Women living with human immunodeficiency virus (HIV) who use alcohol are at a heightened risk of disengagement in HIV care. A mixed-methods substudy was embedded in an implementation science trial to assess perceived satisfaction and acceptability of the Women's Health CoOp (WHC), a gender-focused, alcohol and harmful substance use, HIV biobehavioural intervention in Cape Town, South Africa. A modified version of the Client Satisfaction Questionnaire (CSQ-8)® was used to assess patient satisfaction (N = 456). Eight focus groups were also conducted to assess the perceived acceptability and satisfaction of the WHC after completion of the intervention workshops. Participants reported being very pleased with the WHC with an acceptable internal consistency estimate ([alpha] = 0.81). Intervention satisfaction was high (M = 30.9; SD = 0.1) on the CSQ-8 scale. Focus group participants reported that the WHC helped them reduce the amount and frequency of heavy alcohol use. Knowledge gained through the WHC reduced misperceptions about mixing alcohol with antiretroviral therapy and motivated re-engagement in HIV care. Participants also reported a decrease in condomless sex. Interventions that support and empower women living with HIV reporting heavy alcohol use should be implemented sustainably to improve HIV treatment retention and re-engagement and to reduce alcohol consumption among this population.