, the health communication practices at the multilevel influences possess a significant gap. Besides, patients’ intrinsic motivation and identified regulation, which are the linchpin for effective health outcomes and sustainable behavior change are overlooked. In the same vein, due to the missed opportunities to utilize effective and well-designed communication approaches and strategies, patients are highly dependent on external regulation level of motivation. In conclusion, the results lead us to conclude that the health bureau and the health facility’s communication office should frequently implement SWOT(Strength Weakness Opportunity Threat) analysis to design social and behavioral change communication for health promotion.